Patterns of Catch-Up Growth
2012; Elsevier BV; Volume: 162; Issue: 2 Linguagem: Inglês
10.1016/j.jpeds.2012.10.014
ISSN1097-6833
AutoresC.C. de Wit, Theo Sas, Jan M. Wit, Wayne S. Cutfield,
Tópico(s)Infant Nutrition and Health
ResumoFrom embryogenesis to young adulthood, growth rate declines dramatically. This deceleration in growth velocity is most extreme in infancy with a more subtle slowing in growth velocity through mid-childhood, interrupted by the pubertal growth spurt, after which the growth rate gradually declines to zero.1Tanner J.M. Whitehouse R.H. Takaishi M. Standards from birth to maturity for height, weight, height velocity and weight velocity: British children, 1965 part II.Arch Dis Child. 1966; 41: 613-635Crossref PubMed Scopus (1135) Google Scholar While in the first years of life the length of healthy infants can cross the percentiles toward their genetic target height (TH) SDS, height tends to remain within a narrow "channel" on the growth charts between 3 years and the onset of puberty, close to the same percentile or SDS position. The tendency to keep to this narrow and predictable track of growth is called "canalization."2Waddington C.H. The strategy of the genes. A discussion of some aspects of theoretical biology. George Allen and Unwin, London1957Google Scholar An SDS change of >0.25/year is rarely seen in longitudinal growth studies on normal children.3Sorva R. Tolppanen E.M. Lankinen S. Perheentupa J. [Evaluation of childhood growth].Duodecim. 1985; 101: 465-476PubMed Google ScholarA large variety of growth-retarding illnesses, including hypothyroidism, celiac disease (CD), malnutrition, Cushing syndrome or chronic steroid treatment, and growth hormone (GH) deficiency, can lead to a slowing in growth with a downward deviation from the standard growth curve. After release from these growth-inhibiting conditions, exaggerated acceleration in linear growth can occur. In 1963, Prader et al4Prader A. Tanner J.M. Von Harnack G.A. Catch-up growth following illness or starvation. An example of developmental canalization in man.J Pediatr. 1963; 62: 646-659Abstract Full Text PDF PubMed Scopus (351) Google Scholar and Tanner5Tanner J.M. Regulation of growth in size from mammals.Nature. 1963; 199: 845-850Crossref PubMed Scopus (97) Google Scholar introduced the term "catch-up growth" to describe this period of rapid linear growth in children that followed a period of growth inhibition, leading toward their original growth channel. The term catch-up growth is also used for the growth acceleration seen in ∼85% of infants born small for gestational age (SGA),6Hokken-Koelega A.C.S. Ridder de M.A.J. Lemmen R.J. Hartog den H. de Muinck Keizer-Schrama S.M.P.F. Drop S.L.S. Children born small for gestational age: do they catch up?.Pediatr Res. 1995; 38: 267-271Crossref PubMed Scopus (420) Google Scholar although in these cases there is usually no information about the foregoing downward deviation.The term catch-up growth is mostly used for height. Catch-up growth has been defined as "a height velocity above the statistical limits of normality for age or maturity during a defined period of time, following a transient period of growth inhibition; the effect of catch-up growth is to take the child towards his/her pre-retardation growth curve."7Boersma B. Wit J.M. Catch-up growth.Endocr Rev. 1997; 18: 646-661Crossref PubMed Scopus (191) Google Scholar Even though this definition would imply that for a proper assessment of catch-up growth the full growth trajectory has to be evaluated (up to adult height), only few studies on catch-up growth have included all parts of this trajectory (the phases of growth inhibition, growth acceleration, growth maintenance, and puberty and the achieved adult height in comparison with the genetic growth potential). Furthermore, several alternative definitions of catch-up growth have been used, for example (in children born SGA) reaching an SDS of >−2 for the reference population8Lee P.A. Chernausek S.D. Hokken-Koelega A.C. Czernichow P. International Small for Gestational Age Advisory Board consensus development conference statement: management of short children born small for gestational age, April 24-October 1, 2001.Pediatrics. 