Tsitsami Elena, Bozzola Elena, Magni-Manzoni Silvia, Viola Stefania, Pistorio Angela, Ruperto Nicolino, Martini Alberto, Ravelli Angelo
IRCCS Policlinico S. Matteo, Università di Pavia, Pavia, Italy.
Arthritis Rheum. 2003 Aug 15;49(4):488-93. doi: 10.1002/art.11191.
In the 1997 revision of the International League of Associations for Rheumatology (ILAR) criteria for juvenile idiopathic arthritis (JIA), a family history of psoriasis is an exclusion for the oligoarthritis category. We investigated whether psoriasis in a first or second degree relative influences the clinical expression and course of JIA patients with oligoarthritis.
In a cross-sectional study, consecutive oligoarticular-onset JIA patients were investigated. Clinical evaluations included confirmation of a family history of psoriasis and assessment of nail abnormalities, dactylitis, psoriatic rash, variables of JIA activity, and laboratory indicators of inflammation. Retrospective assessments included sex, onset age, disease duration, antinuclear antibodies, HLA-B27, uveitis, ocular complications, second-line therapies, intraarticular corticosteroid injections, radiographic joint lesions, joint involvement over time, and laboratory investigations at disease presentation and first observation.
A total of 185 patients were included. Thirty-three had a positive family history of psoriasis (group 2) and 139 did not (group 1). Thirteen patients fulfilled the ILAR criteria for juvenile psoriatic arthritis (group 3). Patients in groups 1 and 2 were comparable for all parameters, except for a higher frequency of females in group 1 (P = 0.04). As compared with group 2, patients in group 3 were less frequently antinuclear antibody positive and had a more severe arthritis and a different distribution of joint involvement.
We found close similarities in the clinical features and course among patients with oligoarthritis who had a positive family history for psoriasis and those who did not. These findings argue against the exclusion of the former patients from the oligoarthritis category of JIA.
在1997年国际风湿病联盟（ILAR）幼年特发性关节炎（JIA）标准修订版中，银屑病家族史是少关节炎类别的排除标准。我们研究了一级或二级亲属中患银屑病是否会影响少关节炎型JIA患者的临床表现和病程。
在一项横断面研究中，对连续的少关节起病的JIA患者进行调查。临床评估包括确认银屑病家族史以及评估指甲异常、指（趾）炎、银屑病皮疹、JIA活动变量和炎症实验室指标。回顾性评估包括性别、起病年龄、病程、抗核抗体、HLA - B27、葡萄膜炎、眼部并发症、二线治疗、关节内注射皮质类固醇、放射学关节病变、随时间推移的关节受累情况以及疾病初发和首次观察时的实验室检查。
共纳入185例患者。33例有银屑病家族史（第2组），139例无银屑病家族史（第1组）。13例患者符合幼年银屑病关节炎的ILAR标准（第3组）。第1组和第2组患者在所有参数上具有可比性，但第1组女性比例更高（P = 0.04）。与第2组相比，第3组患者抗核抗体阳性频率较低，关节炎更严重，关节受累分布不同。
我们发现有银屑病家族史的少关节炎患者与无银屑病家族史的少关节炎患者在临床特征和病程方面有密切相似之处。这些发现反对将前一类患者排除在JIA少关节炎类别之外。
