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Glucocorticoid effects on statural growth

L V Avioli1

  • 1Division of Endocrinology, Jewish Hospital of St Louis, MO 63110.

British Journal of Rheumatology
|May 1, 1993
PubMed
Summary

Glucocorticoid medications can significantly stunt children's growth, even at low doses. Careful consideration of various factors is crucial when assessing growth impacts in pediatric patients.

Area of Science:

  • Pediatric Endocrinology
  • Pharmacology
  • Growth Medicine

Background:

  • Glucocorticoid therapy in children presents unique challenges beyond adult side effects.
  • Adverse effects on statural growth are a significant concern, with even low doses like 2.5-5.0 mg of prednisolone daily impacting growth.

Purpose of the Study:

  • To highlight the severe adverse effects of glucocorticoids on pediatric statural growth.
  • To emphasize the dose-dependent relationship between glucocorticoid use and growth retardation.
  • To discuss factors influencing glucocorticoid impact on child growth.

Main Methods:

  • Review of existing literature on glucocorticoid effects on pediatric growth.
  • Discussion of knemometry as a sensitive method for measuring long bone growth.

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  • Analysis of factors influencing growth rate measurements.

    • Main Results:

    • A direct correlation exists between glucocorticoid dosage and the degree of statural growth retardation.
    • Knemometry enhances the accuracy of growth rate measurements in children.
    • Factors like disease, sex, therapy schedule, ethnicity, and immobilization influence growth outcomes.

    Conclusions:

    • Alternate day therapy may not be universally beneficial for all pediatric patients.
    • Newer glucocorticoid generations with potentially fewer detrimental effects on growing children should be explored.
    • Comprehensive evaluation is needed to mitigate growth suppression in pediatric glucocorticoid users.