Algorithm for monitoring physical and pubertal development in children with chronic diseases

Children with chronic diseases frequently present growth disorders and delayed puberty, complications that negatively impact general health status and quality of life. Aim of the study: to elaborate a diagnostic algorithm for endocrine comorbidities in pediatric chronic diseases, using juvenile idiopathic arthritis as a model. According to the study design, children with juvenile idiopathic arthritis were included, in whom growth parameters, pubertal development, and endocrine function were assessed using age- and sex-specific percentiles. The investigations comprised anthropometric indices, Tanner staging, hormonal analyses, and ultrasound, integrated with clinical disease activity scores. Based on the obtained results and current literature data, a structured algorithm for auxological and pubertal monitoring was developed. The study confirmed that growth delay, delayed or abnormal puberty, and endocrine comorbidities are frequent in children with chronic inflammatory diseases. Significant correlations were identified between growth velocity, pubertal progression, hormonal profiles, and disease activity. The proposed algorithm integrates anthropometric, pubertal, endocrine, and imaging evaluations, allowing early detection of developmental disorders and supporting individualized management. Conclusions: The algorithm provides a practical framework for the systematic evaluation of physical and pubertal development in children with chronic diseases. Its implementation may improve early detection of growth and endocrine disorders, support therapeutic decisions, and optimize the long-term prognosis