Delays in puberty, growth, and accrual of bone mineral density in pediatric Crohn's disease: despite temporal changes in disease severity, the need for monitoring remains.

摘要: Crohn’s disease (CD) is an immune-mediated process causing injury to the small intestinal and colonic mucosa, leading local systemic inflammation (1). Although hallmarked by symptoms such as weight loss, abdominal pain bloody diarrhea, CD can have insidious onset that escapes clinical detection. has been associated with shortfalls in linear growth and—when occurs prior puberty—with substantial delays timing of puberty (2). The failure are primarily bowel involvement (3, 4) generally not seen ulcerative colitis (UC), another inflammatory (IBD) which activity restricted mucosa. delay exacerbate other potential sequelae, including decreased bone mineral density (BMD, from multiple factors a lack sex steroids at appropriate age), short stature (from loss pubertal spurt)(2, 5), self-esteem later than one’s peers). for these sequelae raises need close monitoring status among adolescents CD. Although prevalence findings setting reported historically be relatively common, more current evidence suggests continued but overall modest advent modern treatments—a trend also pediatric chronic diseases cystic fibrosis. In this review we will cover data regarding endocrine CD, consider mechanisms related their pathophysiology discuss approaches diagnosis treatment.