Abstract
This study aimed to investigate the clinical and laboratory features of children with juvenile idiopathic arthritis (JIA) that followed up at Dicle University Hospital Department of Pediatrics. Totally, 121 (64 male, 57 female) children with the mean age of 10.0±4.1 (range, 1.5-1.8) years were included. The mean disease onset age was 7.9±3.8 (range, 0.8-15.4) years and the mean follow up period was 2.1±1.9 years. The percentages of JIA subtypes were as follows: Oligoarticular JIA 67 (55.4%), polyarticular 45 (37.2%), enthesitis related arthritis 5 (4.1%) and systemic JIA 4 (3.3%). The most common complaints were arthralgia (91.7%), fever (57.0%), fatigue (38.8%) and malaise (34.7%) and the most frequently involved joints were knee (74.4%), ankle (57.9) and wrist (48.8%). Complete remission were achieved in 28 (23.1%) and partial remission in 56 (46.3%), however 27 (21.3%) cases not responded to treatment satisfactorily. Significant risk factors for poor response to treatment with logistic regression were found as delay in treatment ≥6 months (Odds ratio, OR:11.1; p=0.006), existence of thrombocytosis (OR: 7.5; p=0.009) and early disease onset (age<5 years) (OR:18.1; p=0.004). In conclusion, JIA is a heterogeneous childhood disease with varied clinical manifestations. Early onset disease, delay in treatment and existence of thrombocytosis were the risk factors for an unfavorable outcome.
Highlights
Juvenile idiopathic arthritis (JIA) is chronic inflammatory disease that affects synovial membranes of joints and sometime extraarticular organs including liver, spleen, pleura and pericardium
Classification of JIA has changed over the years and different percentages and clinical characteristics of subgroups have been reported in various studies from particular areas of the world
The diagnosis of JIA was done according to the classification criteria set up by Task Force of Pediatric Standing Committee of International League of Associations for Rheumatology (ILAR) [6]
Summary
Juvenile idiopathic arthritis (JIA) is chronic inflammatory disease that affects synovial membranes of joints and sometime extraarticular organs including liver, spleen, pleura and pericardium. JIA is a heterogenous group of autoimmune diseases and may lead to childhood disability. Diagnosis of JIA is difficult and usually laboratory evidence of inflammation is available. The diagnosis of JIA is one of exclusion, obligating to rule out rheumatic, infectious and other potential causes of chronic synovitis [1, 6,7]. Classification of JIA has changed over the years and different percentages and clinical characteristics of subgroups have been reported in various studies from particular areas of the world. Despite various previous studies on predictive factors for good or poor prognosis of JIA, no consensus available about the prognostic factors of the disease [12,13,14]
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