LAUSR

Background Delayed puberty is common in children with chronic illnesses such as Juvenile Idiopathic Arthritis (JIA),especially in cases with an earlier age of onset.Its etiology is multifactorial and includes low weight,complications arising from the disease itself and the adverse effects of treatment. Objectives To compare uterine and ovarian size as well as artery pulsatility between girls with juvenile idiopathic arthritis (JIA) and healthy participants using abdominal pelvic ultrasound,and identify these findings and pubertal staging,sex hormones and disease characteristics in girls with JIA. Methods This study involved 44 girls with JIA and 59 healthy controls aged between six and 18 incomplete years.Pelvic ultrasound was used to determine uterine volume and length,the corpus/cervix ratio,ovarian volume and length,and the pulsatility index (PI) of uterine arteries.Hormone levels were also measured in girls with JIA. Results All US parameters were associated with Tanner stages in the control group (p<0.001).Uterine and ovarian measures were smaller in girls with JIA than in the control group.The mean PI of uterine arteries was higher in girls with JIA.Comparisons by age group revealed that uterine volumes were smaller in girls with JIA aged between 10 and 11 years (p=0.004) and 14 to 15 years (p=0.042),and the corpus/cervix ratio was smaller in girls aged 10 to 11 years (p=0.007).US measures were not associated with disease factors in the JIA group.LH and estradiol levels were found to be positively associated with ovarian and uterine size (p<0.001),but negatively correlated with the mean PI of uterine arteries (p<0.01).Table 1. Comparison of abdominal pelvic US findings between control participants and patients with JIA Variables* Patients (n=?44) Control participants (n=?59) p Uterine volume (cm3) 10.5 (2.4–40) 36.6 (8.8–50.9) 0.009 Uterine length (cm) 4.92±1.83 5.91±1.80 0.008 Corpus to cervix ratio (cm) 1.18±0.25 1.36±0.27 0.001 Endometrium (mm) 1.4 (0–5.2) 5.4 (1.4–7.2) 0.016 Left Ovarian Length (cm) 2.60±0.69 3.04±0.84 0.006 Left Ovarian Volume (cm3) 3.3 (1.5–5.2) 5.0 (3.0–7.1) 0.004 Right Ovarian Length (cm) 2.79±0.71 3.17±0.75 0.013 Right Ovarian Volume (cm3) 2.9 (1.5–6.3) 5.9 (3.0–9.1) 0.006 Mean uterine PI 4.6 (2.7–6.5) 2.5 (1.9–5.1) 0.025 PI, pulsatility index. *Described as median (25th-75th percentile) or mean ± standard deviation. Conclusions Pelvic US is a sensitive method for the assessment of sexual maturation in girls,and can identify developmental delays in girls with JIA which may not be detected by Tanner staging. References Pozo J,Argente J.Delayed puberty in chronic illness.Best Pract Res Clin Endocrinol Metab 2002;16:73–90. Holm K,Laursen EM,Brocks V,Muller J.Pubertal maturation of internal genitalia:authors' reply.Ultrasound Obstet Gynecol 1995;6:452–3. Disclosure of Interest None declared