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Pediatr Rheumatol Online J. 2017 Aug 22;15(1):68. doi: 10.1186/s12969-017-0196-7.

Growth and weight gain in children with juvenile idiopathic arthritis: results from the ReACCh-Out cohort.

Author information

1
From British Columbia Children's Hospital and University of British Columbia, Vancouver, Canada. jguzman@cw.bc.ca.
2
Division of Pediatric Rheumatology, BC Children's Hospital, 4500 Oak St, Suite K4-122, Vancouver, BC, V6H 3N1, Canada. jguzman@cw.bc.ca.
3
Division of Pediatric Rheumatology, BC Children's Hospital, 4500 Oak St, Suite K4-122, Vancouver, BC, V6H 3N1, Canada.
4
Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Canada.
5
Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.
6
Royal University Hospital and University of Saskatchewan, Saskatoon, Canada.
7
Hospital for Sick Children and University of Toronto, Toronto, Canada.
8
Centre Hospitalier Universitaire de Sherbrooke and Université de Sherbrooke, Sherbrooke, Canada.
9
From British Columbia Children's Hospital and University of British Columbia, Vancouver, Canada.
10
Janeway Children's Health and Rehabilitation Centre and Memorial University, Saint John, 's, Canada.
11
McGill University Health Centre and McGill University, Montreal, Canada.
12
IWK Health Centre and Dalhousie University, Halifax, Canada.
13
Shands Children's Hospital and University of Florida, Gainesville, USA.
14
London Health Sciences Centre and Western University, London, Canada.
15
Alberta Children's Hospital and University of Calgary, Calgary, Canada.
16
McMaster University, Hamilton, Canada.
17
Centre Hospitalier Universitaire de Laval and Université Laval, Quebec, Canada.
18
Centre Hospitalier Universitaire Ste. Justine and Université de Montréal, Montréal, Canada.
19
Stollery Children's Hospital and University of Alberta, Edmonton, Canada.
20
Department of Pediatrics University of British Columbia, Vancouver, Canada.
21
Université de Montréal, Montréal, Canada.

Abstract

BACKGROUND:

With modern treatments, the effect of juvenile idiopathic arthritis (JIA) on growth may be less than previously reported. Our objective was to describe height, weight and body mass index (BMI) development in a contemporary JIA inception cohort.

METHODS:

Canadian children newly-diagnosed with JIA 2005-2010 had weight and height measurements every 6 months for 2 years, then yearly up to 5 years. These measurements were used to calculate mean age- and sex-standardized Z-scores, and estimate prevalence and cumulative incidence of growth impairments, and the impact of disease activity and corticosteroids on growth.

RESULTS:

One thousand one hundred forty seven children were followed for median 35.5 months. Mean Z-scores, and the point prevalence of short stature (height < 2.5th percentile, 2.5% to 3.4%) and obesity (BMI > 95th percentile, 15.8% to 16.4%) remained unchanged in the whole cohort. Thirty-three children (2.9%) developed new-onset short stature, while 27 (2.4%) developed tall stature (>97.5th percentile). Children with systemic arthritis (n = 77) had an estimated 3-year cumulative incidence of 9.3% (95%CI: 4.3-19.7) for new-onset short stature and 34.4% (23-49.4) for obesity. Most children (81.7%) received no systemic corticosteroids, but 1 mg/Kg/day prednisone-equivalent maintained for 6 months corresponded to a drop of 0.64 height Z-scores (0.56-0.82) and an increase of 0.74 BMI Z-scores (0.56-0.92). An increase of 1 in the 10-cm physician global assessment of disease activity maintained for 6 months corresponded to a drop of 0.01 height Z-scores (0-0.02).

CONCLUSIONS:

Most children in this modern JIA cohort grew and gained weight as children in the general population. About 1 in 10 children who had systemic arthritis, uncontrolled disease and/or prolonged corticosteroid use, had increased risk of growth impairment.

KEYWORDS:

Corticosteroids; Growth; Juvenile arthritis; Obesity

PMID:
28830457
PMCID:
PMC5567720
DOI:
10.1186/s12969-017-0196-7
[Indexed for MEDLINE]
Free PMC Article

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