Danner Stéphanie, Sordet Christelle, Terzic Joelle, Donato Lionel, Velten Michel, Fischbach Michel, Sibilia Jean
Department of Pediatry, Laboratory of Epidemiology, and Department of Rheumatology, CHU Hautepierre, Strasbourg, France.
J Rheumatol. 2006 Jul;33(7):1377-81.
To determine the incidence, prevalence, and principal characteristics of the different forms of juvenile idiopathic arthritis (JIA) in the region of Alsace, northeastern France, using the new classification of the International League of Associations for Rheumatology (ILAR).
In 2002 we performed a retrospective epidemiologic study pertaining to the year 2001. The pediatricians, rheumatologists, ophthalmologists, orthopedic surgeons, and physicians involved in functional reeducation in the Alsace region were interviewed, and all patients were classified according to the new ILAR classification using the criteria revised in Durban in 1997.
Among the 361 clinicians contacted, the participation rate was 97.8%. The study identified 67 children followed for JIA in Alsace in 2001, from a total population of 1.8 million inhabitants including 339,095 children under age 16 years. The incidence was calculated to be 3.2 cases/100,000/year and the prevalence 19.8 cases/100,000 children under age 16 years. Among these 67 cases of JIA, the most frequent forms were oligoarthritis (n = 27, 40.3%), polyarthritis without rheumatoid factor (RF; n = 15, 22.4%), and enthesitis related arthritis (n = 12, 17.9%). Other forms, notably systemic arthritis (n = 6, 8.9%) and psoriatic arthritis (n = 3, 4.5%), were more rare and in this study there was no case of polyarthritis with RF. Only 4 patients (6%) were classified in the undifferentiated arthritis group using the new classification. Antinuclear antibodies (ANA; by indirect immunofluorescence, HEp >/= 1/80) were detected in patients with oligoarthritis (81%) and polyarthritis without RF (79%). Uveitis occurred in 41% of children with oligoarthritis and in 14% of those with polyarthritis without RF.
Our results are comparable to those of other studies carried out in Caucasian populations with regard to incidence and prevalence. This work also highlights the frequent presence of ANA and uveitis in patients with oligoarthritis or polyarthritis without RF.
采用国际风湿病联盟（ILAR）的新分类法，确定法国东北部阿尔萨斯地区不同类型幼年特发性关节炎（JIA）的发病率、患病率及主要特征。
2002年，我们开展了一项针对2001年的回顾性流行病学研究。对阿尔萨斯地区的儿科医生、风湿病学家、眼科医生、骨科医生以及从事功能康复治疗的医生进行了访谈，并根据1997年在德班修订的标准，按照新的ILAR分类法对所有患者进行分类。
在联系的361名临床医生中，参与率为97.8%。该研究确定2001年在阿尔萨斯有67名儿童因JIA接受随访，该地区总人口为180万，其中16岁以下儿童有339,095名。计算得出发病率为3.2例/10万/年，患病率为19.8例/10万16岁以下儿童。在这67例JIA病例中，最常见的类型为少关节炎（n = 27，40.3%）、无类风湿因子（RF）的多关节炎（n = 15，22.4%）和附着点炎相关关节炎（n = 12，17.9%）。其他类型，尤其是全身型关节炎（n = 6，8.9%）和银屑病关节炎（n = 3，4.5%）则较为少见，且本研究中无RF阳性的多关节炎病例。按照新分类法，只有4例患者（6%）被归类为未分化关节炎组。少关节炎患者（81%）和无RF的多关节炎患者（79%）检测出抗核抗体（ANA；间接免疫荧光法，HEp≥1/80）。少关节炎患儿中41%发生葡萄膜炎，无RF的多关节炎患儿中14%发生葡萄膜炎。
我们的研究结果在发病率和患病率方面与其他针对白种人群开展的研究结果相当。这项研究还突出了少关节炎或无RF的多关节炎患者中ANA和葡萄膜炎的常见情况。
