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Pubertal Development in Patients with Juvenile Idiopathic Arthritis

Year 2019, Volume: 24 Issue: 1, 53 - 58, 30.01.2019
https://doi.org/10.21673/anadoluklin.420547

Abstract

Aim

It is a known fact that pubertal development is negatively affected in patients with chronic diseases. In this study, we aimed to investigate the effects of juvenile idiopathic arthritis (JIA), the most common chronic rheumatic disease of childhood, on pubertal development.

Materials and Methods

A total of 72 children (42 girls, 30 boys) diagnosed with JIA according to the International League of Associations for Rheumatology diagnostic criteria were included. Pubertal development was assessed by the Tanner–Marshall method. Breast development in girls (thelarche stage 1–5) and testis volume in boys (genital stage 1–5) were assessed. The Tanner stages of the patients were compared with the pubertal development averages of healthy Turkish children reported previously.

Results

The mean patient age was 13.8±3.3 years. The girls’ mean age at puberty onset and menarcheal age were found to be 10.87±1.22 and 12.83±1.05 years, respectively. They did not differ from healthy Turkish girls in terms of puberty onset age and menarcheal age (p=0.07) and from their own mothers in terms of menarcheal age (p=0.66); however, their completion of puberty was delayed (p=0.001). The boys’ mean age at puberty onset was 13.8±2.2 years, and we found that both onset and completion of puberty were delayed (p=0.001; p=0.003, respectively). The rate of delayed puberty in all patients was found to be 4.1%.

Discussion and Conclusion: We found that completion of puberty was delayed in girls with JIA, although puberty onset age and menarcheal age were not affected, and that both onset and completion of puberty were delayed in boys with JIA. 

References

  • Cassidy JT, Petty RE. juvenile rheumatoid arthritis. In: Cassidy JT, Petty RE (eds) Textbook of Pediatric Rheumatology. Elsevier Saunders Company, Fifth edition 2005:206-260.
  • 2. Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J, He X, Maldonado-Cocco J, Orozco-Alcala J, Prieur AM, Suarez-Almazor ME, Woo P; International League of Associations for Rheumatology. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004;31(2):390-2. 3. Marshall WA, Tanner J.M. Variations in the pattern of pubertal changes in boys. Arch Dis Child. 1970;45:13-23. 4. Marshall WA, Tanner J.M. Variations in the pattern of pubertal changes in girls. Arch Dis Child. 1969; 44: 291-303 5. Simon D. Puberty in chronically diseased patients. Horm. Research 2002; 57 : 53-56. 6. Pozo J. Delayed puberty in chronic illness. Best Practice & Research Clinical Endocrinol. And Metabolism 2002; 16: 73-90. 7. Fraser PA, Hoch S, Erlandsob D, Partridge R, Jackson JM. The timing of menarche in Juvenile rheumatoid arthritis. J Adolescence Health Care 1988; 9: 483-487. 8. Rusconi R, Corona F, Grassi A. Age at menarche in juvenile rheumatoid artritis. J Pediatr Endocrinol 2003; 16: 285-88 9. Umławska W, Prusek-Dudkiewicz A. Growth retardation and delayed puberty in children and adolescents with juvenile idiopathic arthritis. Arch Med Sci. 2010; 6(1):19-23. 10. El Badri D, Rostom S, Bouaddi I, Hassani A, Chkirate B, Amine B, Hajjaj-Hassouni N. Sexual maturation in Moroccan patients with juvenile idiopathic arthritis. Rheumatol Int. 2014;34(5):665-8.11. Aggarwal B, Bhalla AK, Singh S. Sexual maturation in boys with juvenile rheumatoid arthritis. Rheumatol Int. 2011;31(11):1419-21. 12. Maher SE, Ali FI.Sexual maturation in Egyptian boys and girls with juvenile rheumatoid arthritis. Rheumatol Int. 2013;33(8):2123-6 13. Cole TJ, Bellini MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000; 320: 1240-1243. 14. Semiz S, Kurt F. Pubertal Development of Turkish children. J Pediatr Endocrinol. 2008; 21: 951-961. 15. Ostensen M, Almberg K, Koksvik HS.Sex, reproduction, and gynecological disease in young adults with a history of juvenile chronic arthritis. J Rheumatol. 2000;27(7):1783-7.16. Umławska W, Krzyzanowska M. Growth and menarche during remission in children with juvenile idiopathic arthritis. Med Wieku Rozwoj. 2009;13(3):194-20 17. Roche AF, Wellens R, Attie KM. The timing of sexual maturation in agroup of U.S. white youths. J Pediatr Endocrinol. 1995; 8: 11-15.

Jüvenil İdiyopatik Artritli Hastalarda Pubertal Gelişim

Year 2019, Volume: 24 Issue: 1, 53 - 58, 30.01.2019
https://doi.org/10.21673/anadoluklin.420547

Abstract

Amaç: Kronik hastalıklarda puberte gelişiminin olumsuz etkilendiği bilinmektedir. Bu çalışmada çocukluk çağının en yaygın kronik romatolojik hastalığı olan jüvenil idiyopatik artritin (JİA) puberte gelişimine olan etkilerini araştırmak amaçlanmıştır.

