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Puberty and Pediatric-Onset Inflammatory Bowel Disease

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Pediatric Inflammatory Bowel Disease

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Abstract

Delayed puberty and attenuated growth are frequently associated with childhood-onset inflammatory bowel disease (IBD). In turn, disorders of puberty can also influence other aspects of health in children with IBD. This chapter provides a framework for identifying IBD-related pubertal delay, and for understanding the scientific basis among undernutrition, inflammation, and hormonal changes in these children.

Nutritional deficiencies are common in children with IBD. As optimal nutrition is necessary for the initiation and maintenance of normal reproductive function, undernutrition is likely to be one of the major contributing factors in the delay in the onset and progression of puberty in IBD. However, studies in both humans and in animal models of colitis suggest that inflammatory modulators of IBD also play a role in the pubertal delay independent of nutritional factors. In addition, both undernutrition and inflammatory cytokines influence the hypothalamic-pituitary-gonadal axis. Due to the complex interaction of each of these factors in different patients, it is difficult to determine how much each individual factor influences the onset and progression of puberty in childhood-onset IBD. Optimum control of active inflammation and provision of adequate nutrient intake are both essential in promoting normal puberty in adolescents with IBD. In addition, there may be a role for sex hormone therapy to initiate or advance puberty in these children.

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Authors and Affiliations

  1. Department of Pediatrics, Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism, The University of Chicago, 5841 S. Maryland Avenue MC 5053, Chicago, IL, 60637, USA

    Dianne Deplewski MD

  2. Department of Pediatrics, Section of Pediatric Gastroenterology, Hepatology, and Nutrition, The University of Chicago, 5841 S. Maryland Avenue MC 4065, Chicago, IL, 60637, USA

    Barbara S. Kirschner MD

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  1. Dianne Deplewski MD
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  2. Barbara S. Kirschner MD
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Correspondence to Dianne Deplewski MD .

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Editors and Affiliations

  1. Perelman School of Medicine, The Children’s Hospital of Philadelphia, University of Pennsylvania, 34th St. & Civic Ctr. Blvd., Philadelphia, 19104, Pennsylvania, USA

    Petar Mamula

  2. School of Medicine--Greenville, Pediatric Gastroenterology & Nutrition, University of South Carolina, 200 Patewood Drive, Suite A-140, Greenville, 29615, South Carolina, USA

    Jonathan E. Markowitz

  3. Perelman School of Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 34th St. & Civic Ctr. Blvd., Philadelphia, 19104, Pennsylvania, USA

    Robert N. Baldassano

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Deplewski, D., Kirschner, B.S. (2013). Puberty and Pediatric-Onset Inflammatory Bowel Disease. In: Mamula, P., Markowitz, J., Baldassano, R. (eds) Pediatric Inflammatory Bowel Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5061-0_14

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