Glucocorticoid effects on statural growth

Abstract

Glucocorticoid use in children is not only associated with the side effects which are seen in adults, but also with severe adverse effects on statural growth. As little as 2.5-5.0 mg prednisolone/day can cause a retardation in statural growth. A direct relationship exists between the dose of glucocorticoid used and statural growth. The use of knemometry, a sensitive technique for measuring the growth of long bones in children has increased the accuracy of growth rate measurements. Many factors, such as disease process, sex, daily vs alternate day therapy, ethnic variations or whether the patient has been immobilized must be considered when evaluating the effects on stature of a particular glucocorticoid. Although alternate day therapy may benefit some patients (particularly those with juvenile chronic arthritis), not all patients respond beneficially to this type of regimen. New generations of glucocorticoids which may not be as detrimental to the growing child should now be considered.