J J Liem1, A M Rosenberg. 1. Section of Rheumatology, Department of Pediatrics, University of Saskatchewan, Saskatoon, Canada.
Abstract
OBJECTIVE: To define patterns of growth in juvenile rheumatoid arthritis (JRA) and to evaluate possible associated clinical and laboratory correlates. METHODS: The study population comprised 67 children with JRA who had been followed for 5 years or longer and whose follow-up period did not extend beyond 18 years of age. Height and weight z scores were calculated with reference to age-related standards for each of the annual follow-up intervals and correlated with JRA subtype, the presence of rheumatoid factor (RF), the erythrocyte sedimentation rate (ESR), alkaline phosphatase level (ALP) and medication history. RESULTS: Initial height-for-age (HAZ) scores for pauciarticular, polyarticular and systemic JRA onset groups (PaJRA, PoJRA and SJRA respectively) were +0.27, -0.07 and +0.40 respectively. A significantly lower HAZ score in the SJRA population compared to the PaJIA population first became apparent at year 2 and the difference was maintained throughout the 9-year follow-up period. A significantly lower HAZ score in the SJRA population compared to the PoJRA population first became apparent at year 6 and the difference was maintained until the ninth year. During the 9-year follow-up period, RF-positive children tended to have negative HAZ scores whereas RF-negative children tended to have positive HAZ scores. The SJRA onset group displayed significantly lower HAZ scores, as compared to the HAZ score at onset, for 7 of the 9 subsequent follow-up intervals. Only 2 patients had heights < 2SD below the mean at final determination. Delay in generalized linear growth occurred predominantly in the SJRA population and to a lesser degree in those with PoJRA associated with RF positivity. CONCLUSIONS: Delay in linear growth occurs in some children with JRA. Patients with pauciarticular and RF-negative polyarticular disease can have growth patterns similar to normal children. Children with RF-positive polyarticular and systemic JRA have more significant growth retardation that occasionally can be sustained and extreme.
OBJECTIVE: To define patterns of growth in juvenile rheumatoid arthritis (JRA) and to evaluate possible associated clinical and laboratory correlates. METHODS: The study population comprised 67 children with JRA who had been followed for 5 years or longer and whose follow-up period did not extend beyond 18 years of age. Height and weight z scores were calculated with reference to age-related standards for each of the annual follow-up intervals and correlated with JRA subtype, the presence of rheumatoid factor (RF), the erythrocyte sedimentation rate (ESR), alkaline phosphatase level (ALP) and medication history. RESULTS: Initial height-for-age (HAZ) scores for pauciarticular, polyarticular and systemic JRA onset groups (PaJRA, PoJRA and SJRA respectively) were +0.27, -0.07 and +0.40 respectively. A significantly lower HAZ score in the SJRA population compared to the PaJIA population first became apparent at year 2 and the difference was maintained throughout the 9-year follow-up period. A significantly lower HAZ score in the SJRA population compared to the PoJRA population first became apparent at year 6 and the difference was maintained until the ninth year. During the 9-year follow-up period, RF-positive children tended to have negative HAZ scores whereas RF-negative children tended to have positive HAZ scores. The SJRA onset group displayed significantly lower HAZ scores, as compared to the HAZ score at onset, for 7 of the 9 subsequent follow-up intervals. Only 2 patients had heights < 2SD below the mean at final determination. Delay in generalized linear growth occurred predominantly in the SJRA population and to a lesser degree in those with PoJRA associated with RF positivity. CONCLUSIONS: Delay in linear growth occurs in some children with JRA. Patients with pauciarticular and RF-negative polyarticular disease can have growth patterns similar to normal children. Children with RF-positive polyarticular and systemic JRA have more significant growth retardation that occasionally can be sustained and extreme.
Authors: Jaime Guzman; Tristan Kerr; Leanne M Ward; Jinhui Ma; Kiem Oen; Alan M Rosenberg; Brian M Feldman; Gilles Boire; Kristin Houghton; Paul Dancey; Rosie Scuccimarri; Alessandra Bruns; Adam M Huber; Karen Watanabe Duffy; Natalie J Shiff; Roberta A Berard; Deborah M Levy; Elizabeth Stringer; Kimberly Morishita; Nicole Johnson; David A Cabral; Maggie Larché; Ross E Petty; Ronald M Laxer; Earl Silverman; Paivi Miettunen; Anne-Laure Chetaille; Elie Haddad; Lynn Spiegel; Stuart E Turvey; Heinrike Schmeling; Bianca Lang; Janet Ellsworth; Suzanne E Ramsey; Johannes Roth; Sarah Campillo; Susanne Benseler; Gaëlle Chédeville; Rayfel Schneider; Shirley M L Tse; Roxana Bolaria; Katherine Gross; Debbie Feldman; Bonnie Cameron; Roman Jurencak; Jean Dorval; Claire LeBlanc; Claire St Cyr; Michele Gibbon; Rae S M Yeung; Ciarán M Duffy; Lori B Tucker Journal: Pediatr Rheumatol Online J Date: 2017-08-22 Impact factor: 3.054
Authors: Anna-Carin Lundell; Malin Erlandsson; Maria Bokarewa; Hille Liivamägi; Karin Uibo; Sirje Tarraste; Tiina Rebane; Tiina Talvik; Chris Pruunsild; Rille Pullerits Journal: J Immunol Res Date: 2018-11-28 Impact factor: 4.818
Authors: Vilma Pinchi; Ilenia Bianchi; Francesco Pradella; Giulia Vitale; Martina Focardi; Ingrid Tonni; Luigi Ferrante; Andrea Bucci Journal: Int J Legal Med Date: 2020-08-20 Impact factor: 2.686
Authors: Flora McErlane; Roberto Carrasco; Lianne Kearsley-Fleet; Eileen M Baildam; Lucy R Wedderburn; Helen E Foster; Yiannis Ioannou; S E Alice Chieng; Joyce E Davidson; Wendy Thomson; Kimme L Hyrich Journal: Semin Arthritis Rheum Date: 2017-11-07 Impact factor: 5.532