Steroid Administration and Growth Impairment in Children with Crohnʼs Disease

Duchatellier, Carl Frédéric; Kumar, Rituanjali; Krupoves, Alfreda; Herzog, Denise; Amre, Devendra

doi:10.1097/mib.0000000000000669

Cited by 9 publications

(15 citation statements)

References 34 publications

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“…The lack of association between the number of corticosteroids courses and short stature at adulthood in either CD or UC patients is comparable with previous reports which did not demonstrate negative effect of cumu-lative steroid use on growth in pediatric-onset CD [1,24,49]; however, our study was limited in its retrospective design thus not enabling an accurate calculation of accumulated corticosteroids exposure over the disease course.…”

Section: Discussionsupporting

confidence: 89%

Prevalence and Predictors of Growth Impairment and Short Stature in Pediatric-Onset Inflammatory Bowel Disease

et al. 2019

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Background and Aims: Growth impairment is common in children with inflammatory bowel diseases (IBD). However, the magnitude of short stature at adulthood is not well characterized. We aimed to determine the prevalence and predictors of growth impairment at diagnosis and adulthood in children with IBD. Methods: Height z-scores at diagnosis of IBD and at adulthood among 291 children with Crohn's disease (CD) and 125 with ulcerative colitis (UC) were retrieved retrospectively and compared to matched controls. Growth impairment at diagnosis was defined as height z-score for age less than or equal to-1 and short stature at adulthood as less than or equal to-2. Results: Mean height z-score at adulthood in subjects with CD or UC was significantly different from controls although mean height did differ in males only (CD 172.3 cm ± 6.7, UC 172.7 cm ± 5.3, controls: 174.2 cm ± 7.3, p = 0.003 and p = 0.047, respectively). Diagnosis prior to final stage of puberty and male gender were risk factors for being short statured at adulthood in CD (mean difference [MD] 2.5, p = 0.013 and MD 6.25, p = 0.001, respectively) and UC (MD 4.9, p = 0.011 and MD 3.3, p = 0.034, respectively). Conclusion: Increased proportion of pediatric-onset IBD patients has growth impairment at adulthood. Male gender and diagnosis prior to puberty were found to impose risk for reduced adult height in both diseases.

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Section: Discussionsupporting

confidence: 89%

Prevalence and Predictors of Growth Impairment and Short Stature in Pediatric-Onset Inflammatory Bowel Disease

et al. 2019

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“…A secondary outcome measure was the presence of any growth retardation at the same time point. Growth retardation was defined as >8.5 cm of height below the target height (roughly equal to >1.5 SD) …”

Section: Methodsmentioning

confidence: 99%

Adult height in patients with childhood‐onset inflammatory bowel disease: a nationwide population‐based cohort study

Mouratidou

Malmborg

Sachs

et al. 2020

Aliment Pharmacol Ther

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Summary Background Growth retardation is well described in childhood‐onset inflammatory bowel disease (IBD). Aims To study if childhood‐onset IBD is associated with reduced final adult height. Methods We identified 4201 individuals diagnosed with childhood‐onset IBD 1990‐2014 (Crohn's disease: n = 1640; ulcerative colitis: n = 2201 and IBD‐unclassified = 360) in the Swedish National Patient Register. Results Patients with IBD attained a lower adult height compared to reference individuals (adjusted mean height difference [AMHD] −0.9 cm [95% CI −1.1 to −0.7]) and to their healthy siblings (AMHD −0.8 cm [−1.0 to −0.6]). Patients with Crohn’s disease (CD) were slightly shorter than patients with ulcerative colitis (UC; −1.3 cm vs −0.6 cm). Lower adult height was more often seen in patients with pre‐pubertal disease onset (AMHD −1.6 cm [−2.0 to −1.2]), and in patients with a more severe disease course (AMHD −1.9 cm, [−2.4 to −1.4]). Some 5.0% of CD and 4.3% of UC patients were classified as growth retarded vs 2.5% of matched reference individuals (OR 2.42 [95% CI 1.85‐3.17] and 1.74 [1.36‐2.22] respectively). Conclusion Patients with childhood‐onset IBD on average attain a slightly lower adult height than their healthy peers. Adult height was more reduced in patients with pre‐pubertal onset of disease and in those with a more severe disease course.

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“…7,68 Use of EEN restores a normal nutritional status and avoids corticosteroid use, which may also impede linear growth. 69 Growth data reported in one of the pediatric EEN RCTs showed a significant improvement in weight gain with EEN compared to corticosteroids, but no difference in height gain. 51 Protocols for EEN therapy varied with respect to specific formula used (although usually polymeric), mode of administration (nocturnally via nasogastric tube or via oral drinking), allowance of clear fluids other than water during treatment, and duration of therapy.…”

Section: Exclusive Enteral Nutritionmentioning

confidence: 97%

“…Risk factors include prolonged disease before diagnosis and the inter-related factors of chronically, uncontrolled, intestinal inflammation, undernutrition, and chronic corticosteroid use. 6,69 Anti-TNF therapies have been associated with improved growth in IMAgINE-2, 134,135 REACH-1, 131 the French trial, 133 the RISK study, 136 and a prospective cohort study. 137 Anti-TNFs are generally well tolerated; however, increased risk of infections and reactivation of tuberculosis have been reported in adults.…”

Section: Statement 18mentioning

confidence: 99%

Canadian Association of Gastroenterology Clinical Practice Guideline for the Medical Management of Pediatric Luminal Crohn's Disease

et al. 2019

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Steroid Administration and Growth Impairment in Children with Crohnʼs Disease

Cited by 9 publications

References 34 publications

Prevalence and Predictors of Growth Impairment and Short Stature in Pediatric-Onset Inflammatory Bowel Disease

Prevalence and Predictors of Growth Impairment and Short Stature in Pediatric-Onset Inflammatory Bowel Disease

Adult height in patients with childhood‐onset inflammatory bowel disease: a nationwide population‐based cohort study

Canadian Association of Gastroenterology Clinical Practice Guideline for the Medical Management of Pediatric Luminal Crohn's Disease

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