Jüvenil İdiopatik Artritli Çocukların Klinik Ve Laboratuar Özellikleri: Tek Merkez Deneyimi

Öz

Giriş: Jüvenil idiyopatik artrit çocukluk çağında sık olarak görülen ve sakatlıklara neden olan heterojen bir hastalık grubudur. Ülkelere göre hastalığın klinik bulgularındaki farklılıklar birçok yayında bildirilmiştir. Gereç ve Yöntemler: Bu çalışmada bölgemizdeki jüvenil idiyopatik artritli çocuk ve adolesan hastaların International League of Associations for Rheumatology ölçütlerine göre sınıflandırılması, değerlendirilmesi ve her bir alt grubun klinik ve laboratuar özelliklerinin karşılaştırılması planlandı. Jüvenil idiyopatik artrit tanısı alan ve en az bir yıl süreyle takip edilen hastaların hastane kayıt dosyaları geriye dönük olarak incelendi. Bulgular: Bu çalışmaya toplam 75 hasta çalışmaya dahil edildi. Hastaların ortanca yaşları 11,0 (7,0–14,0) yıl ve ortanca tanı yaşları 9,0 (5,0–12,0) yıl olarak tespit edildi. Kız/Erkek oranı 1.02 olarak saptandı. Oligoartiküler tip (28 hasta; %37,3) en sık görülen alt grup olarak belirlendi. Çalışmaya dahil olan tüm hastalardaki anti-nükleer antikor pozitifliği oranı %18,6 olarak saptandı. Romatoid faktör pozitifliği en sık romatoid faktör-pozitif poliartiküler tipte saptandı. Tüm jüvenil idiyopatik artrit hastalarındaki üveit görülme oranı %6,6 olarak tespit edildi. Sonuç: Biz bu çalışmada; bölgemizde en sık görülen jüvenil idiyopatik artrit alt tipinin oligoartiküler tip olduğunu; kızlarda ve erkeklerde eşit sıklıkta görüldüğünü tespit ettik. Anti-nükleer antikor pozitifliği oranının %18,6, romatoid faktör pozitifliği oranının %9,3 ve üveit görülme oranının %6,6 olduğunu saptadık. Anahtar kelimeler: Jüvenil İdiyopatik Artrit; International League of Associations for Rheumatology; Çocuklar.

Anahtar Kelimeler

• Jüvenil İdiyopatik Artrit; International League of Associations for Rheumatology; Çocuklar.

Clinical and Laboratory Characteristics of Children with Juvenil Idiopathic Arthritis: Single-Center Experience

Abstract

Introduction: Juvenile idiopathic arthritis is one of the most common rheumatic diseases of childhood and it is a heterogeneous group of disorders which cause long term disability. Differences in clinical findings of the disease have been reported in many publications from different countries. Material and Methods: In this study, the medical files of the patients who were diagnosed with juvenile idiopathic arthritis and followed up at least one year were evaluated retrospectively. It was aimed to classify and evaluate the juvenile idiopathic arthritis patients according to International League of Associations for Rheumatology classification and to compare clinical and laboratory features of each subgroup. Results: Seventy-five patients were enrolled in the study. The mean age of the patients were 11.0 (7.0–14.0) years and the mean age of the diagnosis of patients were 9.0 (5.0–12.0) years. The ratio of girl/boy was 1.02. Oligoarticular type of juvenile idiopathic arthritis (28 patients, 37.3%) was the most common subgroup. The most common antinuclear antibody positivity was observed in oligoarticular subtype (8 patients, 28.5%) while the most common rheumatoid factor positivity was obtained in rheumatoid factor positive subtype. The anterior uveitis was observed in 6.6% among all patients. Conclusions: In this study, we determined that the oligoarticular onset of juvenile idiopathic arthritis is the most common subtype and we observed with equal frequency in girls and boys in our region. We also observed that the positivity of antinuclear antibody, rheumatoid factor and uveitis were 18.6%, 9.3%, and 6.6%, respectively. Key words: Juvenile Idiopathic Arthritis; International League of Associations for Rheumatology; Children.

Keywords

• Juvenile Idiopathic Arthritis; International League of Associations for Rheumatology; Children.

