Growth retardation (GR) may pose a significant challenge to the quality of life and the proper management of children and adolescents with Crohn's disease (CD). It can occur in a significant proportion of patients, and may precede clinical evidence of bowel disease. Current evidence suggests that GR is a complex interaction between nutritional status, inflammation, disease severity, and genotype, which causes resistance to the effects of growth hormone. Recent research has identified a key role for the inflammatory cytokines TNF alpha, IL-6, and IL1 beta. This review summarizes current knowledge as well as gaps in our understanding of the mechanisms involved and the usefulness of the different treatment modalities in promoting growth in CD patients.
(Inflamm Bowel Dis 2007)
1Pediatric Gastroenterology Division of the Meyer Children's Hospital, Haifa
2Institute for Endocrinology and Diabetes, Schneider Children's Medical Center of Israel, Tel Aviv
3Pediatric Gastroenterology Division of the Wolfson Medical Centers, Tel Aviv
4Ruth and Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Tel-Aviv
5Sackler School of Medicine, Tel-Aviv University, Israel
*Pediatric Gastroenterology Unit, E. Wolfson Medical Center, Sackler School of Medicine, POB 5 Holon, Israel 58100
Received for publication 2 November 2006; Accepted 21 December 2006
Published online 29 January 2007 in Wiley InterScience (www.interscience.wiley.com).