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Growth patterns in juvenile rheumatoid arthritis
1Section of Rheumatology, Department of Pediatrics, University of Saskatchewan, Saskatoon, Canada.
Clinical and Experimental Rheumatology
|November 13, 2003
Summary
Juvenile rheumatoid arthritis (JRA) can cause growth delays, particularly in systemic and RF-positive polyarticular forms. Pauciarticular and RF-negative polyarticular JRA patients often exhibit normal growth patterns.
Area of Science:
- Pediatric Rheumatology
- Growth and Development
- Child Health
Background:
- Juvenile rheumatoid arthritis (JRA) is a chronic inflammatory condition affecting children.
- Growth disturbances are a significant concern in children with JRA.
- Understanding growth patterns is crucial for managing JRA and its long-term effects.
Purpose of the Study:
- To define growth patterns in children with JRA.
- To identify clinical and laboratory factors associated with growth deviations in JRA.
- To compare growth trajectories across different JRA subtypes.
Main Methods:
- Longitudinal study of 67 children with JRA followed for at least 5 years.
- Calculation of height and weight z-scores annually.
- Correlation of growth z-scores with JRA subtype, rheumatoid factor (RF) status, ESR, ALP, and medication history.
Main Results:
- Systemic JRA (SJRA) onset group showed significantly lower height-for-age z-scores (HAZ) compared to pauciarticular JRA (PaJRA) from year 2 and polyarticular JRA (PoJRA) from year 6.
- RF-positive children tended to have negative HAZ scores, while RF-negative children tended to have positive HAZ scores.
- Predominant linear growth delay observed in SJRA, with lesser impact in RF-positive PoJRA.
Conclusions:
- Linear growth delay is a recognized complication in some JRA patients.
- Pauciarticular and RF-negative PoJRA patients may exhibit normal growth.
- RF-positive PoJRA and SJRA patients experience more significant growth retardation, which can be sustained and extreme.
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