Saturday, June 18, 2011

Barriers to Growth in Children with JIA Oligoartikuler

Patients with juvenile idiopathic arthritis (JIA) is non-persistent oligoartikuler very unexpectedly at risk of intrauterine growth (in height). This finding revealed by dr. Padeh Shai and colleagues from the University of Tel Aviv, Israel, published online in the Journal of Pediatrics end of May 2011. "JIA, most common chronic rheumatic disease in children, can cause significant growth retardation due to chronic inflammation or drug side-effects of anti-rheumatic drugs," said dr. Padeh. "Compared with patients suffering from other subtypes of JIA," he added, "patients with JIA oligoartikuler (less than 5 joints affected) have a milder illness that will need fewer drugs and children are expected to grow well." This subtype, which represents about half of reported cases of JIA, can be treated with corticosteroid injection into the joint occurs during exacerbations.

To investigate the possibility of a therapeutic effect on the growth of children, the researchers retrospectively reviewed data 95 pediatric patients who had received cortic
osteroid injections of corticosteroids alone or in combination with disease-modifying antirheumatic drugs (DMARDs). Follow-up done on average for 6 years. When assessing the growth of these children, growth retardation observed in one third of patients, including 11.6% with severe degrees of resistance.

In patients who received a corticosteroid injection alone, growth inhibition occurred in 30.6% of patients, including severe degree of resistance recorded at 6.5% of patients. In patients who received combination therapy, as many as 44.4% of patients experiencing barriers to growth and 21.2% of them with severe degree of growth inhibition. The study is somewhat surprising given previous studies even show that growth retardation is more commonly found in other JIA subtypes and is only found in 11% of JIA patients with oligoartritis.

The research team from Israel was also proved that the increase in erythrocyte sedimentation rate reflects the increased risk of intrauterine growth in a more meaningful; all other clinical variables not associated with intrauterine growth retardation. The researchers eventually concluded that children with JIA oligoartikuler highly at risk of intrauterine growth when not receive adequate therapy. However, these findings require further prospective study to evaluate a number of other aspects, such as additional risk factors, in a longer period of time until the child stops growing in height (in other words, just as the child's adulthood).

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