Endocrine Dysfunction in Children with Crohnʼs Disease

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Abstract
A series of 14 children with Crohn''s disease and growth retardation was screened for endocrine dysfunction. Four children presented with growth failure. All had normal cortisol responses to insulin-induced hypoglycemia. Ten children had normal growth hormone responses in the same test, while 4 had abnormal responses. Gonadotropin responsiveness to LHRH paralleled the clinical evidence of puberty, or its lack. Serum total thyroxine was normal in every patient, while serum total triiodothyronine was low in 6; in these 6 patients serum triiodothyronine normalized with treatment. Serum folate was subnormal in 13 patients and the erythrocyte sedimentation rate was elevated in all at the time of diagnosis. A spectrum of endocrine changes seen in children with Crohn''s disease was demonstrated, particularly prepubertal gonadotropin responses to LHRH and a relative preservation of growth hormone and cortisol responsiveness to hypoglycemia, with a defect in thyroxine to triiodothyronine conversion in severely ill children. Serum folate and sedimentation rate may be useful screening tests for Crohn''s disease in a child presenting with failure of growth.