Growth Pattern in Children with Juvenile Idiopathic Arthritis: A Retrospective Study

Abstract

Aim of this study is to assess growth pattern in children with juvenile idiopathic arthritis (JIA) and factors associated with growth retardation. Methods: A retrospective chart review of all cases of JIA following up at Pediatric Department of King Abdulaziz University Hospital, between July 2000 to July 2016. Demographic, clinical and biological data were collected and analyzed as risk factor for growth retardation. These included age, gender, age at diagnosis, disease duration, type of JIA, the presence of uveitis, rheumatoid factor (RF) positivity, antinuclear antibody (ANA) titer and treatment. Growth pattern was assessed as the percentile for height-for-age, weight-for-age and weight-for-height in reference to the Growth Chart for Saudi Children and Adolescents. Change in percentile rank was divided into 3 categories: regression (a drop of ≥1 percentile); stable (uphold of the same percentile); and progression (change for a superior percentile). Results: A total 78 children were eligible, 52.6% females, mean ± SD age = 9.94 ± 4.92 years, and age at diagnosis = 7.44 ± 4.52 years, mean ± SD [range] disease duration = 2.93 ± 2.70 [6 months; 15 years]. The most frequent types of JIA were systemic (33.3%), oligoarticular (30.8%) and polyarticular negative RF (26.9%). Other parameters included positive ANA in 41.0%, positive RF in 7.7% and uveitis in 9.0%. The most frequent treatment was methotrexate (59.0%), followed by biological therapy (47.4%), non-steroid anti-inflammatory drugs (43.6%) and prednisolone (33.3%). Growth data were available for 67 (85.9%) children, and assessments showed 36% cases of break of the growth curve in both height-for-age and weight-for-age percentiles and 31% in weight-for-height percentiles. In all three parameters, there were shifts towards lower percentiles from time of diagnosis to last follow-up, in both males and females. Correlation and regression analysis showed low age at diagnosis and disease duration to be significant predictors for growth retardation severity. Conclusion: One in three children with JIA has growth retardation, the severity of which is predicted by low age at disease onset and long disease duration.

The Epidemiological Profile of Juvenile Idiopathic Arthritis: Single Center Study in Delta Region of Egypt

“…Weight and height showed no signi cant difference between JIA types. Similarly, Alsulami et al 2017 (19) found no difference between different JIA sub-types in any of the growth parameters.…”

Influence of therapy on the development of long-term articular and extra-articular damages in adult patients with juvenile idiopathic arthritis

“…В дослідженні [6,7] проводили оцінку росту дорослих пацієнтів залежно від тривалості прийому ГК. Показано, що тривалість безперервної терапії ГК менше 1 року не впливає на ріст пацієнта в дорослому віці, однак наявність безперервної терапії ГК більше 1 року може призвести до незворотніх змін, однак ці твердження слід трактувати з обережністю, оскільки висновки зроблені базуючись на дослідженні 30 дорослих пацієнтів з ЮРА [8].…”