PREDICTION OF LONG-TERM EFFECTS OF POLYARTICULAR VARIANT OF JUVENILE IDIOPATHIC ARTHRITIS

Relevance. It is known that the poly-articular variant of JIA is associated with significant articular and extra-articular damages with predominant lesions of small and medium joints with limitation of their function and the development of ankylosis, requiring surgical intervention in these patients...

Full description

Saved in:

Bibliographic Details
Published in:	Medychna nauka Ukraïny Vol. 13; no. 3-4; pp. 28 - 37
Main Authors:	Dzhus, M.B., Marushko, T.V., Mostbauer, H.V., Ivashkivsky, О.І., Kurylchyk, I.V., Yegorova, N.A., Nosovets, О.К.
Format:	Journal Article
Language:	English
Published:	Bogomolets National Medical University 21-06-2018
Subjects:	juvenile idiopathic arthritis, polyarticular variant, adults, prognosis, long term damages, jadi
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Relevance. It is known that the poly-articular variant of JIA is associated with significant articular and extra-articular damages with predominant lesions of small and medium joints with limitation of their function and the development of ankylosis, requiring surgical intervention in these patients. Objective. The aim of the study was to evaluate the risk factors of articular and extra-articular damages in adults with the poly-articular variant of the JIA and to work out a prognostic model for their development. Materials and methods. The study included 45 adult patients with poly-articular (RF+ and RF-) variant of the JIA. Retrospective analysis of medical records of patients with poly-articular variant of JIA was made, taking into account clinical manifestations in the onset of the disease, laboratory parameters and response to therapy. In adulthood, the integral index of articular (JADI-A) and extra-articular (JADI-E) damages was used to assess the long-term effects of JIA. Results. Unfavorable prognostic factors were revealed by method of binary logistic regression. Mathematical model for predicting the probability of long-term negative articular and extra-articular damages of poly-articular JIA was developed. Conclusions 1. The risk factors for the development of articular and extra-articular damages in adulthood in patients with a poly-articular variant of the JIA are female sex, the presence of lymphadenopathy and/or splenomegaly in childhood, the level of ESR during treatment in childhood, the activity of JADAS in childhood, the presence of symmetric arthritis in childhood, the RF positivity in the debut of the disease, the treatment with glucocorticoids, the cumulative dose of the DMARDs, and lack of therapy by DMARDs. 2. A prognostic model for the development of articular and extra-articular damages in adult patients with a poly-articular variant of the JIA is developed. This model is effective and allows determine the adverse course of the disease and can be the basis for personalized treatment for the prevention of the development of significant articular and extra-articular damages of JIA.
ISSN:	2664-472X 2664-4738
DOI:	10.32345/2664-4738.3-4.2017.05