Growth failure in children and adolescents with Crohn's disease

Background/aims: A clinical analysis in children, adolescents and young adults with Crohn's disease was performed to investigate if growth failure is caused by an impaired growth hormone secretion in these patients. Methods: 40 patients with Crohn's disease (26 male, 14 female) with an average age of 16,7 years (median: 17,0 years, range: 4-29) were included in the study. The observation period varied from 8 months to 16,7 years, patient's age ranged from 4 years up to 29 years. To examine growth hormone excretion, urinary growth hormone was measured using an in vitro immunoradiometric assay in three morning urine samples. Renal function was obtained by analysing creatinine and α-1-microglobulin in the same samples. Observation period, chronological age, height, growth rate, pubertal stage, localisation, peidatric Crohn disease activitiy index and corticosteroid treatment as well as IGF-1 levels were determined. We found normal urinary growth hormone levels in Crohn's disease concluding that growth failure in patients with Crohn's disease is not caused by growth hormone deficiency. Evenly corticosteroid therapy did not appear to be the most responsible factor for growth failure in Crohn's disease. Conclusions: Disease activity indicated by a high peidatric Crohn disease activitiy index score had an important impact on impaired growth in children and adolescents with Crohn's disease.