TY - JOUR
T1 - Growth and Puberty in Juvenile Dermatomyositis
T2 - A Longitudinal Cohort Study
AU - for the Paediatric Rheumatology International Trials Organisation
AU - Nordal, Ellen
AU - Pistorio, Angela
AU - Rygg, Marite
AU - Giancane, Gabriella
AU - Maghnie, Mohamad
AU - Di Iorgi, Natascia
AU - Flemming, Kristina
AU - Hofer, Michael
AU - Melo-Gomes, Jose A.
AU - Bica, Blanca E.R.G.
AU - Brunner, Jurgen
AU - Dannecker, Günther
AU - Gerloni, Valeria
AU - Harjacek, Miroslav
AU - Huppertz, Hans Iko
AU - Pratsidou-Gertsi, Polyxeni
AU - Nielsen, Susan
AU - Stanevicha, Valda
AU - Ten Cate, Rebecca
AU - Vougiouka, Olga
AU - Pastore, Serena
AU - Simonini, Gabriele
AU - Ravelli, Angelo
AU - Martini, Alberto
AU - Ruperto, Nicolino
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Objective: To study growth and puberty in a multinational longitudinal prospective cohort of children with juvenile dermatomyositis (DM). Methods: Children from 31 countries who were ages <18 years and had juvenile DM in active phase were studied, and analyses of height, weight, and pubertal development were conducted in those who had follow-up visits during a 2-year period and for whom anthropometric data was available. Results: A total of 196 of 275 children (71%) were included. We found a significant reduction in parent-adjusted height Z score over time in female patients (P < 0.0001) and male patients (P = 0.001), but with catch-up growth at the final study visit. Median body mass index Z score peaked at 6 months (P < 0.0001) and was still significantly above baseline at the final study visit, which was at a median of 26 months after baseline (P = 0.007), with no difference between sexes. Female patients with a disease duration ≥12 months after onset had significantly lower parent-adjusted height Z score (P = 0.002) and no 2-year catch-up growth. At the final study visit, growth failure was seen in 20 of 97 female patients (21%) and in 11 of 73 male patients (15%). Height deflection (∆height Z score less than –0.25/year) was observed in 29 of 116 female patients (25%) and 25 of 80 male patients (31.3%). Delayed puberty was seen in 20 of 55 female patients (36.4%) and in 11 of 31 male patients (35.5%). Children in early pubertal stage at baseline had the highest risk of growth failure. Conclusion: Juvenile DM in the active phase and/or its treatment has a significant impact on growth and puberty in affected children. Children with recent onset of puberty or previous growth failure have the highest risk of delayed pubertal development and further growth retardation.
AB - Objective: To study growth and puberty in a multinational longitudinal prospective cohort of children with juvenile dermatomyositis (DM). Methods: Children from 31 countries who were ages <18 years and had juvenile DM in active phase were studied, and analyses of height, weight, and pubertal development were conducted in those who had follow-up visits during a 2-year period and for whom anthropometric data was available. Results: A total of 196 of 275 children (71%) were included. We found a significant reduction in parent-adjusted height Z score over time in female patients (P < 0.0001) and male patients (P = 0.001), but with catch-up growth at the final study visit. Median body mass index Z score peaked at 6 months (P < 0.0001) and was still significantly above baseline at the final study visit, which was at a median of 26 months after baseline (P = 0.007), with no difference between sexes. Female patients with a disease duration ≥12 months after onset had significantly lower parent-adjusted height Z score (P = 0.002) and no 2-year catch-up growth. At the final study visit, growth failure was seen in 20 of 97 female patients (21%) and in 11 of 73 male patients (15%). Height deflection (∆height Z score less than –0.25/year) was observed in 29 of 116 female patients (25%) and 25 of 80 male patients (31.3%). Delayed puberty was seen in 20 of 55 female patients (36.4%) and in 11 of 31 male patients (35.5%). Children in early pubertal stage at baseline had the highest risk of growth failure. Conclusion: Juvenile DM in the active phase and/or its treatment has a significant impact on growth and puberty in affected children. Children with recent onset of puberty or previous growth failure have the highest risk of delayed pubertal development and further growth retardation.
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U2 - 10.1002/acr.24065
DO - 10.1002/acr.24065
M3 - Article
C2 - 31507092
AN - SCOPUS:85078416354
VL - 72
SP - 265
EP - 273
JO - Arthritis care and research : the official journal of the Arthritis Health Professions Association
JF - Arthritis care and research : the official journal of the Arthritis Health Professions Association
SN - 0893-7524
IS - 2
ER -