the National Key R&D Program of China(2021YFC2702003);the Supporting Program for Youth Innovation Group in Future Medicine of Chongqing Medical University(W0114);the Scientific Research Project of Chongqing Yuzhong District Bureau of Science and Technology(20210136)
Yan ZHANG, Huan XIAO, Chong LUO, et al. Clinical characteristics and risk factors of juvenile idiopathic arthritis-associated uveitis[J]. Journal of Army Medical University, 2024, 46(20): 2346-2351.
DOI:
Yan ZHANG, Huan XIAO, Chong LUO, et al. Clinical characteristics and risk factors of juvenile idiopathic arthritis-associated uveitis[J]. Journal of Army Medical University, 2024, 46(20): 2346-2351. DOI: 10.16016/j.2097-0927.202403053.
Clinical characteristics and risk factors of juvenile idiopathic arthritis-associated uveitis
To analyze the risk factors and clinical characteristics of uveitis in children with juvenile idiopathic arthritis (JIA).
Methods
2
A retrospective case-control study was conducted on 30 children with JIA-associated uveitis (JIA-U) and 36 age- and gender-matched children diagnosed as simple JIA admitted to Children's Hospital of Chongqing Medical University from June 2016 to June 2023. The clinical data
laboratory indicators and radiological findings were collected
and analyzed for the risk factors for JIA-U with univariate and multivariate analysis.
Results
2
In this study
JIA-U mostly occurred in both eyes (63.3%
19/30)
with anterior uveitis as the main cause (86.7%
26/30)
insidious onset
and mostly occurred after JIA diagnosis (60.0%
18/30)
and only 30% showing ocular discomfort or visual impairment. Univariate analysis showed that the JIA children with oligoarthritis JIA
negative rheumatoid factor (RF) and negative anti-cyclic citrullinated peptide antibody (anti-CCP) were prone to be complicated with uveitis (
P
<
0.05). Multivariate logistic regression analysis indicated that RF negativity was an independent risk factor for development of JIA-U (
OR
=5.400
95%
CI
: 1.033~28.227
P
=0.046).
Conclusion
2
IA-U often develops in both eyes
anterior uveitis is the most common
and it mostly diagnosed after JIA. It has no obvious eye symptoms in the early stage and thus is not easily recognized. Oligoarthritis JIA
RF-negative
and anti-CCP antibody-negative are the high-risk factors for the complication of JIA-U in children with JIA.
CHU W H, PENG S. Research progress in the risk factors of juvenile idiopathic arthritis-associated uveitis and its severe visual outcome[J]. Chin J Pediatr, 2018, 56(10): 786-789. DOI: 10.3760/cma.j.issn.0578-1310.2018.10.016.
SEN E S, DICK A D, RAMANAN A V. Uveitis associated with juvenile idiopathic arthritis[J]. Nat Rev Rheumatol, 2015, 11(6): 338-348. DOI: 10.1038/nrrheum.2015.20.
VAN MEERWIJK C, KUIPER J, VAN STRAALEN J, et al . Uveitis associated with juvenile idiopathic arthritis[J ] . Ocul Immunol Inflamm, 2023, 31(10): 1906-1914. DOI: 10.1080/09273948.2023.2278060.
STORWICK J A, BRETT A C, BUHLER K, et al . Prevalence and titres of antinuclear antibodies in juvenile idiopathic arthritis: a systematic review and meta-analysis[J ] . Autoimmun Rev, 2022, 21(6): 103086. DOI: 10.1016/j.autrev.2022.103086.
The Subspecialty Group of Immunology of the Society of Pediatrics of Chinese Medical Association, Chinese Alliance of Pediatric Rheumatic and Immunologic Diseases, Alliance of Rheumatic and Immunologic Diseases. Chinese expert consensus on juvenile idiopathic arthritis-associated uveitis (2023)[J]. Med J Peking Union Med Coll Hosp, 2023, 14(2): 247-256. DOI: 10.12290/xhyxzz.2023-0090.
PETTY R E, SOUTHWOOD T R, MANNERS P, et al . International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001[J ] . J Rheumatol, 2004, 31(2): 390-392.
