Growth abnormalities in children and adolescents with juvenile idiopathic arthritis
Susanne Bechtold1, Dominique Simon
1Division of Pediatric Endocrinology and Diabetology, University Children's Hospital, Munich, Germany, Susanne.Bechtold@med.uni-muenchen.de.
Insights
Juvenile idiopathic arthritis (JIA) can cause growth impairment and body composition changes. Early recognition and management are crucial for preventing long-term complications in affected children.
Area of Science:
- Pediatric Rheumatology
- Endocrinology
- Clinical Pediatrics
Background:
- Juvenile idiopathic arthritis (JIA) frequently leads to growth impairment and altered body composition as long-term complications.
- Active disease phases, particularly in systemic and polyarticular JIA, are associated with significant growth disturbances.
- While some patients achieve catch-up growth with reduced disease activity and lower glucocorticoid doses, 10-20% experience persistent growth issues despite new therapies.
Purpose of the Study:
- To highlight the significance of growth impairment and body composition variance in juvenile idiopathic arthritis (JIA).
- To emphasize the need for early identification and management of these complications to mitigate long-term morbidity.
- To discuss the potential of growth hormone treatment in improving growth and body composition in JIA patients.
Main Methods:
- Review of existing literature on growth and body composition in juvenile idiopathic arthritis (JIA).
- Analysis of factors contributing to growth disturbances, including disease activity and medication use (e.g., glucocorticoids).
- Evaluation of the impact of growth hormone treatment on growth development and body composition in short children with JIA.
Main Results:
- Growth impairment and body composition changes are common and significant long-term issues in JIA.
- Bone mass deficits may correlate with muscle mass deficits.
- Growth hormone treatment shows promise for improving growth, final height, and body composition in affected children.
Conclusions:
- Optimal disease control in JIA should prioritize maintaining normal growth and body composition.
- Early detection of prolonged growth and body composition disturbances is essential for therapeutic intervention.
- Addressing these abnormalities is critical for reducing long-term morbidity in patients with juvenile idiopathic arthritis.
Abstract:
In patients with juvenile idiopathic arthritis (JIA) growth impairment and variance in body composition are well-known long-term complications. In the active phases of the disease, particular patients with systemic and polyarticular JIA reveal growth impairment. Some experience "catch-up" growth following reduction in disease activity and lower glucocorticoid doses. Although new therapeutic options are available, there are still 10-20 % of patients with severe forms of the disease who show continuous growth disturbance. Only few studies have specifically addressed body composition in JIA. Bone mass deficits in part could be related to the deficits of muscle mass. Study data on growth hormone treatment in short children with JIA are promising in respect of growth development, final height and body composition. The major goal for physicians is optimal disease control while maintaining normal growth and body composition. Early recognition of patients who develop prolonged growth and body composition disturbances is important as these abnormalities contribute to long-term morbidity and need to be addressed both diagnostically and therapeutically.
More Related Videos
06:53A Rat Tibial Growth Plate Injury Model to Characterize Repair Mechanisms and Evaluate Growth Plate Regeneration Strategies
Published on: July 4, 2017
07:43In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy
Published on: July 2, 2021
Related Concept Videos
01:09Changes in the Appendicular Skeleton with Age
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
02:23Abnormal Proliferation
02:23Abnormal Proliferation
01:27Growth of Cartilage and Bone Tissue
01:07Development of the Limb Synovial Joints
The mesenchymal stem cells differentiate into chondrocytes that form the hyaline cartilage, and later the cartilaginous model of the bone. This model further transforms into a bone. This process is known as endochondral ossification.
During development, the limbs...
01:27Signs of Puberty