Güneydoğu Anadolu Bölgesi jüvenil idiyopatik artrit hastalarında alt tip dağılımı ve üveit sıklığı

Amaç: Juvenil idiyopatik artrit (JİA) tüm dünyada en sık gözlenen çocukluk çağı romatizmal hastalığıdır. Tek bir hastalık olmayıp alt gruplardan oluşmaktadır. Kas iskelet sistemi dışında üveit şeklinde göz tutulumu önemli bir morbidite nedenidir. Çalışmamızın amacı kliniklerimizde takip edilen JİA hastaların alt tip dağılımını ve üveit sıklığını saptamaktır.Metod: Kliniklerimizde JİA tanısı ile takip ve tedavi edilen tüm hastaların dosyaları geriye dönük olarak taranmıştır. Bulgular: Çalışmamıza 264 JİA hastası dahil edilmiştir. Hastaların %54.9’u kız iken %45.1’i erkek idi ve ortalama takip süresi 13.8 ± 5.8 ay idi. JİA alt tip dağılımına bakıldığında en sık oligoartiküler JİA (%42.4) gözlenmekte idi. Entezit ilişkili artrit (%21.6) ikinci sırada iken diğer JİA alt tip dağılımı şu şekilde idi; sistemik JİA (%13.6), romatoid faktör (RF) negatif poliartiküler JİA (%10.2), RF pozitif poliartiküler JİA (%9.5), psoriatik artrit (%1.9) ve sınıflandırılamayan artrit (%0.8). Üveit toplam 23 hastada (%8.7) gözlenmiş olup üveit hastalarının %91.3’ü oligoartiküler JİA grubunda idi. Sistemik JİA hastalarının %13.8’inde makrofaj aktivasyon sendromu gözlendi. Son kontroldeki hastalık aktivitesine bakıldığında hastaların %18.6’sı aktif iken %81.4’ü remisyonda takip edilmekteydi. Sonuç: Ülkemizde en sık gözlenen JİA alt tipi diğer ülkelerde olduğu gibi oligoartiküler JİA’dır. Ancak batı ülkelerinden farklı olarak ikinci en sık gözlenen alt tip entezit ilişkili artrittir. Ülkemiz JİA hastalarının diğer bir farkı da, JİA ilişkili üveitin daha az gözlenmesidir. Oligoartiküler JİA üveitin en sık gözlendiği alt gruptur. Güncel tedavi seçeneklerinin artması ile hastaların büyük çoğunluğunda hastalık remisyonu sağlanabilmektedir.

Anahtar Kelimeler:

juvenile idiopatik artrit, üveit

Subtype distribution and frequency of uveitis in Southeastern Anatolian children with juvenile idiopathic arthritis

Aim: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood in the world. It is not a single disease rather composed of distinct subtypes. Apart from musculoskeletal complications, uveitis is one of the major causes of morbidity in JIA. The aim of this study was to demonstrate subtype distribution and frequency of uveitis in JIA.Method: The study was conducted in two pediatric rheumatology centers of Southeastern part of Turkey. Results: The cohort consisted of 264 children with slightly female predominance (females: 54.9%, males: 45.1%). Mean duration of follow-up was 13.8 ± 5.8 months. The most common subtype was oligoarticular JIA (42.4%) followed by enthesitis related arthritis (21.6%). The distribution of other subtypes were as follows; systemic JIA (13.6%), rheumatoid factor (RF) negative polyarticular JIA (10.2%), RF positive polyarticular JIA (9.5%), psoriatic arthritis (1.9%) and unclassified arthritis (0.8%). The frequency of uveitis was 8.7% and 91.3% of the patients with uveitis had oligoarticular JIA. Macrophage activation syndrome was observed in 13.8% of systemic JIA patients. While 18.6% of the patients had active disease at the time of enrollment, 81.4% had remission. Conclusion: As in other parts of the world, oligoarticular JIA is the most common subtype in our country. But, in contrast to western countries, enthesitis related arthritis is the second most common subtype in Turkey. The frequency of uveitis is low in Turkish JIA children that is another major difference from the western countries and oligoarticular JIA is the most common subtype associated with uveitis. With the introduction of newer treatment modalities, remission is an achievable goal in most of the JIA patients.

Keywords:

juvenile idiopathic arthritis, uveitis,

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