Gereç ve Yöntemler: Çalışmamıza International League of Associations for Rheumatology tanı kriterlerine göre JİA tanısı almış 72 (42 kız, 30 erkek) çocuk dahil edildi. Pubertal gelişim Tanner–Marshall metoduyla değerlendirildi. Kızlarda göğüs gelişimi (telarş evre 1–5), erkeklerde testis hacmi (genital evre 1–5) değerlendirildi. Hastaların Tanner evreleri sağlıklı Türk çocuklarının önceden bildirilmiş pubertal gelişim ortalamaları ile karşılaştırıldı.

Bulgular: Hastaların yaş ortalaması 13,8±3,3 yıl idi. JİA’lı kızlarda puberte başlangıç yaşı 10,87±1,22, menarş yaşı ise 12,83±1,05 yıl olarak saptandı. Kızların puberte başlangıç ve menarş yaşı sağlıklı Türk kızlarınınkinden (p=0,07) ve menarş yaşı kendi annelerinin menarş yaşından (p=0,66) farklı değildi; fakat pubertenin tamamlanmasının geciktiği saptandı (p=0,001). Erkek çocuklarda ise puberte başlangıç yaşı 13,8±2,2 yıl idi ve pubertenin başlamasının ve tamamlanmasının geciktiği tespit edildi (sırasıyla p=0,001; p=0,003). Tüm hastalarda geç puberte oranı %4,1 olarak saptandı.

Tartışma ve Sonuç: JİA’lı kızlarda puberte başlangıç yaşı ve menarş yaşı etkilenmemekle birlikte pubertenin tamamlanmasının geciktiği, JİA’lı erkek çocuklarda ise hem puberte başlangıcının geciktiği hem de pubertenin tamamlanma süresinin uzadığı saptanmıştır.

References

  • Cassidy JT, Petty RE. juvenile rheumatoid arthritis. In: Cassidy JT, Petty RE (eds) Textbook of Pediatric Rheumatology. Elsevier Saunders Company, Fifth edition 2005:206-260.
  • 2. Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J, He X, Maldonado-Cocco J, Orozco-Alcala J, Prieur AM, Suarez-Almazor ME, Woo P; International League of Associations for Rheumatology. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004;31(2):390-2. 3. Marshall WA, Tanner J.M. Variations in the pattern of pubertal changes in boys. Arch Dis Child. 1970;45:13-23. 4. Marshall WA, Tanner J.M. Variations in the pattern of pubertal changes in girls. Arch Dis Child. 1969; 44: 291-303 5. Simon D. Puberty in chronically diseased patients. Horm. Research 2002; 57 : 53-56. 6. Pozo J. Delayed puberty in chronic illness. Best Practice & Research Clinical Endocrinol. And Metabolism 2002; 16: 73-90. 7. Fraser PA, Hoch S, Erlandsob D, Partridge R, Jackson JM. The timing of menarche in Juvenile rheumatoid arthritis. J Adolescence Health Care 1988; 9: 483-487. 8. Rusconi R, Corona F, Grassi A. Age at menarche in juvenile rheumatoid artritis. J Pediatr Endocrinol 2003; 16: 285-88 9. Umławska W, Prusek-Dudkiewicz A. Growth retardation and delayed puberty in children and adolescents with juvenile idiopathic arthritis. Arch Med Sci. 2010; 6(1):19-23. 10. El Badri D, Rostom S, Bouaddi I, Hassani A, Chkirate B, Amine B, Hajjaj-Hassouni N. Sexual maturation in Moroccan patients with juvenile idiopathic arthritis. Rheumatol Int. 2014;34(5):665-8.11. Aggarwal B, Bhalla AK, Singh S. Sexual maturation in boys with juvenile rheumatoid arthritis. Rheumatol Int. 2011;31(11):1419-21. 12. Maher SE, Ali FI.Sexual maturation in Egyptian boys and girls with juvenile rheumatoid arthritis. Rheumatol Int. 2013;33(8):2123-6 13. Cole TJ, Bellini MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000; 320: 1240-1243. 14. Semiz S, Kurt F. Pubertal Development of Turkish children. J Pediatr Endocrinol. 2008; 21: 951-961. 15. Ostensen M, Almberg K, Koksvik HS.Sex, reproduction, and gynecological disease in young adults with a history of juvenile chronic arthritis. J Rheumatol. 2000;27(7):1783-7.16. Umławska W, Krzyzanowska M. Growth and menarche during remission in children with juvenile idiopathic arthritis. Med Wieku Rozwoj. 2009;13(3):194-20 17. Roche AF, Wellens R, Attie KM. The timing of sexual maturation in agroup of U.S. white youths. J Pediatr Endocrinol. 1995; 8: 11-15.
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Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section ORIGINAL ARTICLE
Authors

Elif Karatoprak

Müferet Ergüven

Publication Date January 30, 2019
Acceptance Date July 6, 2018
Published in Issue Year 2019 Volume: 24 Issue: 1

Cite

Vancouver Karatoprak E, Ergüven M. Jüvenil İdiyopatik Artritli Hastalarda Pubertal Gelişim. Anatolian Clin. 2019;24(1):53-8.

13151 This Journal licensed under a CC BY-NC (Creative Commons Attribution-NonCommercial 4.0) International License.