JABS D A, NUSSENBLATT R B, ROSENBAUM J T, et al . Standardizationof uveitis nomenclature for reporting clinical data. Results of the First International Workshop[J ] . Am J Ophthalmol, 2005, 140(3): 509-516. DOI: 10.1016/j.ajo.2005.03.057.
ANGELES-HAN S T, RINGOLD S, BEUKELMAN T, et al . 2019 American College of Rheumatology/arthritis foundation guideline for the screening, monitoring, and treatment of juvenile idiopathic arthritis-associated uveitis[J ] . Arthritis Care Res, 2019, 71(6): 703-716. DOI: 10.1002/acr.23871.
MALEKI A, PATEL P D, FOSTER C S. Juvenile idiopathic arthritis and its associated uveitis[J]. Expert Rev Clin Immunol, 2023, 19(9): 1157-1169. DOI: 10.1080/1744666X.2023.2231154.
CLARKE S L N, MAGEEAN K S, CARLTON H, et al . "Environmental risk factors associated with juvenile idiopathic arthritis associated uveitis: a systematic review of the literature"[J ] . J Ophthalmic Inflamm Infect, 2021, 11(1): 15. DOI: 10.1186/s12348-021-00247-1.
ANGELES-HAN S T, PELAJO C F, VOGLER L B, et al . Risk markers of juvenile idiopathic arthritis-associated uveitis in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry[J ] . J Rheumatol, 2013, 40(12): 2088-2096. DOI: 10.3899/jrheum.130302.
SEN E S, RAMANAN A V. Juvenile idiopathic arthritis-associated uveitis[J]. Clin Immunol, 2020, 211: 108322. DOI: 10.1016/j.clim.2019.108322.
CAO Y J, FANG W, LIANG F F, et al . Clinical characteristics and visual prognosis factors of uveitis associated with juvenile idiopathic arthritis: an analysis of 42 cases[J ] . Chin J Pract Pediatr, 2022, 37(7): 512-515, 522. DOI: 10.19538/j.ek2022070609.
YASUMURA J, YASHIRO M, OKAMOTO N, et al . Clinical features and characteristics of uveitis associated with juvenile idiopathic arthritis in Japan: first report of the pediatric rheumatology association of Japan (PRAJ)[J ] . Pediatr Rheumatol Online J, 2019, 17(1): 15. DOI: 10.1186/s12969-019-0318-5.
LENTI M V, ROSSI C M, MELAZZINI F, et al . Seronegative autoimmune diseases: a challenging diagnosis[J ] . Autoimmun Rev, 2022, 21(9): 103143. DOI: 10.1016/j.autrev.2022.103143.
PAALANEN K, PUOLAKKA K, NIKIPHOROU E, et al . Is seronegative rheumatoid arthritis true rheumatoid arthritis? A nationwide cohort study[J ] . Rheumatology (Oxford), 2021, 60(5): 2391-2395. DOI: 10.1093/rheumatology/keaa623.
NORDAL E B, SONGSTAD N T, BERNTSON L, et al . Biomarkers of chronic uveitis in juvenile idiopathic arthritis: predictive value of antihistone antibodies and antinuclear antibodies[J ] . J Rheumatol, 2009, 36(8): 1737-1743. DOI: 10.3899/jrheum.081318.
PETTY R E, ZHENG Q. Uveitis in juvenile idiopathic arthritis[J]. World J Pediatr, 2020, 16(6): 562-565. DOI: 10.1007/s12519-019-00331-6.
HAASNOOT A J W, SCHILHAM M W, KAMPHUIS S, et al . Identification of an amino acid motif in HLA-DRβ1 that distinguishes uveitis in patients with juvenile idiopathic arthritis[J ] . Arthritis Rheumatol, 2018, 70(7): 1155-1165. DOI: 10.1002/art.40484.
FENG Y, ZHANG Y, ZHOU J, et al . Clinical value of serum amyloid A in assessment of disease activity for juvenile idiopathic arthritis[J ] . J Third Mil Med Univ, 2017, 39(19): 1933-1938. DOI: 10.16016/j.1000-5404.201704033.
ROSINA S, NATOLI V, SANTANIELLO S, et al . Novel biomarkers for prediction of outcome and therapeutic response in juvenile idiopathic arthritis[J ] . Expert Rev Clin I mmunol, 2021, 17(8): 853-870. DOI: 10.1080/1744666X.2021.1945441.