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Growth Disturbances in Children With Rheumatologic Diseases

Sangeeta Sule1

  • 1Division of Rheumatology, Children's National Hospital, Washington, DC.

Pediatric Annals
|April 2, 2026
PubMed

Insights

Pediatric rheumatologic diseases cause growth impairment through inflammation and other factors. While biologics help, growth delays often persist, necessitating optimized therapeutic strategies for linear growth.

Area of Science:

  • Pediatric rheumatology
  • Endocrinology
  • Growth disorders

Background:

  • Growth impairment is a significant complication in pediatric rheumatologic diseases like juvenile idiopathic arthritis, systemic lupus erythematosus, and systemic sclerosis.
  • Chronic inflammation, malnutrition, endocrine dysfunction, and glucocorticoid toxicity contribute to growth suppression in affected children.
  • Despite advancements in biologic therapies, persistent growth delays remain a challenge, impacting adult height.

Purpose of the Study:

  • To review the mechanisms underlying growth suppression in pediatric rheumatologic conditions.
  • To describe disease-specific impacts on growth.
  • To discuss current therapeutic strategies for optimizing linear growth and development.

Main Methods:

  • Literature review synthesizing current knowledge on growth impairment in pediatric rheumatologic diseases.
  • Analysis of mechanisms including inflammation, endocrine signaling, nutrition, and medication effects.
  • Discussion of contemporary treatment approaches.

Main Results:

  • Pediatric rheumatologic diseases significantly impair growth through multifactorial pathways.
  • Biologic therapies have improved disease control and growth potential but do not fully resolve growth deficits in all cases.
  • Glucocorticoid toxicity is a notable contributor to medication-related growth suppression.

Conclusions:

  • Understanding the complex mechanisms of growth suppression is crucial for managing pediatric rheumatologic diseases.
  • Multifaceted therapeutic strategies are needed to address persistent growth delays and optimize outcomes.
  • Further research into optimizing linear growth in children with rheumatologic conditions is warranted.

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