ABSTRACT
This study was carried out on 40 children having juvenile rheumatoid arthritis [JRA], their mean age was 8.5 +/- 2.8 with a range of 3-18 years. Two hundred and ninety healthy children, age and sex matched with the patients, were included as controls. History, clinical examination and full anthropometry were performed. The basal levels of insulin like growth factor 1 [IGF1] and IGF binding protein 3 [IGFBP3] were assessed. Growth hormone assessment was performed in patients with compromised growth and in those having low IGF1 values. Mean height standard deviation score [SDS] of the patients was significantly lower compared with the controls. Mean IGF1 and IGFBP3 values as well as their Z scores were significantly lower in patients than in controls whether pre or post pubertal. IGF1 Z scores were positively correlated to IGFBP3 Z score in a statistically significant manner. IGF1 Z score was also positively correlated to height SDS and negatively correlated to steroid therapy. The group of patients who received glucocorticoids was shorter, showed less IGF1 Z score and IGFBP3 Z score than the group who did not receive steroid therapy. GH stimulation tests in patients with compromised growth showed normal values [mean +/- SD was 21.0 +/- 5.7 ng/ml, with a range of 10-30]. IGF1 and IGFBP3 Z scores were less in the group with compromised growth than in that with fair growth [-2.40 + 1.58 and -2.34 + 1.85 versus -1.41 + 0.86 and -1.11 + 1.49, respectively] and the difference was statistically significant