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Insulin-like growth factors I and II in children with systemic onset juvenile arthritis.

Systemic onset juvenile arthritis (JA) has been associated with growth failure in children whether or not treated with adrenocorticosteroids. Growth hormone secretion has been reported to be normal, but production of insulin-like growth factors has not been studied. We measured serum concentrations of insulin-like growth factor I and II in a group of children with systemic JA at different times, and during treatment with only nonsteroidal antiinflammatory therapy or while receiving prednisone. Mean concentrations of insulin-like growth factor I and II were below normal for age whether or not prednisone was being given. Growth failure during periods of active disease was observed in both groups. Only 4 of 11 prepubertal children in whom growth rates were measured grew 4.5 cm or more/year. However, longitudinal studies of individual children showed that lowest growth rates occurred while taking prednisone and that growth rates were not correlated to insulin-like growth factor levels.