2003; 111: 1253-1261Crossref PubMed Scopus (483) Google Scholar or a cut-off of a change of >0.67 SDS in the first year.9Ong K.K. Ahmed M.L. Emmett P.M. Preece M.A. Dunger D.B. Association between postnatal catch-up growth and obesity in childhood: prospective cohort study.Br Med J. 2000; 320: 967-971Crossref PubMed Scopus (1295) Google Scholar Data on the growth curve after the initial phase of catch-up growth and on the adult height corrected for mid-parental height (TH) are often lacking, presumably because of the difficulties in obtaining frequent growth data over long periods of time. In only a few studies, for example in GH deficiency,10Westphal O. Lindberg A. Final height in Swedish children with idiopathic growth hormone deficiency enrolled in KIGS treated optimally with growth hormone.Acta Paediatr. 2008; 97: 1698-1706Crossref PubMed Scopus (32) Google Scholar, 11Sas T.C. de Ridder M.A. Wit J.M. Rotteveel J. Oostdijk W. Reeser H.M. et al.Adult height in children with growth hormone deficiency: a randomized, controlled, growth hormone dose-response trial.Horm Res Paediatr. 2010; 74: 172-181Crossref PubMed Scopus (26) Google Scholar hypothyroidism,12Rivkees S.A. Bode H.H. Crawford J.D. Long-term growth in juvenile acquired hypothyroidism: the failure to achieve normal adult stature.N Engl J Med. 1988; 318: 599-602Crossref PubMed Scopus (195) Google Scholar, 13Ranke M.B. Schwarze C.P. Mohnike K. von Muhlendahl K.E. Keller E. Willgerodt H. et al.Catch-up growth after childhood-onset substitution in primary hypothyroidism: is it a guide towards optimal growth hormone treatment in idiopathic growth hormone deficiency?.Horm Res. 1998; 50: 264-270Crossref PubMed Scopus (20) Google Scholar and CD,14Damen G.M. Boersma B. Wit J.M. Heymans H.S. Catch-up growth in 60 children with celiac disease.J Pediatr Gastroenterol Nutr. 1994; 19: 394-400Crossref PubMed Scopus (62) Google Scholar have data on the complete pattern of catch-up growth including data on adult height been described.Catch-up growth also occurs for other growth parameters, such as body weight, body composition, head circumference, and body segments (sitting height and leg length). For example, catch-up growth observed in the early stages after treatment of CD is generally characterized by an initial weight increase before height catches up, thus an initial rise of body mass index.14Damen G.M. Boersma B. Wit J.M. Heymans H.S. Catch-up growth in 60 children with celiac disease.J Pediatr Gastroenterol Nutr. 1994; 19: 394-400Crossref PubMed Scopus (62) Google Scholar A mismatch between catch-up growth in height and in abdominal fat is seen in babies born preterm or SGA, in which there is greater increase in adiposity than height, which has been associated with a higher risk of cardiovascular disease.15Euser A.M. Finken M.J. Keijzer-Veen M.G. Hille E.T. Wit J.M. Dekker F.W. Associations between prenatal and infancy weight gain and BMI, fat mass, and fat distribution in young adulthood: a prospective cohort study in males and females born very preterm.Am J Clin Nutr. 2005; 81: 480-487PubMed Google ScholarParameters of Catch-Up GrowthWe have previously argued16Wit J.M. Boersma B. Catch-up growth: definition, mechanisms, and models.J Pediatr Endocrinol Metab. 2002; 15: 1229-1241PubMed Google Scholar that the first year height velocity is not suitable as the sole parameter for catch-up growth, because it is highly variable, lacks precision, and incompletely depicts catch-up growth.17Voss L.D. Wilkin T.J. Bailey B.J.R. Betts P.R. The reliability of height and height velocity in the assessment of growth (the Wessex Growth Study).Arch Dis Child. 1991; 66: 833-837Crossref PubMed Scopus (82) Google Scholar In addition, the average height velocity for age is highly dependent on the height percentile of the child. For example, if height is to stay on 3rd percentile, a height velocity at approximately the 25th percentile is needed.16Wit J.M. Boersma B. Catch-up growth: definition, mechanisms, and models.J Pediatr Endocrinol Metab. 2002; 15: 1229-1241PubMed Google Scholar Furthermore, from a series of height velocities one cannot get a good impression of the position of the patient's height versus the population's reference charts.A better parameter of catch-up growth, particularly when assessed over the full trajectory, is height SDS and its change over time.16Wit J.M. Boersma B. Catch-up growth: definition, mechanisms, and models.J Pediatr Endocrinol Metab. 