Jüvenil İdiyopatik Artritli Hastalarda Pubertal Gelişim

Amaç: Kronik hastalıklarda puberte gelişiminin olumsuz etkilendiği bilinmektedir. Bu çalışmadaçocukluk 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 tanıkriterlerine 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 testishacmi (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 yaşı10,87±1,22, menarş yaşı ise 12,83±1,05 yıl olarak saptandı. Kızların puberte başlangıç ve menarşyaşı 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). Erkekçocuklarda 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 birliktepubertenin tamamlanmasının geciktiği, JİA’lı erkek çocuklarda ise hem puberte başlangıcınıngeciktiği hem de pubertenin tamamlanma süresinin uzadığı saptanmıştır.

Pubertal Development in Patients with Juvenile Idiopathic Arthritis

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.

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