Poor catch-up growth after proctocolectomy in pediatric patients with ulcerative colitis receiving prolonged steroid therapy.
OBJECTIVE
The aim of the present study was to review the complications and growth after proctocolectomy and ileal J-pouch anal anastomosis (IPAA) in pediatric ulcerative colitis (UC) patients receiving prolonged steroid therapy.


METHODS
We experienced 209 patients with UC who received IPAA between September 2000 and June 2009, and reviewed the medical records of 16 pediatric (<15 years of age at operation and >1 year follow-up) patients.


RESULTS
The total dose of preoperative prednisolone (PSL) was 9,829 +/- 9,283 mg (mean +/- 1SD 880-30,000 mg). The dose of preoperative PSL was significantly related to the occurrence of preoperative major steroid-related complications (SRC). Older patients (>11 years at operation) grew more slowly compared with younger patients (< or =11 years at operation) for 5 years. There was a significant difference in height between PSL high-dose (>10,000 mg) and PSL low-dose (< or =10,000) patients for 5 years after colectomy. The mean height of PSL high-dose patients did not reach the standard level during the 5-year follow-up.


CONCLUSIONS
Preoperative prolonged high steroid therapy may disturb growth recovery of pediatric patients with UC, while early induction of colectomy allowed pediatric patients with PSL dependency to become free of steroids and get normal growth.
Uchida
Keiichi
K
Department of Gastrointestinal and Pediatric Surgery, Graduate School of Medicine, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. ucchie@clin.medic.mie-u.ac.jp
Araki
Toshimitsu
T
Inoue
Mikihiro
M
Otake
Kohei
K
Yoshiyama
Shigeyuki
S
Koike
Yuhki
Y
Matsushita
Kohei
K
Okita
Yoshiki
Y
Miki
Chikao
C
Kusunoki
Masato
M
D000293:Adolescent; D001827:Body Height / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000601:surgery*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D057238:Growth Charts; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000139:chemically induced; D011239:Prednisolone / Q000009:adverse effects* / Q000627:therapeutic use; D016737:Proctocolectomy, Restorative / Q000379:methods*; D012189:Retrospective Studies; D013995:Time; D055815:Young Adult
D005938:Glucocorticoids; D011239:Prednisolone