PREDICTION OF LONG-TERM EFFECTS OF POLYARTICULAR VARIANT OF JUVENILE IDIOPATHIC ARTHRITIS
DOI:
https://doi.org/10.11603/1811-2471.2018.v0.i1.8461Keywords:
juvenile idiopathic arthritis, polyarticular variant, adults, prognosis, long term damages, JADI.Abstract
It is known that the enthesitis-associated variant of JIA, in some cases, can lead to significant development of both extra-articular and articular damages. Predominantly hip and knee joints are affected with limitation of their function and the development of ankylosis, requiring surgical intervention in these patients, as well as cataracts and blindness often developed due to uveitis in childhood.
The aim of the study was to evaluate the risk factors of articular and extra-articular damages in adults with the enthesitis-associated variant of the JIA and to work out a prognostic model for their development.
Materials and methods of research. The study included 45 adult patients with enthesitis-associated variant of the JIA. Retrospective analysis of medical records of patients with enthesitis-associated variant of JIA was made, taking into account clinical manifestations in the onset of the disease, laboratory parameters and response to therapy. In adulthood, the integral index of articular (JADI-A) and extra-articular (JADI-E) damages was used to assess the long-term effects of JIA.
Results. Unfavorable prognostic factors were revealed by method of binary logistic regression. Mathematical model for predicting the probability of long-term negative articular and extra-articular damages of poly-articular JIA was developed. Conclusions 1. The risk factors for the development of articular and extra-articular damages in adulthood in patients with the enthesitis-associated variant of the JIA are the patient's age at the onset of the disease, the delay in diagnosis, the presence of dactylitis in childhood, symmetrical arthritis, spinal pain, JADAS activity in childhood, the history of glucocorticoids intake, need for intensified therapy. 2. A prognostic model for the development of articular and extra-articular damages in adult patients with an enthesitis-associated variant of the JIA has been developed. This model is effective and allows determine the adverse course of the disease and can be the basis for personalized treatment for the prevention of the development of significant articular and extra-articular damages of JIA.
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