In pediatric Crohn's disease, which of the following is a negative effect of corticosteroids?

• A. Negatively impact bone mineral density
• B. Increase height velocity
• C. Improve mucosal healing
• D. No negative effects

Answer: (A)

Steroids in children with Crohn’s disease can have meaningful adverse effects on growing bones and height. In kids, systemic corticosteroids can blunt bone formation and accelerate bone loss, leading to lower bone mineral density and a higher risk of fractures, especially during the years when bone mass is actively being accumulated. They can also slow linear growth, reducing height velocity. So the negative effect described as negatively impacting bone mineral density is the best choice, because it captures a real and important safety concern with steroids in pediatric patients. The idea that steroids would increase height velocity is incorrect—growth can be impaired. While steroids can improve mucosal inflammation (a therapeutic benefit), that is not a negative effect, and there are indeed negative effects, so “no negative effects” is false.