CHILDREN with juvenile idiopathic arthritis (JIA) face more than just joint pain, emerging research reveals that the condition may significantly delay puberty. A new systematic review highlights the impact of inflammatory cytokines, medication use, and disease severity on pubertal development, raising important considerations for healthcare providers managing young patients with JIA.
The review, which analyzed 11 studies from over 4,000 initial search results, found that girls with JIA experienced later onset of menarche compared to their peers, with an average delay ranging from 12.0 ± 0.3 to 13.39 ± 0.93 years. Delayed puberty was most frequently reported in the polyarticular and oligoarticular subtypes, suggesting that disease severity plays a crucial role. Additionally, menstrual irregularities—including metrorrhagia, oligomenorrhea, and secondary amenorrhea—were commonly observed in JIA patients.
One of the primary contributors to puberty disruption in JIA is corticosteroid use, which is often necessary for disease management but may have unintended hormonal effects. Other key influencing factors include disease duration, JIA subtype, and age at onset. These findings emphasize the need for early intervention and close monitoring to mitigate long-term reproductive and developmental consequences in children with JIA.
While much research has focused on how JIA affects growth and bone health, fewer studies have explored the reverse relationship—how puberty impacts JIA progression and disease outcomes. Understanding this interplay could open new doors for treatment strategies aimed at minimizing endocrine disruption while effectively managing inflammation.
This review underscores the importance of a multidisciplinary approach, integrating rheumatology, endocrinology, and pediatric care to optimize long-term health outcomes for children with JIA. With early assessment and appropriate interventions, some of the influencing factors leading to pubertal delays may be modifiable, offering hope for improved patient management.
Reference: Boussaid S et al. Pubertal disorders in juvenile idiopathic arthritis: a systemic review. J Pediatr Endocrinol Metab. 2025. doi: 10.1515/jpem-2024-0412. [Online ahead of print].
Anaya Malik | AMJ
