Growth Delay

[kernelmom3]

I took DS for his 6 month follow up appointment with his GI and all was great except that he hasn't grown at all. He's 15 1/2 years old and he's 5'5. Actually cording to his projected height (based on my height and my husband's) he should reach about 5'9". So he did a bone age xray and his age and bone age match. His GI wants him to see an endocrinologist but I called the one he referred us to to see what our options are before we go. She told me there's nothing they can do! She said with his bone age being so close to 17 growth hormones won't work and he doesn't have much growing to do. It was a REALLY depressing call! Does anyone have any experience with growth issues with your teen? Isn't there anything I can do!!? HELP!

 

[my little penguin]

Once the growth plates closed -then growth stops

That said if his crohns is truly under controlled then growth should be normal
What meds is he on?
Does he drink formuls to increase calories and growth ?
You said 6 month follow up? DS has never gone more than 3-4 months between appts . For the past three years.

Most endos will not do hormones on crohns kids since it's the inflammation and malabsorption that causes the issues
I will post the links

 

[my little penguin]

Links for you
http://onlinelibrary.wiley.com/doi/10.1002/ibd.20115/full

http://m.pediatrics.aappublications.org/content/114/5/1281.abstract

http://www.practicalgastro.com/pdf/January06/FaubionArticle.pdf

http://mobile.journals.lww.com/jpgn....aspx?year=2000&issue=07000&article=00009#ath

http://www.ncbi.nlm.nih.gov/m/pubmed/24865777/

 

[Crohnick]

Ask your current, or seek an endocrinologist that is familiar with options to delay closing of growth plates.

My son has growth delay too, though his bone age lags actual age by more than two years. We have taken him to endocrinologist, and she says administering growth hormones won't do anything, especially if natural levels are appropriate for his age. But she did mention there is experimental therapy that will delay closing of growth plates if there isn't appropriate growth. She didn't get into details at the time, but I did some quick searches, and ran across articles that mention using Anastrozole to delay closing of growth plates. Apparently estrogen plays a role in the plate closure mechanism.

Edit: I'm too new and can't post links, so I'm editing my original post with these search hints. Google "PMC2266949 Anastrozole" and "11194703 Anastrozole". They should get you to the PubMed/NIH articles.

We are going back to our son's endocrinologist in about a month for scheduled follow-up. I will ask more details about the exact therapy she was referring to and post the info here then.

 

[kernelmom3]

Thanks for the info! I'll start looking at the links.
It was THREE month follow up but six months since surgery (oops!)
but GI said he doesn't need to see him for six months from now.

 

[Mehita]

Same response here from our endocrinologist. Growth plates matched his age so she didn't feel there was much she could do.

Is he in remission? Good, solid remission? If so, with surgery not being that long ago, he may still have some growing to go. My son has had a lot of "catch up" growth in he last 18 months since surgery and getting his disease under control. His Endo said it's possible that he could get up to his pre-Crohn's growth percentiles.

 

[Tink572]

Ask your current, or seek an endocrinologist that is familiar with options to delay closing of growth plates.

My son has growth delay too, though his bone age lags actual age by more than two years. We have taken him to endocrinologist, and she says administering growth hormones won't do anything, especially if natural levels are appropriate for his age. But she did mention there is experimental therapy that will delay closing of growth plates if there isn't appropriate growth. She didn't get into details at the time, but I did some quick searches, and ran across articles that mention using Anastrozole to delay closing of growth plates. Apparently estrogen plays a role in the plate closure mechanism.

Edit: I'm too new and can't post links, so I'm editing my original post with these search hints. Google "PMC2266949 Anastrozole" and "11194703 Anastrozole". They should get you to the PubMed/NIH articles.

We are going back to our son's endocrinologist in about a month for scheduled follow-up. I will ask more details about the exact therapy she was referring to and post the info here then.

My son's endocrinologist started my son (16) on Arimidex (anastrozole) several months ago to slow down growth plate closure. He was on it for about 2 weeks when he started suffering from major depression--didn't want to do any of his usual activities or hang out with friends, sad, angry, crying, wanting to do nothing but sleep. It was really scary. We took him off of it and he was back to his usual self after several days. Definitely something to talk to the endocrinologist about if you decide to go this route.

 

[Jmrogers4]

I'm with Mehita, my son 15 1/2 was nearly 2 years behind though but did not really hit the big growth until we had disease under control for nearly 6 months. He started out at 5'1" last January when he began remicade and grew an inch about May by July he was the same height as me 5'4". He is now somewhere between 5'7" and 5'8" (will get official height tomorrow at infusion).
Hope he takes off with growth and it's one less thing you have to worry about but I certainly understand wanting to do everything you can to ensure he gets to whatever height he was destined to be before Crohn's hit.

 

[Cross-stitch gal]

I'm the shortest in my family and I wasn't diagnosed till I was 18. My growth was stunted as well even though, I may not have gotten a whole lot taller since my parents aren't very tall people (only 5ft ranges). I too hope his disease is under control and am thankful for those kids who're able to be taken care of before 18 while they're still young enough to grow and be healthy.

