Longitudinal growth patterns and final height in childhood-onset systemic lupus erythematosus

Jongvilaikasem, Pondtip; Rianthavorn, Pornpimol

doi:10.1007/s00431-020-03910-2

Cited by 13 publications

(10 citation statements)

References 41 publications

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“…Similar observations were made Heshin-Bekenstein et al, who observed a shorter than expected nal adult height in a US based cohort with SLE and concluded that onset of SLE in the pubertal period may have a signi cant impact on nal adult height (14). A signi cant loss of growth potential among SLE patients has also been observed in other studies (17,25). In a previous study, the prevalence of growth failure in SLE females with disease onset before the age of 12 was 22% compared to a prevalence of 3.3% in females with disease onset after 12 years of age (16).…”

Section: Discussionsupporting

confidence: 83%

“…On the contrary, no signi cant association between age at diagnosis and height attainments of SLE girls representing present study could be observed. Pondtip et al (17), reported that children who are short statured at diagnosis are at higher risk of greater growth failure; however, due to non-availability of data related to recorded height at diagnosis for our SLE girls, we cannot conclude the same from our study.…”

Section: Discussioncontrasting

confidence: 53%

“…Despite being a major manifestation, growth and pubertal development in systemic lupus erythematosus, are not well studied 13 and still remains an under-researched area. There are only a few reports from the west suggesting compromised physical growth (12)(13)(14)(15)(16)(17) as well as delayed pubertal attainments (11,15,16,18) among children and adolescents with SLE. There hasn't even been a single study so far that documents the auxological pattern in Indian SLE children.…”

Section: Introductionmentioning

confidence: 99%

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Pattern of Physical Growth and Pubertal Changes in Adolescent Girls with Systemic Lupus Erthythematosus

Nori,

kaur,

Singh

et al. 2023

Preprint

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Background To study the pattern of physical growth and pubertal changes in adolescent girls with Systemic Lupus Erythematosus (SLE). Methods Weight, height, BMI, waist and hip circumference among 50 adolescent SLE girls (aged 8-17years), was cross-sectionally studied using standardised techniques and instruments. Breast development stage, presence or absence of pubic and axillary hair and age of attainment of menarche were also noted. Results With advancement of age, mean weight and height of SLE girls increased but they were lighter and shorter compared to normal Indian peers. 18.4% of study girls were short-statured while, only 1 participant was underweight. As per mid-parental height, 34.3% were predicted to have shorter final heights. BMI demonstrated an inconsistent trend with 12.3% and 9.2% being obese and overweight, respectively. Interestingly, 10.7% of SLE girls were at risk of metabolic syndrome (waist circumference > 70th centile). About 50% of study girls had attained menarche (mean age: 13.04 ± 1.38years). Appearance of pubic and axillary hair occurred around 1 year later than attainment of menarche. 33.80% of study subjects were in prepubertal stage of breast development and rest 66.20% were in advanced stages of breast development. SLE girls who had younger age at diagnosis and longer duration of therapy had significant delay in breast development and attainment of menarche. Conclusions SLE girls show delayed growth and pubertal attainments compared to their normal Indian and western counterparts. The data presented will provide understanding of the auxological dynamics and pattern of pubertal changes among adolescent girls with SLE living in north-western India.

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Section: Discussionsupporting

confidence: 83%

Section: Discussioncontrasting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

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Pattern of Physical Growth and Pubertal Changes in Adolescent Girls with Systemic Lupus Erthythematosus

Nori,

kaur,

Singh

et al. 2023

Preprint

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“…Dosages of GC ≥ 7.5 mg/day were associated with cataract, osteoporotic fractures, and cardiovascular damage in SLE patients [141]. Furthermore, the glucocorticoid effect on chondrocytes and the hypothalamic-pituitary-gonadal axis interferes in the developmental stage of adolescence and impacts final height and puberty [142][143][144]. In a retrospective cohort of 97 cSLE patients, 23% of the participants were classified as having short final height and they had a higher cumulative corticosteroid dose compared with those with normal final height [143].…”

Section: Immunomodulation and Immunosuppressionmentioning

confidence: 99%

“…Furthermore, the glucocorticoid effect on chondrocytes and the hypothalamic-pituitary-gonadal axis interferes in the developmental stage of adolescence and impacts final height and puberty [142][143][144]. In a retrospective cohort of 97 cSLE patients, 23% of the participants were classified as having short final height and they had a higher cumulative corticosteroid dose compared with those with normal final height [143]. Rygg et al showed that delayed pubertal onset was observed in 15.3% of females with cSLE and 24% of males [144].…”

Section: Immunomodulation and Immunosuppressionmentioning

confidence: 99%

An Update on the Management of Childhood-Onset Systemic Lupus Erythematosus

et al. 2021

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Childhood-onset systemic lupus erythematosus (cSLE) is a prototype of a multisystemic, inflammatory, heterogeneous autoimmune condition. This disease is characterized by simultaneous or sequential organ and system involvement, with unpredictable flare and high levels of morbidity and mortality. Racial/ethnic background, socioeconomic status, cost of medications, difficulty accessing health care, and poor adherence seem to impact lupus outcomes and treatment response. In this article, the management of cSLE patients is updated. Regarding pathogenesis, a number of potential targets for drugs have been studied. However, most treatments in pediatric patients are off-label drugs with recommendations based on inadequately powered studies, therapeutic consensus guidelines, or case series. Management practices for cSLE patients include evaluations of disease activity and cumulative damage scores, routine non-live vaccinations, physical activity, and addressing mental health issues. Antimalarials and glucocorticoids are still the most common drugs used to treat cSLE, and hydroxychloroquine is recommended for nearly all cSLE patients. Disease-modifying antirheumatic drugs (DMARDs) should be standardized for each patient, based on disease flare and cSLE severity. Mycophenolate mofetil or intravenous cyclophosphamide is suggested as induction therapy for lupus nephritis classes III and IV. Calcineurin inhibitors (cyclosporine, tacrolimus, voclosporin) appear to be another good option for cSLE patients with lupus nephritis. Regarding B-cell-targeting biologic agents, rituximab may be used for refractory lupus nephritis patients in combination with another DMARD, and belimumab was recently approved by the US Food and Drug Administration for cSLE treatment in children aged > 5 years. New therapies targeting CD20, such as atacicept and telitacicept, seem to be promising drugs for SLE patients. Anti-interferon therapies (sifalimumab and anifrolumab) have shown beneficial results in phase II randomized control trials in adult SLE patients, as have some Janus kinase inhibitors, and these could be alternative treatments for pediatric patients with severe interferon-mediated inflammatory disease in the future. In addition, strict control of proteinuria and blood pressure is required in cSLE, especially with angiotensin-converting enzyme inhibitor and angiotensin receptor blocker use.

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