2002; 15: 1229-1241PubMed Google Scholar There is no agreed cut-off criterion for catch-up growth, and we suggest that a sustained increase in height SDS toward the height SDS before the start of growth retardation would suffice as definition. One would expect that the size and speed of the height SDS change during the first years of catch-up growth depend on the distance between height SDS and TH SDS, as well as on age. In fact, this has been observed for GH deficiency.18Ranke M.B. Lindberg A. Chatelain P. Wilton P. Cutfield W. Albertsson-Wikland K. et al.Derivation and validation of a mathematical model for predicting the response to exogenous recombinant human growth hormone (GH) in prepubertal children with idiopathic GH deficiency. KIGS International Board. Kabi Pharmacia International Growth Study.J Clin Endocrinol Metab. 1999; 84: 1174-1183Crossref PubMed Google ScholarPotential Mechanisms of Catch-Up GrowthWe have previously discussed the 2 main hypotheses that have been proposed to explain catch-up growth: the neuroendocrine hypothesis and the growth plate hypothesis.7Boersma B. Wit J.M. Catch-up growth.Endocr Rev. 1997; 18: 646-661Crossref PubMed Scopus (191) Google Scholar The neuroendocrine hypothesis was proposed by Tanner in 1963 and is based on the classical endocrine concept of central steering of processes.5Tanner J.M. Regulation of growth in size from mammals.Nature. 1963; 199: 845-850Crossref PubMed Scopus (97) Google Scholar Tanner suggested that a mechanism—possibly located in the hypothalamus—is able to compare the size of the body with the individual's expected size for that age. This was called a "time tally." If a mismatch is recognized, the body is encouraged to continue growing at a faster-than-normal rate. When the mismatch becomes less distinct, the growth velocity will decrease.5Tanner J.M. Regulation of growth in size from mammals.Nature. 1963; 199: 845-850Crossref PubMed Scopus (97) Google Scholar So far, no experimental evidence for this hypothesis has been collected.The growth plate hypothesis is based on an old concept proposed by Osborne and Mendel in 1914, who showed that prolonged nutritional deprivation in the rat was followed by growth at an age well beyond the normal growth period of the species. They suggested that age is not the limiting factor for growth but that growth is limited by the intrinsic capacity for growth of the tissue itself.19Osborne T.B. Mendel L.B. The suppression of growth and the capacity to grow.J Biol Chem. 1914; 18: 95-106Google Scholar After further work in this area by Williams,20Williams J.P. Catch-up growth.J Embryol Exp Morphol. 1981; 65: 89-101PubMed Google Scholar a study in rabbits by Baron et al21Baron J. Oerter Klein K. Colli M.J. Yanovski J.A. Novosad J.A. Bacher J.D. et al.Catch-up growth after glucocorticoid excess: a mechanism intrinsic to the growth plate.Endocrinology. 1994; 135: 1367-1371Crossref PubMed Scopus (104) Google Scholar gave this hypothesis its present shape by suggesting that the mechanism for catch-up growth is intrinsic to the growth plate. They proposed that catch-up growth arises from a delay in normal growth plate senescence. During normal growth plate senescence, the proliferative rate of the growth plate chondrocytes diminishes with each successive stem cell cycle. Thus, growth plate senescence is not a function of time per se but rather a function of the cumulative number of divisions the stem cells have undergone. After cessation of suppression of proliferation, in Baron et al's experiments by glucocorticoids or hypothyroidism, the cumulative number of stem cell divisions is lower than expected. After the suppression of proliferation, the cells therefore begin to proliferate at a faster rate than the nonexposed cells, leading to local catch-up growth.21Baron J. Oerter Klein K. Colli M.J. Yanovski J.A. Novosad J.A. Bacher J.D. et al.Catch-up growth after glucocorticoid excess: a mechanism intrinsic to the growth plate.Endocrinology. 