Clinical and laboratory features of juvenile idiopathic arthritis with wrist involvement:Results of a retrospective cohort study  

作　　者：Lyubov Sorokina Maria Kaneva Artem Artamonov Natalia Gordeeva Irina Chikova Mikhail Kostik 

机构地区：[1]Hospital Pediatry,Saint Petersburg State Pediatric Medical University,Saint Petersburg 194100,Russia [2]Department of Consulting and Diagnostic,Saint-Petersburg Children’s Hospital#2,n.a.Saint Mary Magdalene,Saint Petersburg 199004,Russia [3]Research Laboratory of Autoimmune and Autoinflammatory Diseases,Almazov National Medical Research Center,Saint-Petersburg 197341,Russia

出　　处：《World Journal of Clinical Pediatrics》2024年第3期22-33,共12页世界临床儿科杂志

基　　金：Supported by Ministry of Science and Higher Education of the Russian Federation,No.075-15-2022-301.

摘　　要：BACKGROUND Previous studies in the pre-biological era showed an association of wrist inflammation in juvenile idiopathic arthritis(JIA)with progressive disease course,polyarticular involvement and failure of methotrexate treatment.AIM To describe features of JIA,associated with wrist arthritis.METHODS Data from about 753 JIA patients were included in this retrospective cohort study.The clinical and laboratory features of patients with and without wrist involvement were analyzed.RESULTS Wrist involvement was found in oligoarthritis(5.8%),RF(−)/RF(+)polyarthritis(44.9%/15.0%),enthesitis-related arthritis(17.7%),and systemic(58.6%)JIA categories.Unilateral wrist involvement was typical for oligoarthritis patients,bilateral involvement was either equal to that of unilateral involvement or was more frequent in other categories.Wrist arthritis was found to be associated with female sex,a low incidence of uveitis,and more indications of systemic inflammation,including elevated levels of C-reactive protein,erythrocyte sedimentation rate,and platelets,as well as involvement of the cervical spine,temporomandibular,shoulder,elbow,metacarpophalangeal,proximal interphalangeal,distal interphalangeal,hip,ankle,and tarsus arthritis.The number of patients with hip osteoarthritis and hip replacement was also higher.Wrist arthritis was associated with a lower probability of achieving remission[hazard ratio(HR)=1.3(95%CI:1.0-1.7),P=0.055],and a higher probability of being treated with biologics[HR=1.7(95%CI:1.3-2.10,P=0.00009)].CONCLUSION Wrist arthritis in JIA patients is a marker of a severe disease course,characterized by more intensive inflammation,unfavorable outcomes,and.requiring more intensive treatment with early administration of biologics.Close monitoring of wrist inflammation with ultrasound and MR assessment with early biological treatment might improve the outcomes.

关 键 词：WRIST HAND Juvenile idiopathic arthritis OUTCOMES BIOLOGICS METHOTREXATE 

分 类 号：R684.3[医药卫生—骨科学]