[巴西一个大型队列中青少年起病型与成人起病型脊柱关节炎的流行病学概况]

[Epidemiologic profile of juvenile-onset compared to adult-onset spondyloarthritis in a large Brazilian cohort].

作者信息

Duarte Angela P, Marques Cláudia D L, Bortoluzzo Adriana B, Gonçalves Célio R, da Silva José Antonio Braga, Ximenes Antonio Carlos, Bértolo Manoel B, Ribeiro Sandra Lúcia E, Keiserman Mauro, Skare Thelma L, Carneiro Sueli, Menin Rita, Azevedo Valderilio F, Vieira Walber P, Albuquerque Elisa N, Bianchi Washington A, Bonfiglioli Rubens, Campanholo Cristiano, Carvalho Hellen M S, Costa Izaias P, Kohem Charles L, Leite Nocy, Lima Sonia A L, Meirelles Eduardo S, Pereira Ivânio A, Pinheiro Marcelo M, Polito Elizandra, Resende Gustavo G, Rocha Francisco Airton C, Santiago Mittermayer B, Sauma Maria de Fátima L C, Valim Valéria, Sampaio-Barros Percival D

机构信息

Universidade Federal de Pernambuco, Recife, PE, Brasil.

Insper Instituto de Educação e Pesquisa, São Paulo, SP, Brasil.

出版信息

Rev Bras Reumatol. 2014 Nov-Dec;54(6):424-30. doi: 10.1016/j.rbr.2014.06.005. Epub 2014 Sep 28.

DOI:10.1016/j.rbr.2014.06.005

PMID:25458023

Abstract

OBJECTIVE

To analyze the clinical and epidemiologic characteristics of juvenile-onset spondyloarthritis (SpA) (< 16 years) and compare them with a group of adult-onset (≥ 16 years) SpA patients.

PATIENTS AND METHODS

Prospective, observational and multicentric cohort with 1,424 patients with the diagnosis of SpA according to the European Spondyloarthropathy Study Group (ESSG) submitted to a common protocol of investigation and recruited in 29 reference centers participants of the Brazilian Registry of Spondyloarthritis (RBE - Registro Brasileiro de Espondiloartrites). Patients were divided in two groups: age at onset<16 years (JOSpA group) and age at onset ≥ 16 years (AOSpA group).

RESULTS

Among the 1,424 patients, 235 presented disease onset before 16 years (16.5%). The clinical and epidemiologic variables associated with JOSpA were male gender (p<0.001), lower limb arthritis (p=0.001), enthesitis (p=0.008), anterior uveitis (p=0.041) and positive HLA-B27 (p=0.017), associated with lower scores of disease activity (Bath Ankylosing Spondylitis Disease Activity Index - BASDAI; p=0.007) and functionality (Bath Ankylosing Spondylitis Functional Index - BASFI; p=0.036). Cutaneous psoriasis (p<0.001), inflammatory bowel disease (p=0.023), dactylitis (p=0.024) and nail involvement (p=0.004) were more frequent in patients with adult-onset SpA.

CONCLUSIONS

Patients with JOSpA in this large Brazilian cohort were characterized predominantly by male gender, peripheral involvement (arthritis and enthesitis), positive HLA-B27 and lower disease scores.

摘要

目的

分析青少年起病的脊柱关节炎（SpA）（<16岁）的临床和流行病学特征，并与一组成人起病（≥16岁）的SpA患者进行比较。

患者与方法

这是一项前瞻性、观察性多中心队列研究，纳入了1424例根据欧洲脊柱关节病研究组（ESSG）诊断为SpA的患者，这些患者遵循共同的调查方案，并在巴西脊柱关节炎登记处（RBE - Registro Brasileiro de Espondiloartrites）的29个参考中心招募。患者分为两组：发病年龄<16岁（青少年脊柱关节炎组）和发病年龄≥16岁（成人脊柱关节炎组）。

结果

在1424例患者中，235例在16岁之前发病（16.5%）。与青少年脊柱关节炎相关的临床和流行病学变量包括男性（p<0.001）、下肢关节炎（p=0.001）、附着点炎（p=0.008）、前葡萄膜炎（p=0.041）和HLA-B27阳性（p=0.017），且疾病活动度评分（巴斯强直性脊柱炎疾病活动指数 - BASDAI；p=0.007）和功能评分（巴斯强直性脊柱炎功能指数 - BASFI；p=0.036）较低。成人起病的SpA患者中，皮肤银屑病（p<0.001）、炎症性肠病（p=0.023）、指（趾）炎（p=0.024）和指甲受累（p=0.004）更为常见。