Growth failure in children with systemic juvenile idiopathic arthritis and prolonged inflammation despite treatment with biologicals: Late normalization of height by combined hormonal therapies
Hormone Research in Paediatrics Jul 01, 2018
de Zegher F, et al. - Considering an extremely short stature for age, related to supra-physiological glucocorticoid doses administered to the systemic juvenile idiopathic arthritis (sJIA) children receiving biologicals for alleviating the inflammatory activity, researchers sought to provide long-term (up to 10 years) results regarding normalization of the adult height of these sJIA children. This work provided proof-of-concept evidence suggesting a possible achievement of normalization of adult stature and adipose body composition of short sJIA children with a hormonal combination strategy: (i) pubertal onset is postponed with a gonadotropin-releasing hormone analog (triptorelin) until a minimum height is reached, or until prepubertal growth is exhausted, and (ii) height gain is promoted with growth hormone (≈50 μg/kg/day), once inflammation is under control and high glucocorticoid doses are no longer needed. This strategy was suggested leading consistently – albeit late – to a normal adult stature.
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