Extrahepatic Portal Vein Obstruction in Children: Anthropometry, Growth Hormone, and Insulin‐Like Growth Factor I

Abstract

Background:Extrahepatic portal vein obstruction has been shown to cause growth retardation in children, though literature is scant. No information is available regarding the cause of growth retardation in these patients.Methods:To document the presence of growth retardation in this disease, we studied growth and nutrition in 33 consecutive prepubertal patients. Anthropometry, fasting growth hormone, and insulin‐like growth factor I levels were compared in 22 well‐nourished patients from this group with 35 age‐matched well‐nourished controls.Results:Mean ± SD height standard deviation score of well‐nourished patients (‐1.88 ± 1.33) was significantly below that of the controls (‐1.06 ± 0.64, p < 0.01). Patients also had significantly lower midarm muscle circumference z scores (‐2.65 ± 1.09) than controls (‐1.17 ± 1.09, p < 0.0001), though triceps skinfold thickness z scores were comparable in the two groups (‐1.60 ± 0.68 vs ‐1.24 ± 0.79, p = NS). Insulin‐like growth factor I z scores were significantly lower in patients (‐1.48 ± 0.88) than in controls (‐0.49 ± 1.09, p < 0.001), whereas basal growth hormone was significantly higher in patients (4.60 ± 3.70 mIU/L) compared with controls (2.66 ± 0.82, p < 0.01).Conclusion:Extrahepatic portal vein obstruction in children leads to growth retardation. Anthropometric and preliminary hormonal evaluation suggest resistance to the action of growth hormone as a possible mechanism.