1994; 135: 1367-1371Crossref PubMed Scopus (104) Google ScholarNone of the 2 hypotheses gives a fully satisfactory explanation for the mechanism of catch-up growth in humans. The neuroendocrine hypothesis lacks experimental support, and the growth plate hypothesis can only explain one specific type of catch-up growth.22Emons J.A. Boersma B. Baron J. Wit J.M. Catch-up growth: testing the hypothesis of delayed growth plate senescence in humans.J Pediatr. 2005; 147: 843-846Abstract Full Text Full Text PDF PubMed Scopus (34) Google ScholarPublished Patterns of Catch-Up GrowthIn 2 seminal articles,23Tanner J.M. Foetus into man. Physical growth from conception to maturity.2nd ed. Open Books, London1978Google Scholar, 24Tanner J.M. Catch-up growth in man.Br Med Bul. 1981; 37: 233-238PubMed Google Scholar Tanner distinguished 3 different growth patterns that potentially lead to the same (normal) adult height. In the first pattern (A), the cessation of the growth restriction is followed by an increased height velocity (up to 4 times the mean velocity for chronologic age), which fully eliminates the growth deficit. When the original growth curve is achieved, height velocity returns to normal. In the second pattern (B), the growth-restricted child grows slightly faster than normal for age but at a normal velocity for bone age, resulting in a longer growth period and a normal adult height. The third pattern (C) shows a growth velocity at the average level for chronologic age but with delayed bone maturation, resulting in growth that goes on for longer than usual. As noted by Tanner and by ourselves, type C formally cannot be considered catch-up growth, because by definition "velocity" should be above normal for age,16Wit J.M. Boersma B. Catch-up growth: definition, mechanisms, and models.J Pediatr Endocrinol Metab. 2002; 15: 1229-1241PubMed Google Scholar, 24Tanner J.M. Catch-up growth in man.Br Med Bul. 1981; 37: 233-238PubMed Google Scholar and we do not discuss this further.Type A catch-up growth is seen as the classic example of catch-up growth and has been reported for several children, such as in some of the cases in the first reports of Prader et al4Prader A. Tanner J.M. Von Harnack G.A. Catch-up growth following illness or starvation. An example of developmental canalization in man.J Pediatr. 1963; 62: 646-659Abstract Full Text PDF PubMed Scopus (351) Google Scholar and Tanner.25Tanner J.M. Growth as a target-seeking function; catch-up and catch-down growth in man.Hum Growth. 1986; 1: 167-179Crossref Google Scholar This pattern can be seen in some infants and young children after growth restriction due to CD when a gluten-free diet is introduced,14Damen G.M. Boersma B. Wit J.M. Heymans H.S. Catch-up growth in 60 children with celiac disease.J Pediatr Gastroenterol Nutr. 1994; 19: 394-400Crossref PubMed Scopus (62) Google Scholar in the majority of young children with hypothyroidism after treatment with levothyroxine,13Ranke M.B. Schwarze C.P. Mohnike K. von Muhlendahl K.E. Keller E. Willgerodt H. et al.Catch-up growth after childhood-onset substitution in primary hypothyroidism: is it a guide towards optimal growth hormone treatment in idiopathic growth hormone deficiency?.Horm Res. 1998; 50: 264-270Crossref PubMed Scopus (20) Google Scholar and in many children with GH deficiency who are receiving GH treatment. Children with CD show on average a type B catch-up growth, with a height velocity that is consistent with height age and bone age,22Emons J.A. Boersma B. Baron J. Wit J.M. Catch-up growth: testing the hypothesis of delayed growth plate senescence in humans.J Pediatr. 2005; 147: 843-846Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar conforming to the hypothesis of delayed senescence.21Baron J. Oerter Klein K. Colli M.J. Yanovski J.A. Novosad J.A. Bacher J.D. et al.Catch-up growth after glucocorticoid excess: a mechanism intrinsic to the growth plate.Endocrinology. 1994; 135: 1367-1371Crossref PubMed Scopus (104) Google Scholar, 26Gafni R.I. Baron J. Catch-up growth: possible mechanisms.Pediatr Nephrol. 2000; 14: 616-619Crossref PubMed Scopus (56) Google Scholar Another example of type B catch-up growth was given in a report on 2 men with hypopituitarism, in whom GH treatment was started at age 22.7 and 24.3 years at a bone age of 13-14 years. At ages 27.9 and 29.1 years, respectively, they had gained 22 and 21 cm in height, and their growth velocity was normal for their bone age.27van der Werff ten Bosch J.J. Bot A. Growth hormone and androgen effects in the third decade.Acta Endocrinol. 