Impact of Juvenile Dermatomyositis on Growth, Puberty, Bone Mineral Density, and Body Composition in Children.

Juvenile Dermatomyositis (JDM) is a rare autoimmune disease characterised by chronic inflammation of the skeletal muscles and skin. This review examines effects of JDM and its treatments, particularly corticosteroids and immunosuppressive therapies, on growth, puberty, bone mineral density (BMD), and body composition. A comprehensive literature search was conducted in PubMed, EMBASE, Scopus, and Web of Science (1992-2025) using combinations of MeSH terms and keywords related to JDM, growth, puberty, BMD, fat distribution, lipodystrophy, and body composition. Methodological quality was appraised using a domain-based checklist adapted from the Newcastle-Ottawa Scale. High-dose corticosteroid therapy, which is commonly used to treat JDM, can lead to growth failure, delayed puberty, and changes in body composition, such as obesity, lipodystrophy, and fluctuations in muscle mass. Furthermore, long-term use of corticosteroids is linked to reduced BMD and an increased risk of osteoporosis and fractures. The chronic inflammation associated with JDM also contributes to metabolic complications, including insulin resistance, hyperlipidaemia, and heightened cardiovascular risk. Studies comparing JDM with other paediatric autoimmune conditions reveal that chronic disease activity and treatment significantly affect growth and pubertal development. However, much of the available evidence is derived from small, heterogeneous cohorts with inconsistent adjustment for factors such as pubertal status, nutrition, physical activity, and disease control. These limitations restrict interpretation and caution against overgeneralisation of findings. Standardised, adequately powered longitudinal studies are needed to clarify developmental trajectories and modifiers of risk. Clinically, proactive multidisciplinary care remains essential to optimise growth, bone health, and long-term metabolic outcomes in JDM.