What is a common side effect of long-term steroid use in children?

Long-term steroid use in children is associated with several significant side effects due to the impact of these medications on growth and hormonal regulation. One of the notable effects is the delayed onset of puberty, which occurs as steroids can interfere with the normal hormonal signaling pathways critical for developmental processes.

Steroids, such as glucocorticoids, suppress the hypothalamic-pituitary-gonadal axis, leading to alterations in sex hormone production, which are essential for the maturation of secondary sexual characteristics and the overall progression of puberty. This interruption can result in a delay in the physical changes associated with puberty, including breast development in girls and testicular enlargement in boys. Consequently, the likelihood of delayed puberty as a side effect of prolonged steroid use is significant in pediatric patients.

The other options, such as weight loss, increased energy, or enhanced immune function, do not accurately represent common effects of long-term steroid use. In fact, steroid use typically leads to weight gain rather than loss, and it generally does not increase energy levels or enhance immune function; rather, long-term use can suppress immune responses, making children more susceptible to infections.