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Routine care for Crohn's disease in children should include measurement of bone age
Date:5/25/2012

d me was that 41 percent of our patients had BA-Z scores that were less than -2. I did not expect that such a large proportion of patients would have this degree of delay," said Gupta.

Crohn's disease is a chronic disorder characterized by inflammation in the gastrointestinal tract. It is one of the two main disease subcategories of inflammatory bowel disease, along with ulcerative colitis. About one quarter of the more than one million Americans with inflammatory bowel disease are diagnosed in childhood and adolescence. In pediatric patients, the inflammation characteristic of the disease may lead to an inability to grow normally. Poor growth may be the only presenting sign of Crohn's disease in children and adolescents.

The disease is marked by an abnormal response by the body's immune system. The cause is not well understood but probably has a genetic component and an unknown trigger, according to the researchers.

The interpretation of a patient's growth changes when his or her bone age, rather than just chronological age, is taken into consideration, according to the researchers. The added information is also useful for properly interpreting height increments following therapeutic interventions.

"We need further studies to understand the effects of disease activity on bone age advancement and to determine which patients require more frequent monitoring of bone age," Gupta said.

Females in the study had significantly lower average BA-Z scores (-2.0) than males (-1.1). Interestingly, the research team previously had reported that males with Crohn's disease have more growth impairment than females. The researchers are continuing to investigate the underlying reasons for sex differences in growth. Certain factors Caucasian race, exposure to steroids, colonic disease location, earlier pubertal stage, and current treatment with the immunomodulator azathioprine/6-mercaptopurine -- also were associated with lower
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Contact: Juliana Bunim
juliana.bunim@ucsf.edu
415-502-6397
University of California - San Francisco
Source:Eurekalert  

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