Longitudinal Growth in Rheumatologic Conditions: Current and Emerging Treatments of Growth Delay in Children with Chronic Autoimmune Diseases

Abstract

Chronic rheumatologic, inflammatory diseases of childhood, such as juvenile idiopathic arthritis (JIA), Crohn's disease (CD), and systemic lupus erythematosus (SLE), affect both trabecular bone formation and remodeling and longitudinal bone growth resulting in short stature and causing bone developmental deformities. Inflammation alone or together with poor nutritional intake and chronic glucocorticoid therapy are major factors in growth retardation seen in children with chronic inflammatory diseases. When the growing process is continuous, acute or chronic inflammation causes dysregulation of both central endocrine and local paracrine secretion of the growth factors and hormones, impairing bone growth in children. In this chapter, we review major growth factors such as growth hormone that affect longitudinal growth and how they are affected by inflammation in childhood rheumatologic diseases. We also review a recently described growth factor, CNP, and its potential therapeutic role in chronic inflammatory diseases.