Decreased Height Velocity in Children and Adolescents Before the Diagnosis of Crohn's Disease

Severe linear growth retardation occurs in 20%-30% of children with Crohn's disease, yet, it is unknown how often decreased height velocity precedes the diagnosis. The height velocities of 50 children and prepubescent adolescents with Crohn's disease were reviewed. Decreased height velocity antedated the diagnosis in 44 patients. Twenty-one patients had a reduction in height velocity before intestinal symptoms were noted. Additionally, 17 of 32 patients with attenuated linear growth had a reduction in height velocity before any weight loss. Linear growth impairment in Crohn's disease, more common than previously recognized, may precede weight loss and can be the earliest indicator of disease.