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Growth of children with juvenile idiopathic arthritis
Rakesh Mondal1, Sumantra Sarkar, Niloy Kumar Das
1Division of Pediatric Rheumatology, Department of Pediatric Medicine, *Department of Pharmacology and #Department of Physiology, IPGMER Kolkata. Correspondence to: Dr Rakesh Mondal, Balarampur, Mahestala (PO), Kolkata 700 141, India. ivanrakesh2001@gmail.com.
Insights
Children with juvenile idiopathic arthritis (JIA) generally show normal growth compared to controls. However, systemic onset JIA significantly restricts height and weight, while rheumatoid factor-positive JIA impacts growth velocity.
Area of Science:
- Pediatric Rheumatology
- Growth and Development
- Immunology
Background:
- Juvenile idiopathic arthritis (JIA) is a heterogeneous autoimmune condition affecting children.
- Understanding the growth patterns in JIA is crucial for long-term management and predicting outcomes.
Purpose of the Study:
- To assess the growth patterns of children diagnosed with juvenile idiopathic arthritis (JIA) and its various subtypes.
- To compare these growth patterns against age- and sex-matched healthy controls.
Main Methods:
- A prospective study was conducted over 3 years involving 75 children (2-12 years) with JIA and 75 controls.
- Anthropometric parameters including weight, height, and body mass index (BMI) were measured every six months.
- Subtype distribution of JIA was analyzed.
Main Results:
- Overall, children with JIA did not exhibit significantly different anthropometric parameters compared to controls.
- Significant differences in height, weight, and growth velocity were observed among JIA subtypes (P<0.05).
- Systemic onset JIA showed significant height and weight restriction, while rheumatoid factor-positive polyarthritis significantly reduced growth velocity.
Conclusions:
- While overall anthropometric parameters are comparable, specific JIA subtypes have distinct impacts on growth.
- Systemic onset JIA poses a significant risk for height and weight deficits.
- Rheumatoid factor-positive JIA is associated with impaired growth velocity, necessitating targeted monitoring.
Objective:
To evaluate the growth pattern in children with juvenile idiopathic arthritis and its subtypes in comparison with age, sex and temporally matched controls.
Study Design:
Prospective study.
Setting:
Pediatric rheumatology clinic of a tertiary care hospital in Eastern part of India.
Participants:
Seventy-five children (2-12 years) diagnosed as juvenile idiopathic erthritis by International League of Associations for Rheumatology criteria and 75 age- and sex- matched controls.
Intervention:
Weight, height and body mass index were recorded at six monthly interval in both groups over a period of 3 years.
Main Outcome Measures:
weight, height and body mass index.
Results:
Subtype distribution of juvenile idiopathic arthritis was: oligoarthritis (49%, n=37), rheumatoid factor negative polyarthritis (27%, n=20), rheumatoid factor positive polyarthritis (8%, n=6), systemic onset (15%, n=11) and enthesitis related arthritis (1.3%, n=1). Anthropometric parameters in children with juvenile idiopathic arthritis were not significant different from controls. Comparison between the subtypes showed significant differences in height (P=0.011), weight (P=0.005), and growth velocity (P=0.005), but not in body mass index. Systemic onset disease led to significant restriction in height (P=0.018; 95% CI 2.13-33.77) and weight (P=0.008; 95% CI 1.47-14.43) compared to controls. Growth velocity was significantly affected in rheumatoid factor positive polyarthritis (P=0.003; 95% CIO. 46-3.14).
Conclusions:
Children with juvenile idiopathic arthritis do not have significantly lower values of anthropometric parameters compared to controls. Significant restriction in height and weight is seen in systemic onset disease, and growth velocity is significantly reduced in rheumatoid factor positive subjects.
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