17 Anemia in juvenile idiopathic arthritis: analysis of associated factors

Abstract

Abstract Background Anaemia is the most frequent hematological disorder in chronic inflammatory rheumatic disease. Few studies have focused on this impairment in juvenile idiopathic arthritis (JIA). Objectives To identify the factors associated with anaemia in JIA. Methods We conducted a retrospective study including adults with long-standing JIA according to the International League of Associations for Rheumatology (ILAR) criteria over a period of 28 years (1994–2022). Demographic, clinical, biological, and radiographic data were collected. These parameters were compared according to the presence or absence of anaemia. Results Seventeen women and 12 men were enrolled. The mean age was 35.69 ± 11.72 [18–61] years. The mean age of disease onset was 11.10 ± 4.25 [2–16] years. The average diagnostic delay was 52.96 ± 95.97 [0–336] months. The average disease duration was 24.48 ± 12.76 [1–47] years. The polyarticular form was the most frequent (n = 16). Rheumatoid factor, ACPA and antinuclear antibodies were present in 41.4%, 24.1% and 17.2% of cases respectively. Mean CRP values were 42.74 ± 63.37 [2–218] mg/l, a biological inflammatory syndrome was present in 19 cases. NSAIDs, corticosteroids and methotrexate were used in 62.1% (n = 18), 69% (n = 20) and 79.3% (n = 23) respectively. Anaemia was noted in 69% (n = 20) of cases, it was hypochromic in 8 cases and microcytic in 11 cases. The mean haemoglobin value was 11.31 2.10 [6.5–15] g/dl. Anaemia was associated with the following parameters in our study: female sex (88.2% vs 41.7%; p = 0.008), absence of anti-nuclear antibodies (76.9% vs 20%; p = 0.026) and corticosteroid therapy (85% vs 33.3%; p = 0.005). However, the comparison of patients according to the presence of anaemia did not show any significant difference for these parameters: age, age at onset, diagnostic delay, duration of symptoms, extra-articular manifestations, CRP value, presence of biological inflammatory syndrome, rheumatoid factor, ACPA, erosive nature and treatment (NSAIDs and methotrexate). Conclusion Anaemia is common in JIA. Its treatment is part of the overall management of the disease.