References

1. Petty RE, Cassidy TJ. Chronic artritis. In: Cassidy TJ, Petty RE, eds. Textbook of Pediatric Rheumatology. 5th edition. Elsevier Saunders Company, 2005. p. 206—341.
2. Miller ML, Cassidy JT. Juvenile Rheumatoid Artritis. In: Turkish Paediatric Rheumatology Association. Clin Exp Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Rheumatol 2011;29(1):111—6. Textbook of Pediatrics. 18th edition. Philadelphia: Saunders, 14. Yılmaz M, Kendirli SG, Altıntaş DU, Karakoç GB, İnal A, Kılıç 2008. p.1001—11. M. Juvenile idiopathic arthritis profile in Turkish children.
3. Weiss JE, |lowite NT. Juvenile idiopathic arthritis. Rheum Pediatr Int 2008;50(2):154—8. Dis Clin North Am 2007;33:441—70. 15. Cassidy JY, Levinson JE, Bass JC, Baum J, Brewer EJ Jr, Fink
4. Fink CW. Proposal for the development of classification CW, et al. A study of classification criteria for diagnosis of criteria for idiopathic arthritides of childhood. J Rheumatol JRA. Arthritis Rheum 1986;29:274—81. 1995;22(8):1566-9. 16. Gadoth N, Herskovitch Y. Rheumatoid arthritis during the
5. Petty RE, Southwood TR, Baum J, Bhettay E, Glass DN, first year of life: EurJ Pediatr1979;132—8. Manners P, et aI. Revision of the proposed classification 17. Wu CJ, Huang JL, Yang MH, Yan DC, Ou LS, Ho, criteria for juvenile idiopathic arthritis: Durban, 1997. J 18. HH. Clinical characteristics ofjuvenile rheumatoid arthritis in Rheumatol 1998;25(10):1991—4. Taiwan. J Microbiol Immunol Infect 2001;34:211—4.
6. Kasapçopur Ö, Özdoğan H. Jüvenil idiyopatik (romatoid) 21. Pachinon LM, Poznonski AK. Juvenile Rheumatoid Arthritis, artrit. Türkiye Klinikleri J Pediatr Sci 2008;4(3);31—42. Arthritis and Allied Conditions. Pennsylvania; Febiger,
7. Fink CW, Fernandez—Vina M, Stastny P. Clinical and genetic 1993:1021-38. evidence that juvenile arthritis is not a single disease. 22. Rosenberg MA, Romanchuk KG. Antinuclear antibodies in Pediatr Clin North America 1995;42;1155—69. arthritic and nonarthritis children with uveitis. J Rheumatol
8. Graham TB, Glass GN. Juvenile rheumatoid arthritis; ethnic 1990;17:60—1. differences in diagnostic types. J Rheumatol 1997;24;1677—9. 23. Lipnick RN, Tsokov GC, Maglavy DB. Immune abnormalities

9. Ozen S, Karaaslan Y, Ozdemir O, Saatci U, Bakkaloglu A, in the pathogenesis of Juvenile rheumatoid arthritis. Rheum Koroglu E, et al. Prevalence of juvenile chronic arthritis and Dis Clin North Am 1991;17:703—859. familial mediterranean fever in Turkey: a field study. J 24. Petty RE. Classification of childhood arthritis; Pediatric Rheumatol 1998;25:2445—9. Rheumatol 1998;127:2.
10. Özdoğan H, Kasapcopur Ö, Dede H, Arisoy N, Beceren T, 25. Kanski JJ. Uveitis in juvenile chronic arthritis: incidence, Yurdakul S, et al. Juvenile Chronic arthritis in a Turkish clinicalfeatures and prognosis. Eye1988;2:641-5. population. Clin Exp Rheumatol 1991;9;431—5. 26. Dolifus H. Eye involvement in children's rheumatic diseases.
11. Kasapcopur O, Yologlu N, Ozyazgan Y, Ercan G, Caliskan S, BaiIiIieres Clin Rheumatol 1998;12:309-28. Sever L, et al. Uveitis and anti nuclear antibody positivity in 27. Southwood TR, Petty RE, Malleson PN, Delgado EA, Hunt children with juvenile idiopathic arthritis. Indian Pediatr DW, Wood B, et aI. Psoriatic arthritis in children. Arthritis 2004;41;1035—9. Rheum 1989;32(8):1007—13.
12. Demirkaya E, Ozen S, Bilginer Y, Ayaz NA, Makay BB, Unsal 28. Hafner R, Michels H. Psoriatic arthritis in children. Cur Opin E, et al. The distribution ofjuvenile idiopathic arthritis in the eastern Mediterranean: results from the registry of the
13. Rheumatol 1996;8z467—72.