Prognostic Indicators of Juvenile IdiopathicArthritis

Overview

The authors analyze clinical and laboratory data of patients with juvenile idiopathic arthritis (JIA)which could prove useful in early detection of risk patients and could contribute to the classificationof JIA. They evaluated retrospectively 185 patients with JIA whose disease lasted for 5–20 years. Asto clinical parameters the onset, duration and activity of the disease, radiographic changes,functional impairment and ocular manifestations were evaluated. Some immunological factors weretested. As to genetic factors the authors investigated the polymorphism of the interleukin 1 receptorantagonist gene (IL-1Ra). The results of the investigation confirmed a great heterogeneity of JIAand justification of classification into sub-groups. In two thirds of the patients with JIA the authorsconfirmed persisting activity of the disease even after many years and in half of the patients slightor medium severe functional affection. The authors found a significantly higher frequency of allele2 of the gene for IL-1Ra in the whole group with JIA as compared with healthy controls. In thesub-group of oligoarthritis allele 2 was associated with an extended form of oligoarthritis and wasthus described as a prognostic indicator of poorer development of the disease. The second prognosticmarker for the group of oligoarthritis was the ESR value at the onset of the disease. Chronic uveitis,a serious extraarticular manifestation of JIA, was present most frequently in persisting oligoarthritis and was associated with positive ANA. In 4 out of 16 cases uveitis developed after more than 7years of JIA duration.

Key words:
juvenile idiopathic arthritis, uveitis, IL-1Ra, polymorphism