Dracou C, Constantinidou N, Constantopoulos A
1st Department of Paediatrics, Aghia Sophia Children's Hospital, Athens, Greece.
Acta Paediatr Jpn. 1998 Dec;40(6):558-63. doi: 10.1111/j.1442-200x.1998.tb01990.x.
Juvenile chronic arthritis (JCA) is the commonest autoimmune rheumatic disease in childhood and presents different clinical subtypes. Juvenile chronic arthritis is considered to be of a polygenic nature and its genetic background is still under investigation. The clinical profile of JCA in the Greek population has not been studied completely. This study retrospectively analyzed the clinical and immunological features of JCA in Greek children presented between 1989 and 1994. Human leukocyte antigen (HLA)-positive or -negative associations in the different clinical subtypes were also detected. The findings of this study were correlated with those reported from other populations.
Antinuclear antibodies (ANA) anti-ds DNA and anti-extractable nuclear antigen antibodies were estimated by immunofluorescent and ELISA assays. Human leukocyte antigen typing was performed by microlymphocytotoxicity, using immunobeads. The peak ages of JCA onset were between 2 and 5 years and also between 9 and 12 years. There was a high female predominance in pauciarticular and polyarticular groups. The most common disease was pauciarticular (58.7%) followed by systemic (25%) arthritis. The incidence of eye involvement was 12.5% and presented only in the pauciarticular group. Overall, ANA positivity was 53.7%, increasing to 90% in pauciarticular cases associated with chronic uveitis. In the early onset (EOPA) pauciarticular subtype, positive-HLA associations with alleles DR11 and DR8 were shown. In the late onset pauciarticular (LOPA) group only B27 allele was increased.
The results of this retrospective study did not reveal major differences between JCA in Greek children compared with other Caucasian series.
幼年型慢性关节炎(JCA)是儿童期最常见的自身免疫性风湿性疾病,具有不同的临床亚型。幼年型慢性关节炎被认为具有多基因性质,其遗传背景仍在研究中。希腊人群中JCA的临床特征尚未得到全面研究。本研究回顾性分析了1989年至1994年间希腊儿童JCA的临床和免疫学特征。还检测了不同临床亚型中人类白细胞抗原(HLA)阳性或阴性关联。本研究结果与其他人群报告的结果进行了相关性分析。
通过免疫荧光和ELISA检测抗核抗体(ANA)、抗双链DNA和抗可提取核抗原抗体。采用免疫微珠微量淋巴细胞毒性法进行人类白细胞抗原分型。JCA发病的高峰年龄在2至5岁之间以及9至12岁之间。少关节型和多关节型组中女性占主导。最常见的疾病是少关节型(58.7%),其次是全身型(25%)关节炎。眼部受累的发生率为12.5%,仅出现在少关节型组中。总体而言,ANA阳性率为53.7%,在与慢性葡萄膜炎相关的少关节型病例中增至90%。在早发型少关节型(EOPA)亚型中,显示出与DR11和DR8等位基因的HLA阳性关联。在晚发型少关节型(LOPA)组中,仅B27等位基因增加。
这项回顾性研究的结果并未揭示希腊儿童JCA与其他白种人系列之间的重大差异。