Regulation of growth in children with chronic illness. Therapeutic implications for the year 2000

M. S. Kappy

Children with chronic illness often have poor growth and short stature. The causes are multiple and are related to the organ systems involved, malnutrition, superimposed infections, and the effects of specific therapy, eg, steroids. The impairment of growth contributes to poor body image in these children and may result in problems complying with the treatment regimen and poorer long-term outcome, eg, in diabetes. The somatomedin system or net circulating somatomedin activity in the blood has been shown to mediate growth in children. In addition, many authors have now documented reduced somatomedin generation by the liver and an increase in plasma factors that inhibit the effects of somatomedin on growth in children with chronic illness. Recognition of these phenomena may lead to the use of somatomedin to promote growth in certain of these children in the future.