Document Detail


Chronic uveitis in children with and without juvenile idiopathic arthritis: differences in patient characteristics and clinical course.
MedLine Citation:
PMID:  18484686     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Anterior uveitis (AU) in childhood may be the first manifestation of juvenile idiopathic arthritis (JIA). We identified factors that may help to differentiate JIA-associated AU from the more common idiopathic AU (IAU) before the onset of arthritis. METHODS: Children with IAU and with JIA-associated AU were analyzed for their demographics, age at onset of uveitis, uveitis course and complications, ocular surgery, antiinflammatory medication, and best corrected visual acuity (BCVA). RESULTS: AU was associated with JIA in 88 cases, and was idiopathic in another 49. In the JIA group, 60% of patients were female compared to 47% in the IAU group (p = 0.154). Antinuclear antibody (ANA) was significantly more frequent in the JIA group (88% vs 33%; p < 0.001, OR 14.4, 95% CI 5.8-35.6). Insidious uveitis onset occurred more often in JIA than in IAU patients (67% vs 31%; p < 0.001, OR 4.6, 95% CI 2.2-9.8). Persistent uveitis was found in 82% of JIA patients, and in 57% of IAU patients (p = 0.003, OR 3.4, 95% CI 1.5-7.4). Median age of AU onset was 5 years in JIA and 9 years in IAU (p < 0.001). Uveitis complications at first presentation at our institutions were more frequent in JIA than in IAU patients (79% vs 61%; p = 0.027, OR 2.5, 95% CI 1.1-5.3). During followup, 69 surgical procedures (51% of patients, 1.31 per patient) were performed in the JIA group, and 18 in IAU patients (0.57 per patient) (p = 0.008). BCVA was better in the IAU patients at first presentation (p = 0.001). CONCLUSION: The IAU and JIA-associated AU in childhood differ in their clinical course. ANA positivity, presence of uveitis complications at first manifestation, insidious onset, duration over 3 months, BCVA of 20/50 or less, and an age of 3 years or younger might help to detect AU associated with JIA. JIA uveitis manifests earlier, has more complications, and more often requires systemic immunosuppression and surgical intervention.
Authors:
Carsten Heinz; Anne Mingels; Christian Goebel; Thomas Fuchsluger; Arnd Heiligenhaus
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Publication Detail:
Type:  Journal Article     Date:  2008-05-15
Journal Detail:
Title:  The Journal of rheumatology     Volume:  35     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-08     Completed Date:  2008-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  1403-7     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology, St. Franziskus-Hospital Muenster, Muenster, Germany. carsten.heinz@uveitis-zentrum.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antibodies, Antinuclear
Arthritis, Juvenile Rheumatoid / complications*,  diagnosis*
Child
Child, Preschool
Cohort Studies
Female
Humans
Male
Retrospective Studies
Uveitis, Anterior / complications*
Visual Acuity
Chemical
Reg. No./Substance:
0/Antibodies, Antinuclear

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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