Changes in Growth Indices and Bone Mineral Density After Infliximab Therapy in Steroid-Naive Pediatric Crohn’s Disease: A Single-Center Retrospective Study

Background/Objectives: In children, Crohn’s disease (CD) can impair linear growth and skeletal mineralization, resulting in reduced bone mineral density (BMD). We evaluated changes in growth indices and BMD following infliximab (IFX) therapy combined with immunomodulators in pediatric CD. Methods: This single-center retrospective study included 35 steroid-naive pediatric patients with CD who initiated IFX within 6 months of diagnosis between 2020 and 2025. Changes in inflammatory markers, growth indices, and BMD were assessed from baseline to 1 year after IFX initiation. Results: After 1 year of IFX therapy, inflammatory markers and clinical disease activity improved significantly. Weight and body mass index z-scores, insulin-like growth factor 1 (IGF-1) z-score, and vitamin D levels increased significantly. Femoral neck BMD z-score increased, although the increase did not remain statistically significant after correction for multiple comparisons. Lumbar spine BMD z-score showed no significant change. Conclusions: In steroid-naive pediatric patients with CD who started IFX within 6 months of diagnosis, IFX-based therapy was associated with improved inflammatory activity and growth-related parameters. These findings suggest the potential value of such therapy in supporting growth and nutritional recovery, whereas its effects on skeletal health require confirmation in longer-term controlled studies.