Cecchin Vanessa, Sperotto Francesca, Balzarin Marta, Vittadello Fabio, Martini Giorgia, Zulian Francesco
Department of Pediatrics, University of Padua, Padova, Italy.
J Paediatr Child Health. 2017 Apr;53(4):374-377. doi: 10.1111/jpc.13450. Epub 2017 Jan 4.
Oligoarticular onset juvenile idiopathic arthritis (oJIA) is characterised by a prevalent lower limb involvement, antinuclear antibodies (ANA) positivity and high risk of anterior uveitis. As we observed that oJIA patients frequently present with joint hypermobility (JH), we investigated whether there was a relationship between oJIA and JH.
Our series consisted of children with oJIA, as defined by the International League of Associations for Rheumatology criteria, for whom complete clinical data of at least 2 years' duration were available. Clinical and laboratory data, collected at disease onset and at the last follow-up, included: sex, age, presence of JH according to the Beighton score, disease activity, presence of uveitis, ANA, treatment and outcome.
A total of 274 oligoarticular JIA patients (224 female, 50 male; mean age: 11.5) followed on average for 6.6 years, entered the study. The mean age at disease onset was 4.9 years, ANA were positive in 83.9% and uveitis occurred in 20.8%. JH was present in 70.8% of cases at onset, in 44.5% at the last evaluation. JH was more frequent in females (73.7%) than in males (58.0%) (P = 0.028). Uveitis was less frequent in hypermobile children both at diagnosis (17.5 vs. 28.7%, P = 0.037) and during overall disease course (23.7 vs. 36.3%, P = 0.034). Of 163 subjects with at least 5-year follow-up, the full clinical remission rate was significantly higher in JH patients (50.5%) than in those without JH (42.3%; P = 0.042).
In patients with oligoarticular JIA, JH is more frequent than in healthy subjects, uveitis less frequent and the long-term outcome better.
少关节型幼年特发性关节炎（oJIA）的特点是下肢受累普遍、抗核抗体（ANA）阳性以及前葡萄膜炎风险高。由于我们观察到oJIA患者经常出现关节活动过度（JH），我们研究了oJIA与JH之间是否存在关联。
我们的研究系列包括符合国际风湿病联盟标准定义的oJIA儿童，他们有至少2年的完整临床数据。在疾病发作时和最后一次随访时收集的临床和实验室数据包括：性别、年龄、根据贝ighton评分判断的JH情况、疾病活动度、葡萄膜炎的存在情况、ANA、治疗及结果。
共有274例少关节型JIA患者（224例女性，50例男性；平均年龄：11.5岁）进入研究，平均随访6.6年。疾病发作时的平均年龄为4.9岁，83.9%的患者ANA呈阳性，20.8%的患者发生葡萄膜炎。70.8%的病例在发病时有JH，在最后一次评估时为44.5%。女性JH发生率（73.7%）高于男性（58.0%）（P = 0.028）。在诊断时（17.5%对28.7%，P = 0.037）和疾病全程中（23.7%对36.3%，P = 0.034），关节活动过度的儿童葡萄膜炎发生率较低。在163例至少随访5年的受试者中，JH患者的完全临床缓解率（50.5%）显著高于无JH患者（42.3%；P = 0.042）。
在少关节型JIA患者中，JH比健康受试者更常见，葡萄膜炎较少见，长期预后较好。
