Abstract
Growth retardation occurs in approximately 20% of children and adolescents with Crohn's disease (CD). Total parenteral and peripheral intravenous alimentation have reversed this growth retardation, but these methods necessitate prolonged hospitalization. Six consecutive prepubertal patients with CD, all <3rd percentile in height, had caloric intakes 50-73% of the RDA for height age. The effect of oral nutrition combined with medical therapy upon growth velocity was studied in these 6 pts. Low residue formula supplements were added to the diet to provide 80-100 kcal/kg/day and at least 1.5 gm protein/kg/day. Medications were sulfasalazine alone (3 pts) or sulfasalazine and Prednisone (3 pts). Prednisone was given daily for 6-16 wks, then changed to an alternate day regimen. Before therapy, the growth velocities of 5 of the 6 pts were 1.1±1.9 cm/yr (>2 SD below normal); one had a falling growth velocity but remained in the low normal range. Three of these pts were completely growth arrested for >1 yr. After therapy, growth velocities increased to 6.5 ±2.0 cm/yr in 5 pts, which is within the normal range. One pt grew only 1.8 cm/yr which subsequently increased to 5.5 cm/yr after 4 wks of peripheral intravenous alimentation. These results indicate that oral calorie/protein supplementation in conjunction with medical therapy is an effective method for reversing growth retardation in prepubertal CD patients.
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Kirschner, B., Rosenberg, I. & Spector, S. 446 USE OF ORAL NUTRITIONAL SUPPLEMENTS TO REVERSE GROWTH RETARDATION IN CHILDREN WITH CROHN'S DISEASE. Pediatr Res 12 (Suppl 4), 438 (1978). https://doi.org/10.1203/00006450-197804001-00451
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DOI: https://doi.org/10.1203/00006450-197804001-00451