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Growth Velocity and Interleukin 6 Concentrations in Juvenile Idiopathic Arthritis

LETÍCIA S. SOUZA, SANDRA H. MACHADO, CLAITON V. BRENOL, JOÃO CARLOS T. BRENOL, and RICARDO M. XAVIER

ABSTRACT.

Objective.
To evaluate associations of growth velocity with inflammatory markers and cumulative dose of glucocorticoid in a cohort of patients with juvenile idiopathic arthritis (JIA) followed during 1 year.

Methods. Seventy-nine patients were evaluated. Disease activity was evaluated by a pediatric rheumatologist. Anthropometric data were classified according to the World Health Organization standards. Tanner growth velocity curves were used; values below the Z-score ¾ -2 were considered low growth velocity. Serum concentrations of interleukin 6 (IL-6) were measured by ELISA, and values > 1 pg/ml were considered elevated.

Results. The prevalence of low growth velocity was 25.3%, and it was associated with active disease on followup visit, elevated IL-6, erythrocyte sedimentation rate and C-reactive protein, and higher cumulative glucocorticoid doses. In the multiple linear regression with growth velocity as the dependent variable, only elevated IL-6 level was independently and negatively associated with growth velocity.

Conclusion. Low growth velocity is highly prevalent in children with JIA. Elevated IL-6 levels seem to have an important negative influence on growth in these children, while total glucocorticoid exposure appears to be a secondary factor. (J Rheumatol First Release Oct 1 2008)

Key Indexing Terms:

JUVENILE IDIOPATHIC ARTHRITIS
GROWTH VELOCITY
INTERLEUKIN 6


From the Division of Rheumatology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.

Supported by FIPE/HCPA (Fund of Incentive to Research at Hospital de Clínicas de Porto Alegre).

L. Souza, MSc, Hospital de Clínicas de Porto Alegre (HCPA)/ Universidade Federal do Rio Grande do Sul (UFRGS), CAPES Fellow; S.H. Machado, PhD Student, HCPA/UFRGS; C.V. Brenol, MD, MSc, Division of Rheumatology, HCPA; J.C. Brenol, PhD, Assistant Professor, Head, Rheumatology Service, HCPA/UFRGS; R.M. Xavier, MD, PhD, Assistant Professor, Rheumatology Service, HCPA/UFRGS.

Address reprint requests to Dr. R.M. Xavier, Serviço de Reumatologia do Hospital de Clínicas de Porto Alegre, Ramiro Barcelos 2350/sala 645, Porto Alegre/RS 90035-003, Brazil. E-mail:rmaxavier@hcpa.ufrgs.br

Accepted for publication June 23, 2008.



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