Growth in children receiving contemporary disease specific therapy for Crohn's disease. Issue 8 (9th June 2012)

• Record Type: Journal Article
• Authors: Malik, Salma; Mason, Avril; Bakhshi, Andisheh; Young, David; Bishop, Jonathan; Garrick, Victoria; McGrogan, Paraic; Russell, Richard K; Ahmed, S Faisal
• Is Part Of: Archives of disease in childhood. Volume 97:Issue 8(2012)
• Page Start: 698
• Page End: 703
• Publication Date: 2012-06-09
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2011-300771
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Introduction: It is unclear whether recent therapeutic advances have improved the growth of children with Crohn's disease (CD). Aim: To assess the frequency of short stature and poor growth and their relationship to disease course and therapy in children with CD. Methods: The anthropometric and treatment details of 116 children (68 male) with a mean (range) age at diagnosis of 10.8 years (4.9–15.5) and a mean age at maximum follow-up (MF) of 15.4 years (9.4–19.3) were studied retrospectively at diagnosis (T0), at 1 (T1), 2 (T2) and 3 years (T3) after diagnosis and at MF. Results: At T0, mean height SD score (HtSDS) was −0.5 (−3.3 to 2.6) compared to a mid-parental HtSDS of 0.2 (−2.0 to 01.4) (p=0.002). At T1, T2, T3 and MF, mean HtSDS was −0.6 (−4.8 to 7.8), −0.6 (−2.9 to 2.2), −0.7 (−3.6 to 2.5) and −0.5 (−3.5 to 2.9), respectively. Mean Ht velocity (HV) SDS at T1, T2, T3 and MF was −1.4 (−7.4 to 7.4), −0.6 (−7.5 to 6.1), −0.1 (−6.6 to 7.6) and 0.6 (−4.8 to 7.8), respectively (p<0.05). In final models, HtSDS was associated negatively with the use of prednisolone (p=0.0001), azathioprine (p=0.0001), methotrexate (p=0.0001) and weight SDS (WtSDS) (p=0.0001). HVSDS was associated positively with age (p=0.0001) and WtSDS (p=0.01). ΔHtSDS was associated negatively with use of prednisolone (p<0.02). Conclusion: Although current therapy for CD is associated with improved rate of growth for the first few years, a substantial proportion of children remain short. This study also highlights the need for consistency in describing growth in children with chronic diseases.