 

[DustyKat]

Thanks for the info! I'll start looking at the links.
It was THREE month follow up but six months since surgery (oops!)
but GI said he doesn't need to see him for six months from now.

Just picking up on the post surgery side of things…

My daughter was 14.5 years when she had surgery and at that point did not even look like commencing puberty. She was in very poor condition going into surgery and although it put her straight into remission it took a further 9 months (from July 06 - March/April 07) for her body to overcome what it had been through and then puberty to kick in. Once it did though it came on hard and fast. :eek2:

Dusty. xxx

 

[Crohnick]

My son's endocrinologist started my son (16) on Arimidex (anastrozole) several months ago to slow down growth plate closure. He was on it for about 2 weeks when he started suffering from major depression--didn't want to do any of his usual activities or hang out with friends, sad, angry, crying, wanting to do nothing but sleep. It was really scary. We took him off of it and he was back to his usual self after several days. Definitely something to talk to the endocrinologist about if you decide to go this route.

Oh, this is great information to have in the back pocket in case it is ever suggested as an option by the endo.

There is so much information to digest on all the angles of this disease.

Thanks Tink572!

 

[Sascot]

This is something I am worried about. My son is in remission but hasn't grown much in the last couple years and he hasn't changed shoe size for 2 years.
We just got told not to worry!

 

[crohnsinct]

sascot: that doesn't sound right. If they are so sure he is in remission will they refer to the endo?

I am frustrated here also. T has precoscious puberty so grew super tall early on. This just masked the Crohn's.."She can't have Crohn's she is growing like a weed" She got her period when she was 9. We did nothing to stop it because the endo felt she would still grow to her potential. Now at 11, we are told growth plates likely closed and no more growth. Hitting myself over the head for not pushing to get that Crohn's dx a lot sooner because then maybe she would have grown more. Hoping they are wrong about growth plates and that we can squeak a bit more out but even if we can't she is a girl and I guess it isn't much of an issue for them as boys.

 

[Jmrogers4]

I agree with CIC, Sascot maybe a trip to the endo. We were told the same thing when Jack wasn't growing, don't worry, just be patient until all the sudden everybody was worried (GP & GI) and it was a rush to figure out why while we still had time. It wasn't until remicade and really true remission that we had growth

 

[Sascot]

Thanks, he has a check up in April. Will ask for referral if he hasn't gr much again. I know my uncle was really short until after his 16th birthday then shot up, so hopefully we have time

 

[malorymug]

I agree with CIC, Sascot maybe a trip to the endo. We were told the same thing when Jack wasn't growing, don't worry, just be patient until all the sudden everybody was worried (GP & GI) and it was a rush to figure out why while we still had time. It wasn't until remicade and really true remission that we had growth

So when was the rush? Says the mom of a very small 14.5 year old, still being told not to worry.

 

[Jmrogers4]

At 14.5, interesting enough talking to the GI today who said he was glad I pushed and really made them look at his growth and why he wasn't growing since he was 14.5 at the time if it was something other than he was just meant to be small we need to do something quick. I just knew he wasn't where he should be in terms of growth - just that mommy gut feeling.
He was pretty amazed at growth said Jack should be a poster boy for Remicade and again was really glad I pushed the growth issue as he probably would have just let it go and assumed that he was just meant to be small. Can't help but think how many other GI's out there assume the same thing since it seems to be in quite a number of cases our Crohn's kids are on the smaller side and when we read about huge growth spurts when they reach true remission. Kind of makes you go HMMMM?
Malorymug remind me again when did he start remicade? We did not see that huge growth start until after 6 months.

 

[malorymug]

Thank you JMR. He has just started remicade in January. So, really, I know I need to be a little patient, I just feel the clock ticking. So much pressure. I'm not sure why his height is so important to me, but it is.
Remicade has put on some weight. He is out of the 80s.
Look like this summer we should hope to see some new pant sizes!

 

[crohnsinct]

It took O a very long time on Remicade to grow. I would say at least 6 months and even then just drips and drabs. At about the one year point she just took off.

JM: So true! Our doc said 5' 4" was about all we should expect. She is 5' 7" now!

 

[Jmrogers4]

Thank you JMR. He has just started remicade in January. So, really, I know I need to be a little patient, I just feel the clock ticking. So much pressure. I'm not sure why his height is so important to me, but it is.
Remicade has put on some weight. He is out of the 80s.
Look like this summer we should hope to see some new pant sizes!

I so understand the impatience, I could have and probably did write the same question/worry a year ago. Jack had fallen another % on height between starting remicade and next appt with endo so we did the testing for growth hormones and about the same time we did the testing either end of April/beginning of May he started to take off about an inch or so every 8 weeks. Which also was really the start of shorts season (athletic shorts with elastic waistbands - Wahoo!) didn't have to worry about pants length. By the time we had to buy jeans since weather was getting colder we went from a size 14 slim to a men's 28-29 and 32 length!

Hope it's just a matter of time and he is soon passing you in height