Screening of Growth Impairment inJuvenile Rheumatoid Arthritis, Systemic LupusErythematosus and Autoimmune Chronic Liver Disorders In Childhood

Abstract

Autoimmune diseases are a group of diseases in which the body produces antibodies against its own tissue not against infective agents. It is characterized by severe inflammation and widespread tissue damage. Autoimmune diseases are among the leading causes of death in young and middle-age women. Prevalence rates range from less than 5 per 100.000 (e.g. chronic active hepatitis) to 500 per 100.000 (e.g. rheumatoid arthritis). Females are mostly affected in 85% of cases. Although most diseases can occur at any age, some diseases primarily occur in childhood and adolescence. Autoimmune diseases in children include juvenile idiopathic arthritis (JIA), systemic lupus erythmatosus (SLE) autoimmune chronic liver disorders among many others. Juvenile rheumatoid arthritis (JRA) is the most common chronic rheumatic disorder of childhood.In which on inflammatory process may lead not only to fixed deformities but also to growth inhibition. SLE is a systemic autoimmune disease characterized by the production of autoantibodies against a spectrum of nuclear antigens. The auto antibodies are immunoglobulins that bind via the combining sites of antigens originating in the same individual or species. Liver disorders with likely autoimmune pathogenesis in childhood include autoimmune hepatitis, autoimmune sclerosing cholangitis and autoimmune hepatitis after liver transplantation. Many autoimmune diseases are chronic illness which may lead to growth impairment either because of illness itself or because of treatment required for it. Short statue is commonly perceived to be associated with social or psychological disadvantage. In children with severe rheumatic disorders, treatment with glucocorticorids is frequently needed and is associated with growth impairment and osteopenia. Growth hormone (GH) treatment may improve growth and lean body mass but these benefits disappear when GH therapy is stopped. Short stature frequently occurs in children suffering from juvenile idiopathic arthritis. The potential of disturbance of linear growth is greater in children with systemic or non-systemic polyarticular disease of long duration. In this study, one thousand cases of which 593 juvenile rheumatoid arthritis, 305 systemic lupus erythematosus and 102 autoimmune chronic liver disorders was studied to detect impaired growth and delayed puberty.