LAUSR

Background Juvenile idiopathic arthritis (JIA) is a heterogeneous group of diseases with onset before the age of 16 years and joint inflammation as a main feature. Longitudinal growth is one of the main physical changes in childhood and adolescence. The etiology of delayed growth in children with JIA is multifactorial and strongly associated with prolonged inflammatory activity. Objectives To evaluate growth, sexual maturation, and the difference between final and expected height in girls with JIA and no glucocorticoid treatment for at least six months, as compared to a group of healthy girls. Methods This cross-sectional study involved 44 girls with JIA, diagnosed according to International League of Associations for Rheumatology (ILAR) criteria, and 59 healthy controls, aged between eight and 18 (incomplete) years with no comorbid chronic diseases. Demographic data were collected from all participants, and disease and treatment variables were compiled for the patient group. Anthropometric measurements were converted into z-scores based on WHO standards. Sexual maturation was classified according to Tanner stages. Results BMI and height z-scores were lower in girls with JIA as compared to control participants. These values differed significantly in Tanner stage II. Three (6.8%) girls with JIA had height-for-age z-scores <-2 (short stature). Girls with polyarticular JIA and higher cumulative glucocorticoid doses were significantly more likely to present with short stature. The percentage of prepubertal girls in the JIA group was significantly higher than that observed in the control group, (p=0.012). Age of menarche, adult height, and the difference between actual and expected height did not differ between groups.Table 1. Comparison of pre- and postmenarcheal growth parameters between groups Variables Patients (n=44) Control participants (n=59) p Mean ± SD Mean ± SD Menarche – n (%) 17 (38.6) 37 (62.7) 0.026 Age of menarche (years) 12.2±1.51 11.5±1.24 0,066 Menarche >2 years – n (%) 13/17 (76.5) 22/37 (59.5) 0.363 Δ Target height (father/mother) -3.15±7.87 (n=8) 1.31±5.44 (n=16) 0.117 Nutritional data BMI z-score -0.10±1.29 0.92±1.19 0.007 Height/age z-score -0.14±1.24 0.27±1.17 0.253 Bone age z-score -1.53±4.29 -1.42±2.17 0.928 Conclusions These findings suggest that even six months after the suspension of glucocorticoid treatment, children with more severe forms of JIA and exposure to higher doses of glucocorticoids are still susceptible to growth impairment and delayed puberty. References PETTY RE, SOUTHWOOD TR, MANNERS P, et al.: International League of Associations for Rheumatology classificayion of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol 2004, 31:390–2. BECHTOLD S, SIMON D: Growth abnormalities in children and adolescents with juvenile idiopathic arthritis. Rheumatol int 2014; 34:1483–8. GIANNINI C, MOHN A, CHIARELLI F:Growth abnormalities in children with type 1 diabetes, juvenile chronic arthritis, and asthma. Int J Endocrinol 2014; 2014: 265954. Disclosure of Interest None declared