Growth pattern in children with systemic lupus erythematosus

Eiman Abdalla, Lakshamanan Jeyaseelan, Irfan Ullah, Reem Abdwani

Research output: Contribution to journalArticle

Abstract

Objectives: Children with childhood-onset systemic lupus erythematosus (cSLE) enter adulthood with considerable morbidity. Of the recognized morbidities, growth failure is unique to cSLE. The aim of this study was to evaluate the growth pattern in children with cSLE longitudinally and identify possible risk factors. Methods: Serial anthropometric measurements of cSLE patients were obtained over two years and expressed as z-scores. Parental heights were obtained to calculate target height. Parent-adjusted height z-score was calculated as the difference between height z-score and target height. Growth failure was defined as parent-adjusted height z-score < -1.50. Risk factors that might have contributed to growth failure were evaluated including the presence of growth failure at baseline, disease activity, disease duration, and cumulative steroid doses. Results: Twentyfive patients were included in the study. Growth failure was observed in eight patients with an overall incidence of 32.0% (95% confidence interval (CI): 14-50%). When comparing the cohort with and without growth failure, the factors that determined growth failure was the pre-existence of growth failure at the time of diagnosis (z-score < -1.95 vs. 0.35; p < 0.001); higher cumulative steroid dose (15.8 vs. 9.1 g; p = 0.061); and tendency for longer disease duration (5.4 vs. 3.7 years; p = 0.240). However, the severity of disease activity at the time of diagnosis was not a significant contributing factor (12 vs. 14; p = 0.529). Conclusions: Children with cSLE are at risk of having a negative effect on height including patients with pre-existing growth failure, high cumulative steroid dose, and longer disease duration. However, longitudinal prospective studies are needed to examine damage over time to improve health-related quality of life.

Original languageEnglish
Pages (from-to)284-290
Number of pages7
JournalOman Medical Journal
Volume32
Issue number4
DOIs
Publication statusPublished - Jul 1 2017

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Systemic Lupus Erythematosus
Growth
Steroids
Morbidity
Longitudinal Studies
Intercellular Signaling Peptides and Proteins
Quality of Life
Prospective Studies
Confidence Intervals
Incidence

Keywords

  • Corticosteroids
  • Growth
  • Growth failure
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Growth pattern in children with systemic lupus erythematosus. / Abdalla, Eiman; Jeyaseelan, Lakshamanan; Ullah, Irfan; Abdwani, Reem.

In: Oman Medical Journal, Vol. 32, No. 4, 01.07.2017, p. 284-290.

Research output: Contribution to journalArticle

Abdalla, Eiman ; Jeyaseelan, Lakshamanan ; Ullah, Irfan ; Abdwani, Reem. / Growth pattern in children with systemic lupus erythematosus. In: Oman Medical Journal. 2017 ; Vol. 32, No. 4. pp. 284-290.
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AB - Objectives: Children with childhood-onset systemic lupus erythematosus (cSLE) enter adulthood with considerable morbidity. Of the recognized morbidities, growth failure is unique to cSLE. The aim of this study was to evaluate the growth pattern in children with cSLE longitudinally and identify possible risk factors. Methods: Serial anthropometric measurements of cSLE patients were obtained over two years and expressed as z-scores. Parental heights were obtained to calculate target height. Parent-adjusted height z-score was calculated as the difference between height z-score and target height. Growth failure was defined as parent-adjusted height z-score < -1.50. Risk factors that might have contributed to growth failure were evaluated including the presence of growth failure at baseline, disease activity, disease duration, and cumulative steroid doses. Results: Twentyfive patients were included in the study. Growth failure was observed in eight patients with an overall incidence of 32.0% (95% confidence interval (CI): 14-50%). When comparing the cohort with and without growth failure, the factors that determined growth failure was the pre-existence of growth failure at the time of diagnosis (z-score < -1.95 vs. 0.35; p < 0.001); higher cumulative steroid dose (15.8 vs. 9.1 g; p = 0.061); and tendency for longer disease duration (5.4 vs. 3.7 years; p = 0.240). However, the severity of disease activity at the time of diagnosis was not a significant contributing factor (12 vs. 14; p = 0.529). Conclusions: Children with cSLE are at risk of having a negative effect on height including patients with pre-existing growth failure, high cumulative steroid dose, and longer disease duration. However, longitudinal prospective studies are needed to examine damage over time to improve health-related quality of life.

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