[Growth in children with juvenile idiopathic arthritis]
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J García-Consuegra Molina1, R Merino Muñoz, R Lama More
1Unidades de Reumatología Pediátrica. Hospital Universitario Infantil La Paz. Madrid. España. reumaped.hulp@salud.madrid.org
Insights
Growth retardation in juvenile idiopathic arthritis (JIA) is linked to disease activity, steroid use, nutrition, bone density, and early onset. These factors impact linear growth and height velocity in affected children.
Area of Science:
- Pediatric Rheumatology
- Endocrinology
- Growth and Development
Context:
- Juvenile idiopathic arthritis (JIA) is a chronic inflammatory condition.
- Steroid therapy is common but can impede growth.
- Growth retardation is a significant complication in some JIA patients.
Purpose:
- To investigate linear growth patterns in JIA patients.
- To identify factors contributing to growth disturbances in JIA.
- To analyze correlations between growth parameters and disease-related variables.
Summary:
- A study of 91 JIA patients analyzed height and height velocity (HV).
- Factors associated with reduced height included corticosteroid dose, functional class, nutritional index, bone mineral density (BMD), and age at onset.
- Reduced HV was linked to corticosteroid dose and joint swelling.
Impact:
- Identifies key factors influencing growth in JIA, aiding clinical management.
- Highlights the multifactorial nature of growth retardation in JIA.
- Provides data for targeted interventions to optimize growth outcomes in children with JIA.
Introduction:
Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease that often requires steroid therapy. Growth retardation can be a serious complication in some of these patients.
Objective:
To study linear growth in patients with JIA and evaluate the factors involved in its disturbance.
Methods:
We studied 91 patients with JIA with a follow-up of at least one year. A cross sectional study, a longitudinal retrospective study, and a longitudinal prospective study were performed. Height in the first consultation, in the cross sectional study, and one year previously was evaluated. Height velocity (HV) was calculated. Several parameters related to disease activity, corticosteroid therapy, nutritional and hormonal status, and bone mineral density (BMD) were analyzed. A correlation study and multivariate regression analysis were carried out.
Results:
Height was < or = -2 SD in 14.3 % of the series and in 55.6 % of the systemic group. Variables independently associated with height were total corticosteroid dose, functional class, nutritional index, BMD, and age at onset of the disease. HV was < or = 2 SD in 25.3 % of the series and in 61 % of the systemic group. Variables independently associated with HV were corticosteroid dose and the number of swollen joints.
Conclusions:
Growth retardation in patients with JIA was associated with factors related to the disease, corticosteroid therapy, nutritional status, BMD, and earlier onset of the disease.
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