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AB1171 Articular and extra-articular damage index assessment in juvenile idiopathic arthritis patients
  1. SM El-Gamal,
  2. EAK Elewa,
  3. MM Ashour
  1. Rheumatology and Rehabilitation, Zagazig University Hospitals, Zagazig, Egypt

Abstract

Background Juvenile Idiopathic Arthritis is a broad term used to describe several different forms of chronic arthritis in children. Variable assessment tools can be used for assessment of JIA disease activity. JADI is composed of 2 parts (Viola et al., 2005).

Objectives Assessment of the articular and extraarticular damage index in juvenile idiopathic arthritis patients.

Methods This study was carried out on 60 JIA patients. Patients who had inflamed synovia related to trauma or malignant disease, septic arthritis, bone diseases, as dysplasia or osteomyelitis were excluded. Clinical assessment: sex, age at disease onset, JIA category, educational level, loss of school years and previous use of systemic corticosteroid and second-line drug therapies. Local examination: Number of swollen joints, joints with pain on movement/tenderness, joints with limited range of motion, joints with active arthritis were recorded for every patient. Disease activity: was measured by using the (JADAS-27). Functional ability: was assessed by (CHAQ). Laboratory assessment: included ESR and CRP. Radiographic assessment: scored according to the adapted Sharp/van der Heijde score. Damage assessment: was assessed using the Juvenile Arthritis Damage Index.The (JADI-A) and (JADI-E).

Results Patient characteristics: 6 had systemic onset, 29 had polyarthritis, 14 extended oligoarthritis, 11 had persistant oligoarthritis and none of them had psoriatic arthritis. 38 females and 22 males (56.7%) percent of patients lost some years of education ranging from 0–3 years. Patients in remession were very few 5 patients only. According to the C-HAQ score (13.3%) of patients had no disability (11.7%) mild disability (41.6%) moderate disability and (33.3%)severe disability. 60% patients had articular damage and 35% patients had extraarticular damage. The wrist was the most frequently damaged joint.The growth failure, pubertal delay and leg length discrepancy were the most frequently reported extraarticular items. Correlation of JADI with other disease variables: showed that JADI-A is correlated with physician's global assessment, CHAQ, radiological damage.

Conclusions Ours is the first study that has used JADI to assess outcome in patients with JIA in Egypt. JADI has a good correlation with traditional outcome measures in JIA and may be a good tool to be used in clinical practice and is likely to increase current understanding of the natural history of the disease.

References

  1. Singh G., Arthreya B.H., Fries J.F., et al. (1994): Measurement of health status in children with juvenile rheumatoid arthritis. Arthritis Rheum.; 37 (12) 1761–769.

  2. Viola S., Felici E., Magni-Manzoni S., et al. (2005): Development and validation of a clinical index for assessment of long term damage in juvenile idiopathic arthritis. Arthritis & Rheumatism ;52(7):2092–2102.

  3. Ravelli A. and Martini A. (2007): Juvenile idiopathic arthritis. Lancet 369:767–78.

  4. Boros C. (2010): Juvenile idiopathic arthritis. Australian family physician ;39(9):630–636.

  5. Tanner JM, Davies PS 1985.Clinical longitudinal standards for height and height velocity for North American children. J Pediatr 107:317–329.

References

Acknowledgements First of all, thanks to Gracious Allah. I would like to express my profound gratitude and appreciation to Prof. Dr. Enass Abdel Kader Elewa and to Prof. Dr. Mahmoud Moustafa Ashour for support and supervision.

Disclosure of Interest None declared

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