Long-term impact of corticosteroid therapy on adult height in juvenile myasthenia gravis patients: a retrospective multicenter cohort study

Abstract

Aim: This study aims to assess the final adult height of patients with juvenile myasthenia gravis (JMG) who received glucocorticoid treatment during childhood.

Methods: A retrospective cohort study was conducted at two neurology centers in Beijing, China, including patients diagnosed with JMG between March 2006 and April 2022. Participants were stratified into two groups: those receiving long-term corticosteroid therapy (≥ 6 months) and those without such treatment. Further subgroup analysis was performed based on treatment timing (prepubertal vs. postpubertal). Mean differences in adult height were calculated, and binary logistic regression was used to evaluate associations between treatment variables and growth outcomes.

Results: Of 120 diagnosed JMG patients, 47 who reached adult height were analyzed. Adult height in the long-term steroid group (168.64 ± 7.58 cm) did not significantly differ from the control group (171.45 ± 9.58 cm) (P = 0.26). A positive correlation was observed between the age at steroid initiation and the final-predicted height difference (r = 0.23, P = 0.04), while steroid duration showed a negative correlation (r = -3.11, P = 0.04). Prepubertal steroid initiation was associated with a significant negative final-predicted height difference (Z = -2.12, P = 0.03) and a higher likelihood of failing to achieve predicted height (χ² = 6.18, P = 0.03). Prepubertal steroid use emerged as an independent risk factor for not attaining predicted height (OR = 11.07, 95%CI: 1.24-99.15, P = 0.03).

Conclusion: In JMG patients, steroid treatment after puberty appears to have a relatively smaller impact on adult final height compared to treatment before puberty.

Keywords

Myasthenia gravis / juvenile myasthenia gravis (JMG) / final adult height / predicted height / retrospective cohort study

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