Madalyonun Diğer Yüzü: Juvenil İdiyopatik Artritli Hastalarda Üveit

Amaç: Juvenil idiyopatik artrit (JİA), eklem iltihabı ve doku hasarına neden olan çocukluk çağı romatizmal bir hastalıktır. Enfeksiyöz olmayan üveit, JİA’nın en sık görülen eklem dışı belirtisidir. Bu çalışmanın amacı, JIA’lı hastalarda üveit oluşumunda ve tekrarlamasında rol oynayan risk faktörlerini değerlendirmek ve artrit ile üveit aktivitesi arasındaki ilişkiyi belirlemektir. Gereç ve Yöntemler: Bu retrospektif, kesitsel çalışmaya Türkiye’deki bir sevk merkezinden üveiti olan/olmayan JIA hastaları dahil edildi. Hastalık aktivitesini değerlendirmek için Juvenil Artrit Hastalık Aktivite Skoru kullanıldı ve artrit ve üveit için ayrı ayrı hesaplandı. Bulgular: Üveit 195 JIA hastasının 26’sında (%13.3) görüldü. 26 JIA-U hastasının 19’unda (%73) oligoartiküler alt tip vardı. Üveitli JİA’nın tanı ortanca yaşı üveitsiz JİA’ya göre daha gençti (p=0.015). Oligoartiküler JİA üveit nüksü ile ilişkili bulunmuştur (p=0.021). Tekrarlayan üveiti olan hastalarda artrit ve üveitin ortaya çıkış yaşı anlamlı olarak daha gençti (sırasıyla p=0.041, p=0.002). Üveit başlangıcındaki medyan JADAS27 skoru tekrarlayan grupta daha düşüktü (p=0.038). Sonuç: Erken yaş, üveit oluşumu ve nüksü için önemli bir risk faktörüdür. Hastalık seyri sırasında, düşük hastalık aktivitesine sahip hastalarda da üveit gelişebileceğini unutmamak önemlidir.

Anahtar Kelimeler:

Yaş, Hastalık Aktivitesi, Juvenil Idiyopatik Artrit, Pediatri, Nüks, Üveit

The Other Side of the Coin: Uveitis in Patients with Juvenile Idiopathic Arthritis

Objective: Juvenile idiopathic arthritis (JIA) is a childhood rheumatic disease that causes joint inflammation and tissue damage. Non-infectious uveitis is the most common extra-articular manifestation of JIA.The aim of this study is to evaluate the risk factors that play a role in occurrence and recurrence of uveitis and, to determine the relationship between arthritis and uveitis activity in patients with JIA. Material and Methods: This retrospective, cross sectional study included JIA patients with/without uveitis from a referral center in Turkey. The Juvenile Arthritis Disease Activity Score was used to evaluate the disease activity and calculated for arthritis and uveitis separately. Results: Uveitis was seen in 26 (13.3%) of 195 JIA patients. Of 26 JIA associated uveitis (JIA-U) patients, 19 (73%) had an oligoarticular subtype. The median age at diagnosis of JIA with uveitis was younger than without uveitis (p=0.015). Oligoarticular JIA was found to be associated with recurrence of uveitis (p=0.021). The occurrence age of arthritis and uveitis was significantly younger in patients with recurrent uveitis (p=0.041, p=0.002, respectively). The median JADAS27 score at the onset of uveitis was lower in the recurrent group (p=0.038). Conclusion: Early age is a significant risk factor for occurrence and recurrence of uveitis. It is important to remember that, during the disease course, patients with low disease activity may also develop uveitis.

Keywords:

age, disease activity, juvenile idiopathic arthritis, pediatrics, recurrence, uveitis.,

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