Growth and pubertal status following pubertal induction in boys with IBD
A Mason1, S Wong1, R Russell2, P McGrogan2 & S Ahmed1
Background: Children with inflammatory bowel disease (IBD) may suffer from growth and pubertal delay.
Objective: To assess pubertal status and growth in a group of boys with IBD before (T+0) and 6 months after (T+6) initiation of testosterone therapy.
Methods: Retrospective study of boys with IBD undergoing pubertal induction. Height (Ht) and pubertal status were obtained at T+0 and T+6. Markers of disease activity and data on concomitant medication were also collected. Response to testosterone was based on advance of pubertal status and a greater than 50% increase in height velocity (HV).
Results: Eight boys with IBD (7 with Crohns disease and 1 with Ulcerative colitis) and median age of 14.8 years (range, 13.6, 15.6), median TS of 1 (1, 2) and a median bone age delay of 2.9 years (0.8, 3.5) had pubertal induction using either Sustanon 50 mg i.m. monthly or Andropatch 2.5 mg or 5 mg daily applied for 12 h each day. Seven boys showed an advance of pubertal status to a median TS of 3 (2, 4) and 6 boys had a greater than 50% increase in HV following Testosterone. Median HV at T+0 and T+6 was 1.6 and 6.9 cm/year, respectively (P=0.005). Median Ht SDS at T−6, T+0 and T+6 was −1.4(−3.0, −0.8), −1.6 (−3.4, −1.1) and −1.4 (−3.3, −1.1), respectively. Median HV SDS at T+0 and T+6 was −4.2 (−7.6, +2) and +1.2 (−2.7, +8.5) respectively. HV SDS was significantly different following treatment when corrected for both age and pubertal stage (P=0.005 and P=0.01). Median albumin, CRP, ESR and platelets were similar at T+0 and T+6. Although median CRP showed a significant correlation with HV at T+6 (r=−0.786; P=0.021), there were no clear associations of growth response to concomitant therapy.
Conclusion: In this group of boys with IBD Testosterone therapy improves growth and pubertal status to a variable extent and needs further systematic study.