1986; 113: 29-34PubMed Google ScholarAn Intermediate Type of Catch-Up Growth (Type AB)We noticed that some catch-up growth curves of children with CD,14Damen G.M. Boersma B. Wit J.M. Heymans H.S. Catch-up growth in 60 children with celiac disease.J Pediatr Gastroenterol Nutr. 1994; 19: 394-400Crossref PubMed Scopus (62) Google Scholar, 22Emons J.A. Boersma B. Baron J. Wit J.M. Catch-up growth: testing the hypothesis of delayed growth plate senescence in humans.J Pediatr. 2005; 147: 843-846Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar, 28Boersma B. Houwen R.H. Blum W.F. van Doorn J. Wit J.M. Catch-up growth and endocrine changes in childhood celiac disease. Endocrine changes during catch-up growth.Horm Res. 2002; 58: 57-65Crossref PubMed Scopus (60) Google Scholar hypothyroidism,13Ranke M.B. Schwarze C.P. Mohnike K. von Muhlendahl K.E. Keller E. Willgerodt H. et al.Catch-up growth after childhood-onset substitution in primary hypothyroidism: is it a guide towards optimal growth hormone treatment in idiopathic growth hormone deficiency?.Horm Res. 1998; 50: 264-270Crossref PubMed Scopus (20) Google Scholar, 29Boersma B. Otten B.J. Stoelinga G.B. Wit J.M. Catch-up growth after prolonged hypothyroidism.Eur J Pediatr. 1996; 155: 362-367Crossref PubMed Scopus (55) Google Scholar GH deficiency,11Sas T.C. de Ridder M.A. Wit J.M. Rotteveel J. Oostdijk W. Reeser H.M. et al.Adult height in children with growth hormone deficiency: a randomized, controlled, growth hormone dose-response trial.Horm Res Paediatr. 2010; 74: 172-181Crossref PubMed Scopus (26) Google Scholar and preterm born children30Euser A.M. de Wit C.C. Finken M.J. Rijken M. Wit J.M. Growth of preterm born children.Horm Res. 2008; 70: 319-328Crossref PubMed Scopus (126) Google Scholar, 31Finken M.J. Dekker F.W. de Zegher F. Wit J.M. Long-term height gain of prematurely born children with neonatal growth restraint: parallellism with the growth pattern of short children born small for gestational age.Pediatrics. 2006; 118: 640-643Crossref PubMed Scopus (67) Google Scholar showed a catch-up growth pattern inconsistent with the classic types described by Tanner. Instead, they showed an increased growth velocity in the first years of treatment, followed by a stabilization of height SDS about half of the initial height SDS and genetic TH for a number of years, and a delayed pubertal growth spurt, after which they finally reached an adult height that was close to TH (or lower). If this pattern was arbitrarily defined as a failure to catch up toward the target range (TH ±1 SD) within 3 years and further growth toward adult height of >1 SD, it was observed in 4 of 11 children (aged 1.2-10.1 years) with primary hypothyroidism and 2 of 8 children with GH deficiency (aged 0.4-9.3 years) (J.W., unpublished analysis of data reported by Ranke et al13Ranke M.B. Schwarze C.P. Mohnike K. von Muhlendahl K.E. Keller E. Willgerodt H. et al.Catch-up growth after childhood-onset substitution in primary hypothyroidism: is it a guide towards optimal growth hormone treatment in idiopathic growth hormone deficiency?.Horm Res. 1998; 50: 264-270Crossref PubMed Scopus (20) Google Scholar and Sas et al11Sas T.C. de Ridder M.A. Wit J.M. Rotteveel J. Oostdijk W. Reeser H.M. et al.Adult height in children with growth hormone deficiency: a randomized, controlled, growth hormone dose-response trial.Horm Res Paediatr. 2010; 74: 172-181Crossref PubMed Scopus (26) Google Scholar). For illustrative purposes, we show the growth curve of a boy with GH deficiency, who participated in a dose-response study,11Sas T.C. de Ridder M.A. Wit J.M. Rotteveel J. Oostdijk W. Reeser H.M. et al.Adult height in children with growth hormone deficiency: a randomized, controlled, growth hormone dose-response trial.Horm Res Paediatr. 