Bechtold Susanne, Simon Dominique
Division of Pediatric Endocrinology and Diabetology, University Children's Hospital, Munich, Germany,
Rheumatol Int. 2014 Nov;34(11):1483-8. doi: 10.1007/s00296-014-3022-2. Epub 2014 Apr 24.
In patients with juvenile idiopathic arthritis (JIA) growth impairment and variance in body composition are well-known long-term complications. In the active phases of the disease, particular patients with systemic and polyarticular JIA reveal growth impairment. Some experience "catch-up" growth following reduction in disease activity and lower glucocorticoid doses. Although new therapeutic options are available, there are still 10-20 % of patients with severe forms of the disease who show continuous growth disturbance. Only few studies have specifically addressed body composition in JIA. Bone mass deficits in part could be related to the deficits of muscle mass. Study data on growth hormone treatment in short children with JIA are promising in respect of growth development, final height and body composition. The major goal for physicians is optimal disease control while maintaining normal growth and body composition. Early recognition of patients who develop prolonged growth and body composition disturbances is important as these abnormalities contribute to long-term morbidity and need to be addressed both diagnostically and therapeutically.
在幼年特发性关节炎（JIA）患者中，生长发育受损和身体成分差异是众所周知的长期并发症。在疾病的活动期，尤其是全身型和多关节型JIA患者会出现生长发育受损。一些患者在疾病活动度降低和糖皮质激素剂量减少后会经历“追赶”生长。尽管有新的治疗选择，但仍有10%-20%的重症患者存在持续的生长发育障碍。仅有少数研究专门探讨了JIA患者的身体成分。骨量不足部分可能与肌肉量不足有关。关于生长激素治疗JIA矮小儿童的研究数据在生长发育、最终身高和身体成分方面很有前景。医生的主要目标是在维持正常生长和身体成分的同时实现最佳疾病控制。早期识别出现生长发育和身体成分长期紊乱的患者很重要，因为这些异常会导致长期发病，需要从诊断和治疗两方面加以解决。
