Roberto Adriana M, Terreri Maria Teresa R A, Len Cláudio, Muccioli Cristina, Hilário Maria Odete E
Universidade Federal de São Paulo (UNIFESP-EPM), SP, Brazil.
J Pediatr (Rio J). 2002 Jan-Feb;78(1):62-6.
To evaluate the frequency of chronic anterior uveitis in patients with juvenile idiopathic arthritis and its association with the presence of antinuclear antibodies. PATIENTS AND METHODS: We retrospectively studied 72 patients with juvenile idiopathic arthritis. All of them were submitted to slit-lamp examination of the anterior chamber at diagnosis. Both antinuclear antibodies and rheumatoid factor were determined. Patients with positive results for antinuclear antibodies were evaluated every three months and those with negative results were assessed every six months. RESULTS: Forty patients were male (55.5%) and 36 were Caucasoid (50%). The mean age at the onset of juvenile idiopathic arthritis was 6.4 years (range = 1 to 14 years) and the mean age at the beginning of the study was 10.4 years (1 to 19 years). According to the type of disease at onset, 32 were pauciarticular (44.4%) (17 boys and 15 girls), 30 were polyarticular (41.6%) (17 boys and 13 girls) and 10 were systemic (14%) (6 boys and 4 girls). We observed chronic anterior uveitis in five patients (6.5%) (mean age = 11.4 years). Among them, four (80%) had pauciarticular juvenile idiopathic arthritis at disease onset (three girls with type I juvenile idiopathic arthritis and positive antinuclear antibodies and one boy with type I juvenile idiopathic arthritis and negative antinuclear antibodies) and one girl with polyarticular juvenile idiopathic arthritis (negative antinuclear antibodies and rheumatoid factor). In this group, the mean age at the onset of juvenile idiopathic arthritis was 5.1 years and the mean age of uveitis onset was 9 years. Antinuclear antibodies were positive in 3/5 patients (60%) with uveitis. Antinuclear antibodies were positive in 12% of the patients without uveitis (n = 67). Among the patients with uveitis, three had only one flare and the other two had four flares with cataract. The frequency of antinuclear antibodies was statistically higher in the patients with uveitis (P< 0.05). CONCLUSION: Although the incidence of uveitis in our study was lower than that reported in the literature, the frequency of uveitis was higher in females, in those with pauciarticular juvenile idiopathic arthritis and in patients with positive antinuclear antibodies.
评估幼年特发性关节炎患者慢性前葡萄膜炎的发生率及其与抗核抗体存在情况的关联。
我们回顾性研究了72例幼年特发性关节炎患者。所有患者在诊断时均接受了前房裂隙灯检查。同时检测了抗核抗体和类风湿因子。抗核抗体检测结果为阳性的患者每三个月评估一次，结果为阴性的患者每六个月评估一次。
40例为男性（55.5%），36例为白种人（50%）。幼年特发性关节炎发病时的平均年龄为6.4岁（范围为1至14岁），研究开始时的平均年龄为10.4岁（1至19岁）。根据发病时的疾病类型，32例为少关节型（44.4%）（17例男孩和15例女孩），30例为多关节型（41.6%）（17例男孩和13例女孩），10例为全身型（14%）（6例男孩和4例女孩）。我们观察到5例患者（6.5%）患有慢性前葡萄膜炎（平均年龄 = 11.4岁）。其中，4例（80%）在疾病发病时患有少关节型幼年特发性关节炎（3例I型幼年特发性关节炎女孩且抗核抗体阳性，1例I型幼年特发性关节炎男孩且抗核抗体阴性），1例女孩患有多关节型幼年特发性关节炎（抗核抗体和类风湿因子均为阴性）。在这组患者中，幼年特发性关节炎发病时的平均年龄为5.1岁，葡萄膜炎发病时的平均年龄为9岁。5例葡萄膜炎患者中有3例（60%）抗核抗体呈阳性。无葡萄膜炎的患者中12%（n = 67）抗核抗体呈阳性。在葡萄膜炎患者中，3例仅发作一次，另外2例发作四次并伴有白内障。葡萄膜炎患者中抗核抗体的频率在统计学上更高（P < 0.05）。
尽管我们研究中葡萄膜炎的发生率低于文献报道，但葡萄膜炎在女性、少关节型幼年特发性关节炎患者以及抗核抗体阳性的患者中发生率更高。