2010; 74: 172-181Crossref PubMed Scopus (26) Google Scholar in comparison with the theoretical curves for type A and B catch-up growth (Figure 1). This type of catch-up growth is intermediate between types A and B. We suggest calling this form "catch-up growth type AB," which is characterized by an initial faster growth than normal for bone age, which then passes into a phase of stable height SDS, which remains below TH SDS, until the delayed puberty causes an increase of height SDS toward TH SDS.It is unclear why in some children catch-up growth is abrogated halfway and in others it continues until TH SDS is reached. We speculate that if the underlying disease remains active (eg, inadequately treated CD), treatment is nonphysiologic or inadequately dosed (eg, suboptimal dose or poor adherence to GH treatment in children with GH deficiency) or chondrocyte maturation has been adversely affected (by previous exposure to corticoids or sex steroids), type AB may be more likely to occur. In some cases, type AB may also be a manifestation of underlying constitutional delay of growth and puberty or of superimposed illness.Phases of Growth of Children with Catch-Up GrowthIdeally, for each child with an acquired growth disorder who shows catch-up growth, information on his or her growth curve should be available for the whole trajectory. In a complete dataset, various phases of growth can be distinguished: (1) the period of normal growth before the onset of the disease (initial growth); (2) poor growth during the disease (growth retardation); (3) the rapid phase of growth acceleration; (4) the maintenance phase; (5) growth in adolescence; and (6) adult height.To assess whether catch-up growth is complete in an individual child, one can follow 2 approaches. First, adult height can be compared with the preillness growth curve, and catch-up growth can be considered complete if adult height SDS is close to the original height SDS. Second, adult height can be compared with TH, and at an individual level catch-up growth can be considered complete if adult height is within a range of TH ±1.632Hermanussen M. Cole J. The calculation of target height reconsidered.Horm Res. 2003; 59: 180-183Crossref PubMed Scopus (89) Google Scholar or ±1.3.13Ranke M.B. Schwarze C.P. Mohnike K. von Muhlendahl K.E. Keller E. Willgerodt H. et al.Catch-up growth after childhood-onset substitution in primary hypothyroidism: is it a guide towards optimal growth hormone treatment in idiopathic growth hormone deficiency?.Horm Res. 1998; 50: 264-270Crossref PubMed Scopus (20) Google Scholar, 16Wit J.M. Boersma B. Catch-up growth: definition, mechanisms, and models.J Pediatr Endocrinol Metab. 2002; 15: 1229-1241PubMed Google Scholar At a group level, complete catch-up growth is defined by a mean adult height not statistically different from mean TH.The multiphase approach would imply that there is not one single marker of catch-up but rather a pattern composed of several elements. In the following paragraphs, we discuss what is known about these phases in different conditions where catch-up growth has been described.Phases of Catch-Up Growth in Several DisordersHypothyroidismIn theory, hypothyroidism is the best human model for catch-up growth because it is free of growth constraints associated with chronic disease. However, acquired primary hypothyroidism, usually due to Hashimoto thyroiditis, occurs mainly in older children and adolescents, so that catch-up growth is often concurring with the pubertal growth spurt. The growth retardation observed in hypothyroidism appears to be a direct effect of thyroxine deficiency on skeletal growth, but a secondary reduction of GH secretion and circulating insulin-like growth factor-1 may also play a role.33Burstein P.J. Draznin B. Johnson C.J. Schalch D.S. The effect of hypothyroidism on growth, serum growth hormone, the growth hormone-dependent somatomedin, insulin-like growth factor, and its carrier protein in rats.Endocrinology. 1979; 104: 1107-1111Crossref PubMed Scopus (113) Google ScholarOnce thyroxine replacement therapy is commenced, a period of catch-up growth starts. In most young children, type A catch-up growth is observed, but some children show a growth pattern more consistent with type AB.13Ranke M.B. Schwarze C.P. Mohnike K. von Muhlendahl K.E. Keller E. Willgerodt H. et al.Catch-up growth after childhood-onset substitution in primary hypothyroidism: is it a guide towards optimal growth hormone treatment in idiopathic growth hormone deficiency?.Horm Res. 1998; 50: 264-270Crossref PubMed Scopus (20) Google Scholar Because of the unavailability of data on bone age at start of treatment, we cannot rigorously exclude type B catch-up growth in these children. However, growth in the first year is so rapid in some children that it is likely greater than expected for bone age. Even after a prolonged period of growth retardation, a very high growth velocity can be observed.29Boersma B. Otten B.J. Stoelinga G.B. Wit J.M. Catch-up growth after prolonged hypothyroidism.Eur J Pediatr. 