Evaluations of the results and follow in patient with juvenile idiopathic arthritis

Juvenile idiopathic arthritis is the most common rheumatic disease of childhood and chronic inflammatory synovitis is the most typical characteristic of the disease. It often presents with joint involvement; however, extra-articular symptoms such as fever, skin eruption, uveitis, growth and developmental retardation, amyloidosis, and polyserositis may be accompanied. The aim of the study was to evaluate patients with JIA and to identify demographic, clinical, and laboratory characteristics of these patients in our region. This retrospective study included patients with JIA who were diagnosed according to the International League of Associations for Rheumatology (ILAR) criteria. Of 99 eligible patients who were screened at baseline, a total of 89 were included. Using the medical charts, demographic data and laboratory test results were recorded. The Childhood Health Assessment Questionnaire (CHAQ) and Visual Analogue Scale (VAS) scores at the time of diagnosis and at the final visit were noted. Physical and functional disability of the patients were evaluated. Of patients, 44.9% were males and 55.1% were females. Female to male ratio was 5:4. The mean age was 11.6±4.7 years and the mean age at diagnosis was 8.57±4.86 years. The mean follow-up was 2.41±1.88 years. The patients with oligoarticular JIA constituted 61.8% of the patients, followed by polyarticular arthritis, enthesitis-related arthritis, systemic arthritis, and juvenile psoriatic arthritis. The knee joint involvement was the most common presentation. Acute phase reactants (erythrocyte sedimentation rate, C-reactive protein, white blood cell) did not remarkably differ in patients with JIA other than systemic arthritis. Oligoarticular JIA group had the highest number of patients with anti-nuclear antibody (ANA) positivity (50.6%). Rheumatoid factor (RF) was positive in 12.3% of the patients. Of these patients, 6.7% developed uveitis at the time of diagnosis and during follow-up. Remission rates were determined during the treatment of patients. Of patients, 17.9% had an active disease. However, 82.1% met criteria for inactive disease. Of patients in the inactive disease group, 68.4% were in clinical remission with drugs and 32.6% were in drug-free clinical remission. When the scores in CHAQ and disability index were evaluated, 92% of the patients did not have incapability in daily life activities at the final visit. Our study results suggest that the study patients have features both similar to and different than patients in Turkey and in other regions. The occurrence of oligoarticular JIA and gender female were consistent with the findings in other studies for Turkey. JIA is one of the most important causes of movement restriction associated with joint damage in childhood resulting in acquired functional disability. In our study patients, there was an improvement both in the scores of Childhood Health Assessment Questionnaire and the rates of clinical remission with drugs. This improvement is attributed to the achievement of early diagnosis of the disease in recent years as well as to intensive treatment options. Keywords: Juvenile idiopathic arthritis, remission, CHAQ, treatment