Hernández-Huirache Hayde Guadalupe, Armenta-Medina Dagoberto, Rodea-Montero Edel Rafael
Department of Pediatric Rheumatology, Hospital Regional de Alta Especialidad del Bajío, León 37544, Mexico.
CONAHCyT Consejo Nacional de Humanidades, Ciencias y Tecnologías, Ciudad de México 03940, Mexico.
Pediatr Rep. 2024 Feb 7;16(1):151-162. doi: 10.3390/pediatric16010014.
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in childhood, affecting one to four of every 1000 children worldwide. It is characterized by joint inflammation lasting more than six weeks in children under 16 years. The aim of this study was to estimate the frequency of JIA subtypes in the Mexican patient population; compare clinical, immunological and inflammation markers by JIA subtype; and examine the correlation between these variables.
We conducted a cross-sectional study of 50 patients with JIA (2-15 years). We estimated the frequency of each JIA subtype, assessed and compared the immunological characteristics (RF, ANA and anti-CCP) by JIA subtype at the time of diagnosis using Kruskal-Wallis or chi-square tests, and calculated Spearman correlation coefficients between the assessments.
Our analysis included 50 patients, 29 (58%) girls and 21 (42%) boys, aged at the time of diagnosis 10.56 ± 3.99 years. The frequencies of JIA subtypes were RF-seropositive polyarthritis (34%), RF-seronegative polyarthritis (28%), systemic arthritis (16%), oligoarthritis (14%) and arthritis-related enthesitis (8%). We found a significant association between sex and JIA subtype ( = 0.014). There was a significant difference in anti-CCP levels by JIA subtype ( < 0.001). We also detected positive correlations between RF and anti-CCP (r = 0.63, < 0.001) and between age and anti-CCP (r = 0.29, = 0.041).
Our study suggests that the frequency of the polyarticular subtypes of JIA is higher in Mexican children compared to other populations. Our findings highlight the importance of considering the presence of anti-CCP and RF as important criteria when deciding on treatment for JIA patients as elevated levels of these antibodies may indicate early forms of adult rheumatoid arthritis.
幼年特发性关节炎（JIA）是儿童期最常见的慢性风湿性疾病，全球每1000名儿童中有1至4人受其影响。其特征是16岁以下儿童的关节炎症持续超过六周。本研究的目的是估计墨西哥患者群体中JIA亚型的频率；按JIA亚型比较临床、免疫和炎症标志物；并检验这些变量之间的相关性。
我们对50例JIA患者（2至15岁）进行了横断面研究。我们估计了每种JIA亚型的频率，在诊断时使用Kruskal-Wallis检验或卡方检验按JIA亚型评估和比较免疫特征（RF、ANA和抗CCP），并计算评估之间的Spearman相关系数。
我们的分析包括50例患者，其中29例（58%）为女孩，21例（42%）为男孩，诊断时年龄为10.56±3.99岁。JIA亚型的频率分别为RF血清阳性多关节炎（34%）、RF血清阴性多关节炎（28%）、全身型关节炎（16%）、少关节炎（14%）和附着点炎相关关节炎（8%）。我们发现性别与JIA亚型之间存在显著关联（P = 0.014）。按JIA亚型划分，抗CCP水平存在显著差异（P < 0.001）。我们还检测到RF与抗CCP之间存在正相关（r = 0.63，P < 0.001）以及年龄与抗CCP之间存在正相关（r = 0.29，P = 0.041）。
我们的研究表明，与其他人群相比，墨西哥儿童中JIA多关节亚型的频率更高。我们的研究结果强调了在决定JIA患者的治疗时，将抗CCP和RF的存在作为重要标准的重要性，因为这些抗体水平升高可能表明成人类风湿关节炎的早期形式。