1996; 155: 362-367Crossref PubMed Scopus (55) Google Scholar In older children and adolescents, catch-up growth coincides with pubertal development, which is probably the main reason that on average catch-up growth is not complete.12Rivkees S.A. Bode H.H. Crawford J.D. Long-term growth in juvenile acquired hypothyroidism: the failure to achieve normal adult stature.N Engl J Med. 1988; 318: 599-602Crossref PubMed Scopus (195) Google Scholar, 29Boersma B. Otten B.J. Stoelinga G.B. Wit J.M. Catch-up growth after prolonged hypothyroidism.Eur J Pediatr. 1996; 155: 362-367Crossref PubMed Scopus (55) Google Scholar, 34Bucher H. Prader A. Illig R. Head circumference, height, bone age and weight in 103 children with congenital hypothyroidism before and during thyroid hormone replacement.Helv Paediat Acta. 1985; 40: 305-316PubMed Google ScholarThere are very few data on catch-up growth after a long period of thyroxine deficiency in infants born with congenital hypothyroidism, because these children are usually detected very early through congenital hypothyroidism screening. We reported on a 14-year-old patient who had been hypothyroid from birth29Boersma B. Otten B.J. Stoelinga G.B. Wit J.M. Catch-up growth after prolonged hypothyroidism.Eur J Pediatr. 1996; 155: 362-367Crossref PubMed Scopus (55) Google Scholar and showed an extremely fast catch-up growth for ∼5 years, but in this patient pubertal development occurred at the same time and is presumably responsible for the short adult height. In such cases, administration of a gonadotropin-releasing hormone analog in early puberty may improve adult height outcome.35Minamitani K. Murata A. Ohnishi H. Wataki K. Yasuda T. Niimi H. Attainment of normal height in severe juvenile hypothyroidism.Arch Dis Child. 1994; 70: 429-431Crossref PubMed Scopus (14) Google Scholar, 36Teng L. Bui H. Bachrach L. Lee P. Gagne N. Deal C. et al.Catch-up growth in severe juvenile hypothyroidism: treatment with a GnRH analog.J Pediatr Endocrinol Metab. 2004; 17: 345-354Crossref PubMed Scopus (18) Google ScholarCDIn affluent countries, CD is one of the most prevalent causes of reversible growth retardation.37Csizmadia C.G. Mearin M.L. von Blomberg B.M. Brand R. Verloove-Vanhorick S.P. An iceberg of childhood coeliac disease in the Netherlands.Lancet. 1999; 353: 813-814Abstract Full Text Full Text PDF PubMed Scopus (155) Google Scholar The pathophysiology of growth retardation in CD has not been fully elucidated. It is generally assumed that nutritional deficiency due to gastrointestinal malabsorption and inflammation plays a major role, but cytokines from the diseased gastrointestinal tract may also be involved. In a retrospective study on the effect of a gluten-free diet, we found several patients who showed a clear type A pattern of catch-up growth and average height SDS increased to 0 SDS, suggestive of complete catch-up growth.14Damen G.M. Boersma B. Wit J.M. Heymans H.S. Catch-up growth in 60 children with celiac disease.J Pediatr Gastroenterol Nutr. 1994; 19: 394-400Crossref PubMed Scopus (62) Google Scholar However, in a later prospective study we showed that in the first years the average catch-up growth is concordant with type B.22Emons J.A. Boersma B. Baron J. Wit J.M. Catch-up growth: testing the hypothesis of delayed growth plate senescence in humans.J Pediatr. 2005; 147: 843-846Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar, 28Boersma B. Houwen R.H. Blum W.F. van Doorn J. Wit J.M. Catch-up growth and endocrine changes in childhood celiac disease. Endocrine changes during catch-up growth.Horm Res. 2002; 58: 57-65Crossref PubMed Scopus (60) Google Scholar It is unclear whether a suboptimal catch-up growth is primarily seen in patients who are less adherent to the gluten-free diet. In the first 6-12 months after initiation of the gluten-free diet, weight increases to the predicted weight percentile, followed by an increase of length or height SDS.14Damen G.M. B
Referência(s)