title: Growth problems in children with IBD.
abstract: Crohn's disease in childhood causes linear growth retardation, which has a substantial effect on management of this disease. By contrast, growth is rarely a problem in children presenting with ulcerative colitis. Depending on how growth failure is defined, approximately one-third of children with Crohn's disease have growth retardation at diagnosis. Although corticosteroids can suppress growth, decreased height at diagnosis demonstrates that this finding is a consequence of the disease and not merely an adverse effect of treatment. Both inflammation and undernutrition contribute to decreased height velocity. Increased cytokine production acts both on the hepatic expression of insulin-like growth factor 1 (IGF-1) and at chondrocytes of the growth plates of long bones. Growth hormone insensitivity caused by deranged immune function is a major mechanism in growth retardation. Resolution of inflammation is the cornerstone of treatment, but current studies on growth hormone and IGF-1 might yield therapies for those children whose inflammation is refractory to treatment.
authors: Centre for Digestive Diseases, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London. 4 Newark Street, London E1 2AT, UK.
authors: Ian R
authors: IR
authors: Sanderson
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000728:Androgens / Q000627:therapeutic use*; D002648:Child; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy*; D006130:Growth Disorders / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007249:Inflammation / Q000150:complications; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000188:drug therapy; D007334:Insulin-Like Growth Factor I / Q000378:metabolism* / Q000627:therapeutic use; D044342:Malnutrition / Q000209:etiology; D011628:Puberty, Delayed / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000305:Adrenal Cortex Hormones; D000728:Androgens; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D007334:Insulin-Like Growth Factor I