Growth impairment and associated pubertal delay are common complications of pediatric @entity29 ( @entity29 ), particularly @entity30 ( @entity30 ). Chronic undernutrition (related primarily to inadequate intake) and pro-inflammatory cytokines are the two major and interrelated contributory factors. Pathogenic mechanisms include interference with growth hormone/insulin-like growth factor-1 axis, with @entity4396 secretion patterns, and direct cytokine effects on growing bone. Chronic corticosteroid therapy compounds disease-related causes of growth impairment. The influence on growth of polymorphisms in @entity29 susceptibility or modifier genes is under study. Accurate recognition of impaired growth requires appreciation of normal growth. Pre-illness standard deviation scores ( @entity214 ) for height should be obtained and compared with height @entity214 at diagnosis, so that the impact of disease on growth can be fully appreciated. The greater the deficit prior to recognition of @entity29 , the greater is the demand for catch-up growth. Height velocity should be regularly monitored and its adequacy for age and pubertal stage assessed. Restoration and maintenance of pre-illness growth pattern indicate success of therapy. Current treatment regimens limit use of corticosteroids, via optimization of immunomodulatory drugs, use of enteral nutrition in @entity30 , and, if necessary, surgery for @entity31 and for intestinal complications of localized @entity30 . Biologic agents with the potential for mucosal healing hold promise of growth enhancement even among @entity1 , whose growth with previously available therapies remained compromised. For all therapies, there is a window of opportunity to achieve normal growth before puberty is too advanced.

Growth retardation in early-onset @entity29 : should we monitor and treat these XXXX differently?

@entity1 :: ('9606', 'Species') :: ['children'] @entity4396 :: ('2796', 'Gene') :: ['gonadotropin-releasing hormone'] @entity31 :: ('MESH:D003093', 'Disease') :: ['ulcerative colitis'] @entity29 :: ('MESH:D015212', 'Disease') :: ['inflammatory bowel disease', 'IBD'] @entity30 :: ('MESH:D003424', 'Disease') :: ['CD', "Crohn's disease"] @entity214 :: ('CHEBI:8984', 'Chemical') :: ['SDS']
@entity1 :: (9606,Species) :: ['patients']
