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Post a Comment Presence of uveitis as indicator of juvenile idiopathic arthritis severity: results of a retrospective cohort study
- Authors: Yakovlev A.A.1, Gaidar E.V.1, Belozerov K.E.1, Kaneva M.A.1, Kononov A.V.1, Sorokina L.S.1, Isupova E.A.1, Chikova I.A.1, Masalova V.V.1, Dubko M.F.1, Nikitina T.N.1, Kalashnikova O.V.1, Chasnyk V.G.1, Kostik M.M.1
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Affiliations:
- Saint Petersburg State Pediatric Medical University
- Issue: Vol 14, No 2 (2023)
- Pages: 37-47
- Section: Original studies
- URL: https://journals.rcsi.science/pediatr/article/view/131609
- DOI: https://doi.org/10.17816/PED14237-47
- ID: 131609
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Abstract
BACKGROUND: Juvenile idiopathic arthritis is the most common rheumatic disease in children. A frequent extra-articular manifestation of juvenile idiopathic arthritis is uveitis, which is a serious clinical diagnostic problem in routine pediatric practice. Among the known risk factors for uveitis are the early age of the juvenile idiopathic arthritis onset, oligoarticular subtype, seropositivity by antinuclear factor.
AIM: to evaluate the influence of presence of uveitis on the course of juvenile idiopathic arthritis.
MATERIALS AND METHODS: A single-center retrospective study included 520 patients with uveitis. The analysis was carried out among patients who developed (n = 116) and did not develop (n = 404) uveitis. The minimum follow-up period was 2 years, for patients who did not develop uveitis.
RESULTS: Uveitis was diagnosed in 116 (22.3%) children with juvenile idiopathic arthritis. Most often, uveitis occurred in patients with oligoarthritis and psoriatic arthritis. When comparing the features of the articular status of patients with juvenile idiopathic arthritis who developed and did not develop uveitis, a lower frequency of involvement of the cervical spine, temporomandibular, shoulder, elbow, wrist, proximal and distal interphalangeal joints, hip, talus-heel joint, as well as a smaller number of active joints in children with uveitis was found. Patients with uveitis received methotrexate therapy more often, cumulative doses of corticosteroids were lower, the frequency of prescribing genetically engineered biological drugs was approximately the same in both groups. Remission of arthritis was achieved more often, but the proportion of children who developed an exacerbation was higher. When calculating the risk factors of uveitis by binary logistic regression, it was found that the main predictors of uveitis were oligoarthritis, the number of active joints <8, seropositivity by antinuclear factor and recurrent course of arthritis. The difference in the frequency of achieving remission may be due to more aggressive systemic therapy in the presence of uveitis.
CONCLUSIONS: Children with uveitis have a more severe course of juvenile idiopathic arthritis and may require more aggressive immuno-suppressive therapy. Further studies are required to determine the prognostic role of uveitis in the course and outcomes of juvenile idiopathic arthritis.
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##article.viewOnOriginalSite##About the authors
Alexandr A. Yakovlev
Saint Petersburg State Pediatric Medical University
Email: alexandr.med18@gmail.com
SPIN-code: 8475-5794
Resident Doctor, Department of Hospital Pediatrics
Russian Federation, Saint PetersburgEkaterina V. Gaidar
Saint Petersburg State Pediatric Medical University
Email: gaidare85@gmail.com
SPIN-code: 1625-9960
MD, PhD, Rheumatologist, Pediatric Department No. 3
Russian Federation, Saint PetersburgKonstantin E. Belozerov
Saint Petersburg State Pediatric Medical University
Email: biancolago@bk.ru
SPIN-code: 4260-5379
Postgraduate Student, Department of Hospital Pediatrics
Russian Federation, Saint PetersburgMaria A. Kaneva
Saint Petersburg State Pediatric Medical University
Email: alexandr.med18@gmail.com
SPIN-code: 5822-8930
Rheumatologist, Pediatric Department No. 3
Russian Federation, Saint PetersburgAnatolii V. Kononov
Saint Petersburg State Pediatric Medical University
Email: alexandr.med18@gmail.com
Ophthalmologist, Department of Hospital Pediatrics
Russian Federation, Saint PetersburgLyubov S. Sorokina
Saint Petersburg State Pediatric Medical University
Email: alexandr.med18@gmail.com
SPIN-code: 4088-4272
MD, PhD, Rheumatologist, Pediatric Department No. 3
Russian Federation, Saint PetersburgEvgeniya A. Isupova
Saint Petersburg State Pediatric Medical University
Email: alexandr.med18@gmail.com
SPIN-code: 3709-3195
MD, PhD, Rheumatologist, Pediatric Department No. 3
Russian Federation, Saint PetersburgIrina A. Chikova
Saint Petersburg State Pediatric Medical University
Email: alexandr.med18@gmail.com
SPIN-code: 3528-1558
MD, PhD, Associate Professor, Department of Hospital Pediatrics
Russian Federation, Saint PetersburgVera V. Masalova
Saint Petersburg State Pediatric Medical University
Email: alexandr.med18@gmail.com
SPIN-code: 2241-3508
Assistant Professor, Department of Hospital Pediatrics
Russian Federation, Saint PetersburgMargarita F. Dubko
Saint Petersburg State Pediatric Medical University
Email: alexandr.med18@gmail.com
SPIN-code: 4152-4976
MD, PhD, Associate Professor, Department of Hospital Pediatrics
Russian Federation, Saint PetersburgTatiana N. Nikitina
Saint Petersburg State Pediatric Medical University
Email: alexandr.med18@gmail.com
SPIN-code: 8496-2970
MD, PhD, Assistant Professor, Ophthalmology Department
Russian Federation, Saint PetersburgOlga V. Kalashnikova
Saint Petersburg State Pediatric Medical University
Author for correspondence.
Email: alexandr.med18@gmail.com
SPIN-code: 9114-0435
MD, PhD, Associate Professor, Department of Hospital Pediatrics
Russian Federation, Saint PetersburgVyacheslav G. Chasnyk
Saint Petersburg State Pediatric Medical University
Email: alexandr.med18@gmail.com
SPIN-code: 8175-0010
MD, PhD, Dr. Sci. (Med.), Professor, Head of the Department of Hospital Pediatrics
Russian Federation, Saint PetersburgMikhail M. Kostik
Saint Petersburg State Pediatric Medical University
Email: alexandr.med18@gmail.com
SPIN-code: 7257-0795
MD, PhD, Dr. Sci. (Med.), Professor, Department of Hospital Pediatrics
Russian Federation, Saint PetersburgReferences
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