Abstract
Background: Juvenile Idiopathic Arthritis (JIA) is the most common chronic rheumatic disease of childhood and a leading cause of short and long-term disability. Abnormal level of serum homocysteine (Hcy) may be found in Juvenile idiopathic arthritis (JIA) patients. Some studies were done on serum homocyestine levels in children with JIA which showed conflicting results. So far, no study regarding the Hcy level in JIA patients was done in Bangladesh.
 Objectives: The study was aimed to assess the homocysteine level in children with different subtypes of JIA.
 Methods: It was a cross sectional and case control study. Fifty newly diagnosed cases of JIA attending the Pediatric Rheumatology clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from January 2016 to March 2017 were included. Fifty age and sex matched controls were selected. Serum homocysteine levels were measured in both cases and controls.
 Results: Among JIA patients, 36% had high serum homocysteine (Hcy) level whereas 100% of controls had normal level. Mean hcy level was significantly (p<0.05) higher among cases than controls. Significantly higher number and level of hyperhomocystaeinemia was found among JIA patients having duration of illness more than 1 year than duration less than 1 year. Mean homocysteine level of polyarticular RF positive cases was found as 14.38±3.79 µmol/L and that of SJIA was found as 13.0±4.66 µmol/L. When compared with homocysteine levels of control group these two groups had significantly higher homocysteine level.
 Conclusion: More than one third of JIA patients had hyperhomocysteinaemia. Mean hcy level of JIA cases was significantly higher than that of controls. Significant association of hyperhomocysteinaemia was present with duration of illness and certain types of JIA.
 Bangladesh Med Res Counc Bull 2020; 46(1): 12-16
Highlights
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of children
Mean homocysteine level of polyarticular RF positive cases was found as 14.38±3.79 μmol/L and that of SJIA was found as 13.0±4.66 μmol/L
Significant association of hyperhomocysteinaemia was present with duration of illness and certain types of JIA
Summary
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of children. JIA is characterised by idiopathic peripheral arthritis with an immunoinflammatory pathogenesis possibly activated by contact with external antigens. Worldwide incidence of JIA ranges from 0.8 to 22.6 per 100,000 children per year with the prevalence ranges from 7 to 401 per 100,000 children. Its concentration depends on age, gender and ethnic background.[3] Homocysteine can impair bone health by interfering with osteoclastic activity. Juvenile Idiopathic Arthritis (JIA) is the most common chronic rheumatic disease of childhood and a leading cause of short and long-term disability. Abnormal level of serum homocysteine (Hcy) may be found in Juvenile idiopathic arthritis (JIA) patients. Some studies were done on serum homocyestine levels in children with JIA which showed conflicting results. No study regarding the Hcy level in JIA patients was done in Bangladesh
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