Growth and bone mineralization in patients with juvenile idiopathic arthritis

Okumus, Ozgur; Ergüven, Müferet; Devecí, Murat; Yılmaz, Öznur; Okumus, Mine

doi:10.1007/s12098-008-0052-3

Cited by 18 publications

(15 citation statements)

References 24 publications

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“…In adult patients previously diagnosed with juvenile idiopathic arthritis (JIA) Aggarwal et al [9] found decreased BMD. These data are confirmed by another study with 30 JIA patients [10] -with mostly patients from the polyarticular group -suffering from low BMD. The authors did not find a statistic significance for disease duration, but BMD and Z score were associated with lower insulin-like growth factor I (IGF-I) levels, maybe as a sign for restricted growth and bone development in these patients.…”

Section: Concerning Juvenile Idiopathic Arthritis -Jiasupporting

confidence: 68%

Quantifying Bone Disease in Pediatric Rheumatic Patients and It’s Problems

Peitz¹,

Fricke²

2012

Rheumatology

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It is well known, that, due to different reasons, children with rheumatic diseases as well as children with other chronic inflammatory diseases suffer from bone disease like osteopenia or osteoporosis. To measure bone mineral density (BMD) or bone mineral content (BMC), Dual X-Ray Absorptiometry (DXA) is used as golden standard. In this review we will show several problems appearing in measuring bone density in children due to multiple reasons, discuss the necessity to have a closer look on bone and muscle as well as on length and bone age on the examined child and end with the few recommendations there are concerning bone disease in pediatric rheumatology patients.

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Section: Concerning Juvenile Idiopathic Arthritis -Jiasupporting

confidence: 68%

Quantifying Bone Disease in Pediatric Rheumatic Patients and It’s Problems

Peitz¹,

Fricke²

2012

Rheumatology

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“…Aggarwal et al [24] found decreased BMD in adult patients previously diagnosed with JIA. Likewise, Okumus et al [25] found lower BMD levels in 30 JIA patients, especially in the polyarticular group. While they did not detect a statistically significant relationship with disease duration, BMD and the Z score were associated with lower insulin-like growth factor I (IGF-I) levels.…”

Section: Discussionmentioning

confidence: 87%

Definitive differences in laboratory and radiological characteristics between two subtypes of juvenile idiopathic arthritis: systemic arthritis and polyarthritis

Ozawa

Inaba

Mori

et al. 2012

Modern Rheumatology

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We performed this study to investigate the differences in radiological and laboratory findings between systemic juvenile idiopathic arthritis (s-JIA) and polyarthritis (p-JIA). Twenty-two patients with s-JIA and 18 with p-JIA were enrolled. Their laboratory findings and radiographs were examined retrospectively. Plain radiographs were obtained before the induction of biological agents. All radiographs were examined for the presence of soft tissue swelling, juxta-articular osteopenia, joint space narrowing, subchondral bone cyst, erosion, epiphyseal irregularity, and growth abnormalities. Carpal length and bone mineral density of the lumbar spine, an indicator of generalized osteoporosis, were also investigated in all the patients enrolled. Laboratory examinations involved white blood cell counts, platelets, C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (CCP) antibody, and matrix metalloproteinase (MMP)-3. Comparisons of the laboratory findings between s-JIA and p-JIA indicated that the titers of anti-CCP antibody and RF were significantly increased in p-JIA sera (P < 0.05). There was no difference in BMD between the two groups of patients. Carpal length was significantly shorter in p-JIA patients than in s-JIA patients (P < 0.05). The most frequent radiological abnormality in s-JIA was juxta-articular osteopenia (93.8%), in comparison to a frequency of 50.0% in p-JIA. Joint space narrowing was shown in 9.8% of the s-JIA patients compared to 35.7% of the p-JIA patients. Subchondral bone cyst and erosion were more frequent in p-JIA than s-JIA. In conclusion, there were differences in radiographic characteristics and laboratory data between s-JIA and p-JIA in this study. In the radiological evaluation, bone-related abnormality was prominent in s-JIA and joint-related abnormality was striking in p-JIA, and these results indicated that the pathogenic bases of arthritis appear to differ between these two subtypes of JIA.

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“…Previously chronic illnesses, such as inflammatory bowel disease [36], type 1 diabetes [37], juvenile idiopathic arthritis [38] and solid organ [39] and bone marrow transplantation [40] in children are associated with vitamin D deficiency. On the other hand, vitamin D deficiency or insufficiency may be a consequence of a chronic illness that affects vitamin D metabolism or absorption, such as biliary atresia and autoimmune hepatitis [41], chronic kidney disease [42], inflammatory bowel disease [36], or cancer [43].…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Deficiency in Children with a Chronic Illness–Seasonal and Age-Related Variations in Serum 25-hydroxy Vitamin D Concentrations

et al. 2013

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IntroductionChildren and adolescents with a chronic illness have potential risk factors for vitamin D deficiency. An optimal vitamin D status might have multiple health effects. This study evaluated vitamin D status and its association with age, gender, and season in a large cohort of chronically ill Finnish patients at a tertiary pediatric outpatient clinic. A cross-sectional register-based study was carried out, involving altogether 1351 children (51% boys, age range 0.2–18 years), who visited the outpatient clinic during 2007–2010 and had their vitamin D status (S-25-OHD) determined. A post-doc analysis was conducted to identify predisposing and preventing factors for vitamin D deficiency.ResultsAlmost half (47%) of the S-25-OHD values were consistent with subnormal vitamin D status (S-25-OHD <50 nmol/L) while only 12% were >80 nmol/L. Age and season were the most important determinants for S-25-OHD concentration. Mean S-25-OHD concentration differed between age groups (Kruskal-Wallis; p<0.001), adolescents being at highest risk for vitamin D insufficiency. Young age and vitamin D supplementation were preventive factors for deficiency, while non-Finnish ethnic background was a predisposing factor. S-25-OHD showed significant seasonal variation in children older than 6 years. In the whole cohort, S-25-OHD was on average 13 nmol/L higher in summer than in winter, and the prevalence of vitamin D deficiency ( = S-25-OHD <37.5 nmol/l) varied from 11% in summer to 29% in winter.ConclusionsThe finding that almost half of the studied Finnish children with a chronic illness had suboptimal vitamin D status is alarming. Inferior vitamin D status was noted in adolescents compared with younger children, suggesting that imbalance between intake and requirement evolves with age. Although less common during summer, subnormal vitamin D status was still observed in 28% of those evaluated in summer. Clinicians should identify individuals at risk and actively recommend vitamin D supplementation.

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Growth and bone mineralization in patients with juvenile idiopathic arthritis

Cited by 18 publications

References 24 publications

Quantifying Bone Disease in Pediatric Rheumatic Patients and It’s Problems

Quantifying Bone Disease in Pediatric Rheumatic Patients and It’s Problems

Definitive differences in laboratory and radiological characteristics between two subtypes of juvenile idiopathic arthritis: systemic arthritis and polyarthritis

Vitamin D Deficiency in Children with a Chronic Illness–Seasonal and Age-Related Variations in Serum 25-hydroxy Vitamin D Concentrations

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