青少年特发性关节炎的模式;埃及的回顾性研究

Z. Hussein, Reham Wagdy, M. Shawki, Sahar Zohni, Islam Shehawy
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引用次数: 7

摘要

背景:幼年特发性关节炎(JIA)是儿童最常见的自身免疫性肌肉骨骼疾病。JIA患者谱在不同人群中表现出许多相似性和差异性。因此,我们的研究旨在分析埃及人群JIA的临床资料、实验室资料、治疗方案和患者结局。方法:对2004-2010年在亚历山大儿童医院儿科风湿病门诊随访的JIA患儿病历进行核对和分析。结果:我们的研究纳入了63例埃及JIA患者(男性33例,女性30例),平均年龄7.3±3.1岁(范围3-16岁)。我们发现以少关节型为主(41.2%),其次是多关节型(35%),然后是全身性发病型(23.8%)。绝大多数患者生活在农村地区(57.1%)。临床以膝关节(74.6%)为主要表现,关节外以苍白(42.9%)为主要表现(42.2%)。葡萄膜炎(6.3%)仅表现为少关节和多关节亚型。类风湿因子和抗核抗体阳性率分别为69.8%和20.6%。缓解率为47.6%,多发生在少关节亚型。两药联合治疗方案的缓解率最高(39.8%)。结论:埃及儿童JIA以少关节亚型为主,农村地区尤甚,与西方和海湾国家不同。关键词:幼年特发性关节炎,少关节,类风湿因子,晨僵
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The pattern of juvenile idiopathic arthritis; a retrospective Egyptian study
Background: Juvenile idiopathic arthritis (JIA) is the most common autoimmune musculoskeletal disease in children. The spectrum of patients’ profile of JIA showed many similarities and differences among different populations. Therefore, our study aimed to analyze the clinical data, laboratory data, treatment protocols and patient’s outcomes of JIA among Egyptian population. Methods: We checked and analyzed medical files of children with JIA followed up at pediatric rheumatology clinic between 2004-2010 at Alexandria Main Children Hospital. Results: Our study included data about 63 Egyptian JIA patients (33 males and 30 females), with a mean age of 7.3±3.1 years (range 3-16 years). We found that oligoarticular subtype was the predominant (41.2%) among cases followed by polyarticular (35%) then systemic onset type in (23.8%). Most of the patients lived in rural areas (57.1%). Clinically, knee joints (74.6%) were the most affected joints while pallor (42.9%) was main extra-articular manifestations (42.2%) among all subtypes. Uveitis (6.3%) manifested among oligoarticular and polyarticular subtypes only. Rheumatoid factor and anti-nuclear antibody (ANA) were positive among 69.8% and 20.6% of the studied cases respectively. Remission rate was 47.6% and occurred mostly in oligoarticular subtype. Also, the regimen of combination of two drugs showed the highest remission rate (39.8%). Conclusion: The pattern of JIA among Egyptian children showed predominance of oligoarticular subtype specially at rural areas which differed from Western and Gulf countries pattern. Keywords: Juvenile idiopathic arthritis, oligoarticular, Rheumatoid factor, morning stiffness
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