WASHINGTON, D.C.—The teen years are turbulent, especially for adolescents with rheumatic diseases. When treating teenage patients, rheumatologists must assess unique health risks and talk openly about risky behaviors, said experts during a session titled, “Puberty, Adolescence and Rheumatologic Disease,” at the 2012 ACR/ARHP Annual Meeting, held here November 9–14. [Editor’s Note: This session was recorded and is available via ACR SessionSelect at www.rheumatology.org.]
Adolescents go through dramatic psychosocial, psychosexual, and physical changes, said Frank M. Biro, MD, professor of clinical pediatrics at Cincinnati Children’s Hospital. These changes affect how these patients interact with healthcare professionals and how they view their disease, said Dr. Biro. In puberty, reactivation of the hypothalamic–pituitary–gonadal axis spurs intense growth and development, so teens see dramatic changes in body mass index and body composition.
Discussing Risky Behaviors
In teens with rheumatic diseases, however, pubertal changes like adrenarche, thelarche, gonadarche, and menarche may be delayed, he said, causing emotional reactions like poor self-image that may have serious ramifications. “Youths with chronic conditions are as likely or more likely to engage in risky behaviors with greater consequences,” Dr. Biro said. Teens may use drugs, tobacco, or alcohol or engage in sexual activity to fit in with peers, Dr. Biro said.
These behaviors can be more devastating in adolescents with already compromised immune systems, he noted. “Tobacco use can accelerate the development of cardiovascular disease in dermatomyositis and systemic lupus erythematosus. Alcohol use increases the hepatotoxicity of methotrexate,” he stressed. Rheumatologists must communicate carefully with teen patients to assess risky behaviors and psychosocial problems, he concluded.| | | Next → | Single Page