Final adult height of patients with childhood-onset systemic lupus erythematosus: a cross sectional analysis

Heshin‐Bekenstein, Merav; Perl, Liat; Hersh, Aimee O.; Scheven, Emily von; Yelin, Ed; Trupin, Laura; Yazdany, Jinoos; Lawson, Erica

doi:10.1186/s12969-018-0239-8

Cited by 12 publications

(13 citation statements)

References 29 publications

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“…A cross‐sectional study of adults with childhood‐onset SLE demonstrated that patients with childhood‐onset SLE were, on average, 2.4 cm shorter than their target height. The 17 female patients diagnosed with childhood‐onset SLE between age 11 and 13 years had the greatest risk for reduced final height, compared to patients with adult‐onset disease; however, the authors of that study did not report on the relationship between age of diagnosis and menarchal status in individuals (11).…”

Section: Discussionmentioning

confidence: 98%

“…As a result, the timing of childhood‐onset SLE diagnosis may have significant impacts on linear growth and, subsequently, final adult height related to disease activity and medication side‐effects. Few studies have described the final height achieved in patients diagnosed with childhood‐onset SLE (10,11). No prior study has examined the relationship of menarchal status at childhood‐onset SLE diagnosis and final adult height.…”

Section: Introductionmentioning

confidence: 99%

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Timing of Childhood‐Onset Systemic Lupus Erythematosus Diagnosis Relative to Menarche and the Impact on Final Adult Height

Sontichai

Liao

Domínguez

et al. 2022

Arthritis Care & Research

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Objective The aim of this study was to examine the impact of timing of a childhood‐onset systemic lupus erythematosus (SLE) diagnosis relative to menarchal status, on final height, accounting for disease‐associated factors. Methods We conducted a cohort study of female patients age <18 years at childhood‐onset SLE diagnosis, followed at a tertiary care pediatric center from July 1982 to March 2016 and restricted to patients with documented age of menarche and final height. We compared final height between patients diagnosed pre‐ and postmenarche. We tested the association of the timing of childhood‐onset SLE diagnosis with final height, adjusted for ethnicity, in linear regression models. We performed subgroup analyses of patients with growth during follow‐up, additionally adjusting for average daily corticosteroid dose and disease activity. Results Of 401 female childhood‐onset SLE patients in the study, 115 patients (29%) were diagnosed premenarche and 286 (71%) postmenarche. Patients diagnosed premenarche were older at menarche compared with patients diagnosed postmenarche (mean ± SD age 13.5 ± 1.4 versus 12.5 ± 1.3 years; P < 0.001). The mean ± SD final height for girls diagnosed postmenarche (161.4 ± 6.9 cm) was greater than for those diagnosed premenarche (158.8 ± 7.3 cm; P = 0.001). In regression analysis, those diagnosed postmenarche were significantly taller than those diagnosed premenarche, as adjusted for ethnicity and disease severity (mean ± SD β = 2.6 ± 0.7 cm; P = 0.0006). Conclusion In this large cohort study of girls with childhood‐onset SLE, patients diagnosed postmenarche achieved a taller final height than those diagnosed premenarche, even after accounting for ethnicity and disease severity.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Timing of Childhood‐Onset Systemic Lupus Erythematosus Diagnosis Relative to Menarche and the Impact on Final Adult Height

Sontichai

Liao

Domínguez

et al. 2022

Arthritis Care & Research

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“…The detrimental effect of supraphysiologic glucocorticoid treatment on childhood growth is well known and has been described in children treated with steroids for autoimmune conditions [ 37 ] or inflammatory conditions such as asthma [ 38 ]. Adult height in CAH has been an outcome of interest in clinical studies over the years because it reflects the effect of cumulative exposure to both androgens and glucocorticoids.…”

Section: Discussionmentioning

confidence: 99%

Bone Age Maturation and Growth Outcomes in Young Children with CAH Treated with Hydrocortisone Suspension

Al-Rayess

Addo

Palzer

et al. 2021

Journal of the Endocrine Society

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Background Young children with CAH require small doses (0.1-1.25 mg) of hydrocortisone (HC) to control excess androgen production and avoid the negative effects of overtreatment. The smallest commercially available HC formulation, before the recent FDA approval of HC granules, was a scored 5 mg tablet. The options to achieve small doses were limited to using a pharmacy-compounded suspension, which the CAH Clinical Practice Guidelines recommended against, or splitting tablets into quarters or eighths, or dissolving tablets into water. Methods Cross sectional chart review of 130 children with classic CAH treated with tablets versus a pharmacy-compounded alcohol-free hydrocortisone suspension to compare growth, weight, skeletal maturation, total daily HC dose and exposure over the first four years of life. Results No significant differences were found in height, weight, or BMI z-scores at 4 years, and in predicted adult height, before or after adjusting for age at diagnosis and sex. Bone age z-scores averaged 2.8 SDs lower for patients on HC suspension compared to HC tablets (p<0.001) after adjusting for age at diagnosis and sex. The suspension group received 30.4% lower (p>0.001) average cumulative HC doses by their 4th birthday. Conclusions Our data indicates that treatment with alcohol-free HC suspension decreased androgen exposure as shown by lower bone age z-scores, allowed lower average and cumulative daily HC dose compared to HC tablets, and generated no significant differences in SDS in growth parameters in children with CAH at 4 years of age. Longitudinal studies of treating with smaller HC doses during childhood are needed.

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“…In addition, Heshin-Bekenstein et al[ 17 ] have recently revealed the final heights of 72 jSLE patients who entered into adulthood. In that study, patients’ heights were 2.4 cm shorter than their target heights.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of the Factors Affecting Growth Parameters in Turkish Children With Systemic Lupus Erythematosus

et al. 2020

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Objectives: This study aims to investigate the growth parameters in Turkish children with systemic lupus erythematosus (SLE) and to compare these growth parameters according to the presence or absence of cyclophosphamide, rituximab treatment, cumulative corticosteroid dose, proliferative nephritis, and the last visit disease activity and damage index. Patients and methods: Medical data, growth parameters including z-scores for weight, height, and body mass index and parent-adjusted height z-scores of 45 juvenile SLE (jSLE) patients (5 males, 40 females; mean age 12.3±3.2 years; range 7.1 to 18 years) were retrospectively evaluated. Growth parameters were calculated by anthropometric references in Turkish children. The disease activity was assessed by the SLE Disease Activity Index 2000 (SLEDAI-2K). The disease outcome was measured by the Pediatric version of

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Final adult height of patients with childhood-onset systemic lupus erythematosus: a cross sectional analysis

Cited by 12 publications

References 29 publications

Timing of Childhood‐Onset Systemic Lupus Erythematosus Diagnosis Relative to Menarche and the Impact on Final Adult Height

Timing of Childhood‐Onset Systemic Lupus Erythematosus Diagnosis Relative to Menarche and the Impact on Final Adult Height

Bone Age Maturation and Growth Outcomes in Young Children with CAH Treated with Hydrocortisone Suspension

Retrospective Analysis of the Factors Affecting Growth Parameters in Turkish Children With Systemic Lupus Erythematosus

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