Growth Pattern in Children with Systemic Lupus Erythematosus.

Area of Science:

• Pediatric Rheumatology
• Endocrinology
• Growth and Development

Background:

• Childhood-onset systemic lupus erythematosus (cSLE) is associated with significant morbidity in adulthood.
• Growth failure is a unique and concerning comorbidity in pediatric patients with cSLE.
• Understanding longitudinal growth patterns and risk factors is crucial for managing cSLE.

Purpose of the Study:

• To longitudinally evaluate growth patterns in children diagnosed with cSLE.
• To identify specific risk factors contributing to growth failure in this pediatric population.

Main Methods:

• Serial anthropometric measurements were collected over two years and analyzed using z-scores.
• Parent-adjusted height z-scores were calculated to account for parental height.
• Growth failure was defined as a parent-adjusted height z-score below -1.50.

Main Results:

• Growth failure was observed in 32% of the 25 cSLE patients studied.
• Pre-existing growth failure at diagnosis (z-score < -1.95) was a significant predictor (p < 0.001).
• Higher cumulative steroid doses (p=0.061) and longer disease duration (p=0.240) showed a tendency towards increased risk, while disease activity at diagnosis was not significant (p=0.529).

Conclusions:

• Children with cSLE face risks to their final height, particularly those with early growth failure, substantial steroid exposure, and prolonged disease duration.
• Further longitudinal studies are necessary to track long-term damage and enhance health-related quality of life for cSLE patients.