Department of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Pediatr Rheumatol Online J. 2008 Oct 22;6:18. doi: 10.1186/1546-0096-6-18.
Data on outcome of ERA is scarce and there is lack of well-accepted tools. JADI is a newly described outcome measure in JIA that has not been evaluated in ERA. We studied outcome in ERA using JADI and correlated it with traditional outcome measures.
We studied 49 consecutive patients of ERA with age >/= 5 years and duration >/= 1 year. Along with JADI, we recorded enthesitis, lumbar spinal anterior flexion by modified Schober's method, presence of inflammatory backache, loss of school years, HAQ-S, growth and pubertal delay. Parent's/patient's and physician's global assessments on 100 mm visual analogue scale.
The median age was 18.0 (10-27) years and the median duration of disease was 6.0 (1-17) years. All the patients were male and half (53.1%) were HLA B 27 positive. Fourteen had decreased anterior lumbar flexion movement and 32 had inflammatory backache. Active enthesitis was present in 63.3%. Functionally, mild, moderate and severe disability was seen in 18.4%, 34.7% & 14.3% respectively. Sixty five percent of patients lost education years. Twenty-eight patients had damaged joints with median of 2.0 joints (0-9). Seventeen patients (34.7%) had damaged joints in JADI-A score with a median of 1.0 (0-12). Growth failure was the commonest extra articular damage (8.2%) in JADI-E. JADI correlated with HAQ-S, parent's or patient's & physician's global assessment (p < 0.01). Limitation of spinal mobility had high correlation with HAQ-S; correlation with JADI-A was low.
Three fourth of the ERA patients had functional limitations. Half of the patients had damaged joints. Even though JADI correlated well with traditional outcome measures, it underestimates joint damage, and does not assess enthesitis and spinal limitation which affect functional status in ERA. Inclusion of these may make it more useful for ERA.
关于 ERA 结局的数据很少，也缺乏公认的工具。JADI 是一种新描述的 JIA 结局指标，尚未在 ERA 中进行评估。我们使用 JADI 研究了 ERA 的结局，并将其与传统结局指标进行了相关性分析。
我们研究了 49 例年龄≥5 岁且病程≥1 年的 ERA 连续患者。除了 JADI，我们还记录了附着点炎、改良 Schober 法测量的腰椎前屈运动、炎性背痛、失学年限、HAQ-S、生长和青春期延迟、父母/患者和医生的 100mm 视觉模拟量表的总体评估。
中位年龄为 18.0（10-27）岁，中位病程为 6.0（1-17）年。所有患者均为男性，一半（53.1%）为 HLA B27 阳性。14 例患者的前腰椎前屈运动减少，32 例患者有炎性背痛。活动性附着点炎发生率为 63.3%。功能上，轻度、中度和重度残疾分别为 18.4%、34.7%和 14.3%。65%的患者失学。28 例患者有受损关节，中位数为 2.0 个关节（0-9）。17 例（34.7%）患者在 JADI-A 评分中有受损关节，中位数为 1.0（0-12）。生长发育迟缓是 JADI-E 中最常见的关节外损伤（8.2%）。JADI 与 HAQ-S、父母/患者和医生的总体评估呈正相关（p<0.01）。脊柱运动受限与 HAQ-S 高度相关；与 JADI-A 的相关性较低。
四分之三的 ERA 患者存在功能障碍。一半的患者有受损关节。尽管 JADI 与传统结局指标相关性良好，但它低估了关节损伤，并且不能评估附着点炎和脊柱受限，这些因素会影响 ERA 的功能状态。纳入这些因素可能会使它对 ERA 更有用。
