Background Uveitis is a frequent symptom of JIA.
Objectives The aim of this study was to analyze the clinical course of JIA with uveitis in 106 children (66 girls and 40 boys) hospitalized in the Department of Developmental Age Rheumatology of the Institute of Rheumatology in Warsaw in the years 1964-2009 and to compare the course of the disease before and after 1990.
Methods Each patient underwent eye examination, pediatric rheumatologist observation and laboratory tests (ESR, platelets, CRP, IL-1, ANA).
Results The most common form of the disease (JIA with uveitis) is oligoarthritis (80,1%) and the most common first symptom of the disease is arthritis (58,4% of patients). Girls get sick more often, however boys are hospitalized much more often. Most cases of uveitis in the course of JIA occur in the early years of childhood. Uveitis is the first symptom of the disease in 13,2% of patients and more often in boys. Simultaneous occurrence of articular and eye symptoms (26,4% of patients) is more characteristic in girls. In the group of children with oligoarthritis onset of JIA, monocular uveitis is more frequent and independent of sex. In groups with polyarthritis and systemic onset of JIA, dominates occurrance of uveitis in both eyes and more often in boys (not statistically significant – NS). Most common symptom of uveitis is an inflammation of the anterior segment of the eye of a moderate degree and is more common in girls. Inflammation of the anterior segment of the eye of a large and intensive degree is less common and is more characteristic in boys (NS). Elevated ESR, platelets, CRP levels are more common in boys with uveitis (p<0,05). Elevated IL-1 levels are observed more frequently in patients with uveitis than in children without it (p<0,05). In children with JIA hospitalized before 1990 intensive degree of the disease was observed more often. In children hospitalized after 1990 cataract, which is the complication of the disease, is observed more often. The atrophy of the eye is also possible.
Conclusions Despite of the intensification of the basic treatment of JIA and better treatment results in the joints, uveitis in the course of JIA is still a very serious diagnostic and therapeutic problem.
Anesi SD, Foster CS Importance of recognizing and preventing blindness from juvenile idiopathic arthritis-associated uveitis. Arthritis Care Res. 2012; 64: 653-657
Zak M, Fledelius H, Pedersen FK Ocular complications and visual outcome in juvenile chronic arthritis: a 25-year follow-up study. Acta Ophthalmol Scand 2003; 81: 211-5
Petty RE, Smith JR Rosenbaum JT. Arthritis and uveitis in children: a pediatric rheumatology perspective. Am J Ophthalmol 2003; 135: 879-84.
Disclosure of Interest None Declared
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