Effects of the use of growth hormone in children and adolescents with juvenile idiopathic arthritis: a systematic review.
Children with juvenile idiopathic arthritis (JIA) often have impaired growth and short stature. There is evidence that the therapeutic use of growth hormone (GH) is useful and safe in these patients.



To analyze the effects of GH use in patients with JIA.



A systematic review of the literature over the last 18 years in Medline and Embase databases. The criteria were analyzed independently by the researchers. We used the following keywords: "growth hormone", "arthritis, juvenile", "arthritis, rheumatoid", "child" and "adolescent".



Among the 192 identified articles, 20 corresponded to the inclusion criteria. Seventeen longitudinal studies and 3 case reports were found. Most studies analyzed observed increased growth, muscle mass and bone mass using GH. Adverse effects observed were glucose intolerance, diabetes, bone deformities, osteonecrosis, reactivation of the disease and low final height.



The majority of studies reported positive effects after the therapeutic use of GH, but some variability in response to treatment was observed. The combination of growth hormone with other drugs seems to be a good option.
Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Laboratório de Reumatologia, Campinas, SP, Brazil.
Renan Bazuco
RB
Frittoli
Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Laboratório de Reumatologia, Campinas, SP, Brazil.
Barbara Sugui
BS
Longhi
Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Laboratório de Reumatologia, Campinas, SP, Brazil.
Amanda Meireles
AM
Silva
Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Unidade de Reumatologia Pediátrica, Campinas, SP, Brazil.
Antônio de Azevedo Barros
AAB
Filho
Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Unidade de Reumatologia Pediátrica, Campinas, SP, Brazil.
Maria Ângela Reis de Góes
MÂRG
Monteiro
Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Unidade de Reumatologia Pediátrica, Campinas, SP, Brazil; Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Unidade de Reumatologia, Campinas, SP, Brazil. Electronic address: appenzellersimone@yahoo.com.
Simone
S
Appenzeller
D000293:Adolescent; D001171:Arthritis, Juvenile / Q000188:drug therapy* / Q000503:physiopathology; D015519:Bone Density; D001842:Bone and Bones / Q000187:drug effects*; D002648:Child; D006130:Growth Disorders / Q000188:drug therapy*; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008137:Longitudinal Studies; D011627:Puberty / Q000502:physiology; D016896:Treatment Outcome
D019382:Human Growth Hormone
Adolescentes; Adolescents; Artrite idiopática juvenil; Children; Crianças; Growth hormone; Hormônio de crescimento; Juvenile idiopathic arthritis