Sex Differences in Statural Growth Impairment in Pediatric Crohn's Disease

Statural growth is a dynamic marker of disease activity in patients with Crohn's disease. Statural growth impairment is a common complication of Crohn's disease, occurring more frequently in male patients. Delayed bone age is common in Crohn's disease, occurring more frequently in female patients. Data suggest sex-specific pathways lead to growth impairment in Crohn's disease and highlight the essential need for the development of sex-specific, risk-based treatment approaches. Initial referral to endocrinology rather than gastroenterology for children diagnosed with Crohn's disease presenting with growth impairment may lead to delays in diagnosis and increased disease severity at the time of diagnosis. Growth impairment is associated with meaningful impacts on quality of life, psychosocial functioning, and family well-being. As substantial research is needed to clarify ongoing uncertainty regarding the optimal initial subspecialty referral for children presenting with growth impairment and the potential for diagnostic delay with sequential evaluation, a strategy of parallel referral to gastroenterology and endocrinology may be warranted.