Evaluation of etiology, clinical and laboratory data of childhood arthritis

Abstract

Aim: The aim of the present study was to evaluate the etiologies, diagnostic approach, clinical and laboratory data of patients with arthritis in a Turkish tertiary care hospital in children.

Patients and Methods: 306 hospitalized children aged between 7 months-18 years, diagnosed with arthritis were included in the study between 2008 – 2013. The medical records of patients were reviewed retrospectively.

Results: Of the patients, 51.6% were female, 48.4% were male. The average age was 118 months. Arthritis was symmetrical type in 29.4% of patients and asymmetrical type in 70.6%. The diagnoses of patients were Acute Rheumatic Fever/Poststreptococcal reactive arthritis (ARF/PSRA) (39.2%), Collagen Tissue Disorders (CTD) (29%), Brucellar arthritis (13.4%), reactive arthritis (12.5%), septic arthritis (5.2%) and arthritis secondary to malignancy (0.7%), respectively. Of the patients with CTD; Juvenil idiopathic arthritis (JIA) was the most common in frequency (66.3%). Patellar joint involvement was the most common in frequency (62.4%). The mean ASO levels was significantly higher in patients with ARF/PSRA group [p=0.000]. Average leucocyte count of ARF/PSRA group was significantly higher than CTD group [p=0.000]. Average neutrophil percentage was significantly higher in ARF/PSRA group than brucellar arthritis group [p=0.000]. The mean duration of diagnosis and therapy was found to be significantly longer in patients with CTD [p=0.000]. All patients were cured except one patient with brucellar arthritis.

Conclusion:

Arthritis can be a manifestation of multiple disease processes in children. Therefore, the clinician must consider a broad differential diagnosis. Detail history and physical examination with a clinical follow-up in addition to useful laboratory testing may help to establish the cause of arthritis in children.

Keywords

• arthritis,children,etiology

Çocukluk çağı artritlerinin etyolojik, klinik ve laboratuar verilerinin değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı üçüncü basamak olan bir sağlık kuruluşunda artrit tanısıyla takip edilen çocuk hastaların etyolojisi, tanısal yaklaşımı, klinik ve laboratuvar verilerinin değerlendirilmesidir.

Hastalar ve Yöntemler: 2008 - 2013 yılları arasında, 7 ay-18 yaş arasında, hastanede yatarak tedavi gören 306 artrit tanılı çocuk çalışmaya dahil edildi. Hastaların tıbbi kayıtları retrospektif olarak incelendi.

Bulgular: Hastaların % 51,6'sı kız, % 48.4'ü erkekti. Yaş ortalaması 118 ay idi. Hastaların % 29.4'ünde simetrik, % 70.6'sında asimetrik tip artrit tespit edildi. Hastaların tanıları sırasıyla Akut Romatizmal Ateş/Poststreptokoksik reaktif artrit (ARA/PSRA) (% 39.2), Kollajen doku hastalığı (KDH) (% 29), brusella artriti (% 13.4), reaktif artrit (% 12.5), septik artrit (% 5.2) ve maligniteye bağlı artrit (% 0.7) idi. Kollajen doku hastalığı grubunda jüvenil idyopatik artrit (JİA) en sık görülen hastalık idi (% 66.3). Patellar eklem tutulumu en sık tutulan eklemdi (% 62.4). ARA / PSRA grubu olan hastalarda ortalama ASO düzeyleri yüksek bulundu [p = 0.000]. ARA / PSRA grubunun ortalama lökosit sayısı, KDH grubundan yüksekti [p = 0.000]. ARA / PSRA grubunda ortalama nötrofil yüzdesi brusella artriti grubundan daha yüksekti [p = 0.000]. KDH hastalarında ortalama tanı ve tedavi süresi daha uzun bulundu [p = 0.000]. Brusella artriti tanılı bir hasta hariç tüm hastalar sekelsiz iyileşti.

Sonuç:

Artrit çocukluk çağında sistemik hastalık sürecinin bir bulgusu olabilir. Bu nedenle klinisyenin ayırıcı tanı listesi geniş olmalıdır. Kapsamlı öykü ve fizik muayeneye ek olarak seçilecek uygun laboratuvar testleriyle birlikte klinik izlem çocukluk çağında artrit nedenlerini aydınlatmaya yardımcı olabilir.

Keywords

• artritler,çocukluk çağı,etyoloji

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