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Children with oligoarticular juvenile idiopathic arthritis are at considerable risk for growth retardation

Shai Padeh1, Orit Pinhas-Hamiel, Dorith Zimmermann-Sloutskis

  • 1Department of Pediatrics, Sackler School of Medicine, Tel Aviv University, Israel. shay.pade@sheba.health.gov.il

The Journal of Pediatrics
|May 31, 2011
PubMed

Insights

Growth retardation affects a significant portion of children with persistent oligoarticular juvenile idiopathic arthritis (JIA). Elevated erythrocyte sedimentation rate is a key predictor of this growth impairment.

Area of Science:

  • Pediatric Rheumatology
  • Growth and Development
  • Clinical Immunology

Background:

  • Persistent oligoarticular juvenile idiopathic arthritis (JIA) can impact a child's growth.
  • Intra-articular corticosteroid injections (IACSI) are a common treatment modality.
  • Understanding growth patterns is crucial for managing JIA patients.

Purpose of the Study:

  • To evaluate linear growth in persistent oligoarticular JIA patients receiving IACSI.
  • To compare growth outcomes between IACSI alone and combination therapy (IACSI + DMARDs).
  • To identify predictors of growth retardation in this population.

Main Methods:

  • Retrospective chart review of 95 patients with persistent oligoarticular JIA.
  • Analysis of height standard deviation scores (SDS) correlated with disease course.
  • Comparison of growth between patients treated with IACSI alone versus IACSI plus disease-modifying antirheumatic drugs (DMARDs).

Main Results:

  • 35.8% of patients experienced growth retardation (Δ z-score <-0.3), with 11.6% having severe retardation (Δ z-score <-1.0).
  • Patients receiving IACSI plus DMARDs showed a higher incidence of growth retardation compared to IACSI alone (44.4% vs 30.6%).
  • Elevated erythrocyte sedimentation rate (≥ 40 mm/1st h) was a significant predictor of growth retardation.

Conclusions:

  • A substantial number of children with persistent oligoarticular JIA suffer from growth retardation.
  • Severe growth retardation is observed in a minority of these patients.
  • Elevated erythrocyte sedimentation rate is a reliable indicator for predicting growth retardation risk in JIA.
Abstract

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