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Abstract Number: 1846

Menarchal Status at Diagnosis and Final Height in Females with Childhood-Onset Systemic Lupus Erythematosus

Watchareewan Sontichai1, Daniela Dominguez1, Lawrence Ng1, Deborah M. Levy1, Jonathan Wasserman2, Earl Silverman1 and Linda Hiraki1, 1Division of Rheumatology, The Hospital for Sick Children, Toronto, ON, Canada, 2Division of Endocrinology, The Hospital for Sick Children, Toronto, ON, Canada

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: complications, outcomes, Pediatric rheumatology and systemic lupus erythematosus (SLE), Puberty

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Session Information

Date: Monday, October 22, 2018

Title: 4M084 ACR Abstract: Pediatric Rheum–Clinical I: Outcomes & Comorbidities (1846–1851)

Session Type: ACR Concurrent Abstract Session

Session Time: 2:30PM-4:00PM

Background/Purpose: The diagnosis of systemic lupus erythematosus (SLE) in childhood affects growth due to disease and therapy. To date, there are few studies of final adult height achieved in children diagnosed with SLE and no study examining the relationship of pubertal status at diagnosis and final height. Our aim was to examine the relationship between age at menarche and final adult height, accounting for ethnicity.

Methods: We completed a retrospective cohort study, reviewing 564 female patients < 18 years of age at diagnosis, and followed at a tertiary care, pediatric center from July 1982 to March 2016. All patients met American College of Rheumatology and/or Systemic Lupus International Collaborating Clinics classification criteria for SLE. Patients with documented vertebral collapse (15 patients) or growth hormone therapy (4 patients) were excluded. We reviewed prospectively collected demographic and clinical data including self-reported ethnicity, height, age at menarche, age at diagnosis, disease activity, disease damage and medication use. Final height was the height achieved after <1 cm growth per year for 2 years following menarche or height at 18 years of age. We compared age at diagnosis and menarche as well as final height between patients diagnosed with SLE pre- and post-menarche using a t-test. We divided patients diagnosed post-menarche into females who grew >1 cm post-menarche and females who had achieved final height at diagnosis (no growth). We examined SLE diagnosis post-menarche, compared with pre-menarche in association with final height, adjusting for ethnicity, in linear regression models.

Results: Our cohort included 401 female SLE patients with final height and menarche data. Of those, 115 patients (29%) were diagnosed pre-menarche (mean age of diagnosis 10.7 years [SD 2.2 years]) and 286 patients (71%) were diagnosed post-menarche (mean age of diagnosis 15.1 years [SD 1.6 years]). Age of menarche was 13.5 years (SD 1.4 years) in the pre-menarche group, compared to 12.5 years (SD 1.4 years) in the post-menarche group (P <0.001). The mean final height for females diagnosed post-menarche was greater than those diagnosed pre-menarche (Table 1). In subgroup analysis of the post-menarche group, the mean final height of girls with no growth (161.9 cm [SD 6.8 cm]) was greater than girls diagnosed pre-menarche (p=0.001). In regression analysis, those diagnosed post-menarche were significantly taller than those diagnosed pre-menarche, adjusted for ethnicity (Beta = 2.6cm, SD 0.7cm, P <0.001).

Conclusion: In this large cohort study of females with childhood-onset SLE, patients diagnosed post-menarche achieved a taller final height than those diagnosed pre-menarche even after accounting for ethnicity. Future analyses will explore the relationship of disease activity, damage and medication use with growth velocity and final adult height.

Table 1 Comparison of final height between females diagnosed with SLE pre-menarche and post-menarche

Number (%)

Final height (cm), mean ± SD

P value

SLE diagnosis

pre-menarche

SLE diagnosis

post-menarche

Total cohort*

401

158.8 ± 7.3

161.4 ± 6.9

0.001

European

114 (28%)

161.8 ± 7.1

164.0 ± 5.7

0.088

East and Southeast Asian

106 (26%)

156.2 ± 7.3

158.9 ± 5.8

0.053

African and Caribbean

69 (17%)

159.0 ± 7.2

162.0 ± 7.4

0.112

South Asian

55 (14%)

156.8 ± 7.2

159.2 ± 7.2

0.249

Hispanic and Amerindian

17 (4%)

160.6 ± 5.5

159.1 ± 7.7

0.723

Mixed ethnicity

23 (6%)

158.5 ± 7.8

165.6 ± 8.5

0.073

*Ethnicity was missing in 17 patients


Disclosure: W. Sontichai, None; D. Dominguez, None; L. Ng, None; D. M. Levy, None; J. Wasserman, None; E. Silverman, None; L. Hiraki, None.

To cite this abstract in AMA style:

Sontichai W, Dominguez D, Ng L, Levy DM, Wasserman J, Silverman E, Hiraki L. Menarchal Status at Diagnosis and Final Height in Females with Childhood-Onset Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/menarchal-status-at-diagnosis-and-final-height-in-females-with-childhood-onset-systemic-lupus-erythematosus/. Accessed .
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