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.