Pubertal abnormalities in adolescents with chronic disease

Kao, Kung‐Ting; Denker, M.; Zacharin, Margaret; Wong, Sze Choong

doi:10.1016/j.beem.2019.04.009

Cited by 34 publications

(29 citation statements)

References 114 publications

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“…In addition, one study reported that the cellular immune response plays a significant role during HBV and HCV infections, which may result in abnormal ovarian function( Kurmanova, 2016 ). In addition, the treatment process affects the female hypothalamic-gonadal-axis( Kao, et al, 2019 ).The glucocorticoids treatments might be used in some cases, and their effect on the reproductive and endocrine system in women of child-bearing age is not yet known. Currently, there are no clinical data on the impact of COVID-19 on the ovarian function of women of child-bearing age.…”

Section: Introductionmentioning

confidence: 99%

Analysis of sex hormones and menstruation in COVID-19 women of child-bearing age

Chen

Hou

et al. 2021

Reproductive BioMedicine Online

271

259

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Research question Whether SARS-CoV-2 infection has effects on ovarian reserve, sex hormone and menstruation of women of child-bearing age. Design This is a retrospective, cross-sectional study. Clinical and laboratory data from 237 women of child-bearing age diagnosed with COVID-19 were retrospectively reviewed. Menstrual data from 177 patients were analyzed. Blood samples from the early follicular phase were tested for sex hormones and Anti-mullerian hormone (AMH). Results Among 237 patients confirmed with COVID-19, severely ill patients had more comorbidities than mildly ill patients (34% vs 8%), especially for patients with diabetes, hepatic disease and malignant tumors. Among 177 patients with menstrual records, 45 (25%) patients presented with menstrual volume changes, and 50 (28%) patients had menstrual cycle changes, mainly a decreased volume (21%) and a prolonged cycle (19%). The average sex hormone and AMH levels of women of child-bearing age with COVID-19 were not different from those of age-matched controls. Conclusions Average sex hormone levels and ovarian reserve did not change significantly in COVID-19 women of child-bearing age. Nearly one-fifth of patients exhibited a menstrual volume decrease or cycle prolongation. The menstruation changes of these patients might be the consequence of transient sex hormone change cause by suppression of ovarian function that soon resumed after recovery.

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Section: Introductionmentioning

confidence: 99%

Analysis of sex hormones and menstruation in COVID-19 women of child-bearing age

Chen

Hou

et al. 2021

Reproductive BioMedicine Online

271

259

View full text Add to dashboard Cite

show abstract

“…However, it is clear that many exogenous and endogenous factors (nutrition, genes, inflammatory status, endocrine-disruptor agents or societal changes) can influence the pubertal neuroendocrine events [55]. The evident plasticity of puberty timing and the importance of environmental factors allows adaptive changes that represent at the same time a limit and a resource for adolescent growth and health [56]. The activation and the progression of puberty are strong surrogate markers of adolescents' physical and mental health and this condition has obvious consequences in children with chronic diseases [56,57].…”

Section: Puberty and Jiamentioning

confidence: 99%

“…The evident plasticity of puberty timing and the importance of environmental factors allows adaptive changes that represent at the same time a limit and a resource for adolescent growth and health [56]. The activation and the progression of puberty are strong surrogate markers of adolescents' physical and mental health and this condition has obvious consequences in children with chronic diseases [56,57]. Indeed, pubertal disorders in children with JIA, like in those with other inflammatory diseases, are frequently found, especially if they have prepubertal onset of disease and severe and prolonged chronic inflammatory course (sJIA) [58][59][60].…”

Section: Puberty and Jiamentioning

confidence: 99%

“…The most frequent pubertal abnormality described in these patients is delayed puberty, defined as the absence of testis enlargement or breast development at an age that is 2-2.5 SD later than the population mean (Tanner stage G2 in boys after the age of 14 years and B2 stage in girls after the age of 13 years in most Western countries) [61]. Slow clinical progression of puberty, isolated delayed menarche in females and decrease duration and intensity of puberty growth have also been reported [56]. However, few studies evaluating the prevalence of pubertal disorders, specifically in children with JIA, are available in the literature.…”

Section: Puberty and Jiamentioning

confidence: 99%

“…Abnormalities in puberty may compromise the achievement of peak bone mass (PBM), lean mass and linear growth and may also lead to a psychosocial distress with lower quality of life in some of these adolescents. For these reasons, the assessment of pubertal status needs to be incorporated into the routine evaluation of adolescents with JIA [56,64].…”

Section: Puberty and Jiamentioning

confidence: 99%

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Growth and puberty in children with juvenile idiopathic arthritis

et al. 2021

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Juvenile Idiopathic Arthritis is one of the most prevalent chronic diseases in children, with an annual incidence of 2–20 cases per 100,000 and a prevalence of 16–150 per 100,000. It is associated with several complications that can cause short-term or long-term disability and reduce the quality of life. Among these, growth and pubertal disorders play an important role. Chronic inflammatory conditions are often associated with growth failure ranging from slight decrease in height velocity to severe forms of short stature. The prevalence of short stature in JIA varies from 10.4% in children with polyarticular disease to 41% of patients with the systemic form, while oligoarthritis is mostly associated with localized excessive bone growth of the affected limb, leading to limb dissymmetry. The pathogenesis of growth disorders is multifactorial and includes the role of chronic inflammation, long-term use of corticosteroids, undernutrition, altered body composition, delay of pubertal onset or slow pubertal progression. These factors can exert a systemic effect on the GH/IGF-1 axis and on the GnRH-gonadotropin-gonadic axis, or a local influence on the growth plate homeostasis and function. Although new therapeutic options are available to control inflammation, there are still 10–20% of patients with severe forms of the disease who show continuous growth impairment, ending in a short final stature. Moreover, delayed puberty is associated with a reduction in the peak bone mass with the possibility of concomitant or future bone fragility. Monitoring of puberty and bone health is essential for a complete health assessment of adolescents with JIA. In these patients, an assessment of the pubertal stage every 6 months from the age of 9 years is recommended. Also, linear growth should be always evaluated considering the patient’s bone age. The impact of rhGH therapy in children with JIA is still unclear, but it has been shown that if rhGH is added at high dose in a low-inflammatory condition, post steroids and on biologic therapy, it is able to favor a prepubertal growth acceleration, comparable with the catch-up growth response in GH-deficient patients. Here we provide a comprehensive review of the pathogenesis of puberty and growth disorders in children with JIA, which can help the pediatrician to properly and timely assess the presence of growth and pubertal disorders in JIA patients.

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Delayed menarche in girls with chronic kidney disease and the association with short stature

Kim

Matheson

et al. 2020

Pediatr Nephrol

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Pubertal abnormalities in adolescents with chronic disease

Cited by 34 publications

References 114 publications

Analysis of sex hormones and menstruation in COVID-19 women of child-bearing age

Analysis of sex hormones and menstruation in COVID-19 women of child-bearing age

Growth and puberty in children with juvenile idiopathic arthritis

Delayed menarche in girls with chronic kidney disease and the association with short stature

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