Kaplan Melike Mehveş, Ekici Tekin Zahide, Güngörer Vildan, Çelikel Elif, Kurt Tuba, Polat Merve Cansu, Sezer Müge, Tekgöz Nilüfer, Karagöl Cüneyt, Coşkun Serkan, Öner Nimet, Çelikel Acar Banu
Division of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara City Hospital, 06800-Bilkent, Ankara, Turkey.
Mod Rheumatol. 2024 Aug 20;34(5):1036-1042. doi: 10.1093/mr/road101.
Our study aimed to evaluate the relationship of small joint involvement with demographic, clinical, and laboratory findings and to determine its possible effects on prognosis.
This retrospective observational study was conducted in patients diagnosed with oligoarticular juvenile idiopathic arthritis (oJIA) in the paediatric rheumatology department of Ankara City Hospital between April 2009 and September 2022. The relationship between small joint involvement and demographic, clinical, and laboratory findings and prognosis was investigated by statistical methods with the data recorded from the medical records of oJIA patients.
Of the 198 patients diagnosed with oJIA, small joint involvement was observed in a total of 20 (10%) patients, 11 (5.5%) at the time of diagnosis, and 9 (4.5%) during the follow-up period. The frequency of small joint involvement in extended oJIA was significantly higher than in persistent oJIA (P = .001). Patients with small joint involvement had significantly higher erythrocyte sedimentation rate and C-reactive protein values at admission (P = .047, P = .038) and Juvenile Arthritis Disease Activity Score at 3, 6, and 12 months (P = .001, P = .001, P = .018). The need for conventional disease-modifying antirheumatic drugs and biologic disease-modifying antirheumatic drugs was significantly higher in patients with small joint involvement (P = .001, P = .001).
oJIA patients with small joint involvement may have higher acute phase reactants at diagnosis, a more extended course and active disease in follow-up, and the need for treatment escalation.
本研究旨在评估小关节受累与人口统计学、临床及实验室检查结果之间的关系，并确定其对预后的可能影响。
本回顾性观察性研究于2009年4月至2022年9月在安卡拉市医院儿科风湿病科诊断为少关节型幼年特发性关节炎（oJIA）的患者中进行。通过统计学方法，利用oJIA患者病历记录的数据，研究小关节受累与人口统计学、临床及实验室检查结果以及预后之间的关系。
在198例诊断为oJIA的患者中，共有20例（10%）出现小关节受累，其中11例（5.5%）在诊断时出现，9例（4.5%）在随访期间出现。扩展性oJIA中小关节受累的频率显著高于持续性oJIA（P = 0.001）。小关节受累患者入院时红细胞沉降率和C反应蛋白值显著更高（P = 0.047，P = 0.038），在3、6和12个月时的幼年关节炎疾病活动评分也更高（P = 0.001，P = 0.001，P = 0.018）。小关节受累患者对传统改善病情抗风湿药物和生物改善病情抗风湿药物的需求显著更高（P = 0.001，P = 0.001）。
小关节受累的oJIA患者在诊断时可能具有更高的急性期反应物，随访期间病程更长且疾病更活跃，并且需要升级治疗。
