Atherosclerosis is a chronic inflammatory disease of the arteries. Clinical consequences of the atherosclerotic process occur in the adult population, however atherosclerotic process begins in childhood. The classic risk factors for atherosclerosis include obesity, dyslipidaemia, age, gender or family history. In recent years, attention has been drawn to the similarity between atherosclerotic inflammatory processes and inflammatory changes in the course of systemic connective tissue disease, in particular systemic lupus etythematosus (SLE) or rheumatoid arthritis (RA). There is also observed the similarity of the pathogenetic background of development of atherosclerosis and juvenile idiopathic arthritis (JIA). Elevated levels of pro-inflammatory cytokines are observed in the course of juvenile idiopathic arthritis. Also homocysteine concentrations, which may play a significant role in the development of atherosclerotic lesions, are observed higher in patients with JIA. Some studies revealed higher carotid intima-media thickness (IMT) index values in children with JIA. In view of the fact that atherosclerotic process begins as early as in childhood, the introduction of appropriate preventive measures in children is a matter of utmost importance.

The study was aimed to evaluate cardiovascular risk parameters, body mass index (BMI) centiles for sex and age, and body fat percentage using the electric bioimpedance method in children with juvenile idiopathic arthritis (JIA). 30 children with JIA participated in the study. A control group included 20 children. Patients were well matched for the age and sex. The body mass and body fat percentage were determined using the segmental body composition analyser; the BMI centiles were determined. All patients had the following parameters determined: lipid profile, hsCRP, homocysteine, and IL-6. The intima media thickness (IMT) was measured. Patients with JIA had significantly lower body weight, BMI, and the BMI centile compared to the control group. The IL-6 levels were significantly higher in patients with JIA compared to the control group. There were no differences between two groups with regard to the lipid profile, % content of the fat tissue, homocysteine levels, hsCRP, and IMT. Further studies are necessary to search for reasons for lower BMI and BMI centile in children with JIA and to attempt to answer the question of whether lower BMI increases the cardiovascular risk in these patients, similarly as in patients with rheumatoid arthritis (RA).

ObjectiveTo assess the prevalence of pain in the musculoskeletal system and possible reasons for these complaints among early age children from Warsaw schools.Material and methodsThe study was conducted in 34 randomly selected primary schools in Warsaw in 2011. 2748 survey-questionnaires were given to parents or legal guardians by children. Of these, 1509 surveys were subject to a final analysis. The survey included 66 questions regarding, among other things, pain in the musculoskeletal system in children. Additionally, there were questions about possibly occurring diseases, any postural defects, significant obesity, as well as effects of these complaints on the child's physical activity. Survey data regarded 6–7-year-old children.ResultsIn the group of 1509 respondents, 242 children (16%) complained about pain in the musculoskeletal system. Pain was located most frequently in the knee joints, and more rarely in the spine and joints in the upper extremities. In the group of children who complained about pain, moderate physical activity was statistically significantly limited. According to parents, physicians did not diagnose any medical conditions in 106 children. Joint disease was diagnosed in 33 children. Postural defects were diagnosed in 589 children. In 123 children complaining about pain at least one postural defect was diagnosed. Such defects were diagnosed statistically significantly more rarely (p = 0.011) in 1234 children who did not complain about pain (460 children). Platypodia or other foot deformation was observed in 25% of these children, spinal curvature in 12%, abnormal knee joint position in 11% and uneven hip position in 2% children. Of note, 17% of all children were significantly overweight. In overweight children the prevalence of pain, especially in the knee joints and feet, was significantly higher.ConclusionsThis study aims to underline the problem of musculoskeletal pain in early-age children which limits their physical activity. Also the authors draw attention to the issue of postural defects in a large group of school children. This issue undoubtedly requires more attention and a plan how to create more effective methods of prevention.

A case report of a boy with juvenile idiopathic arthritis since the age of 2 years, generalized onset, complicated by nephrotic syndrome due to secondary type A amyloidosis is presented.In the patient the disease had an especially severe course, complicated by frequent infections, making routine treatment difficult. Amyloidosis was diagnosed in the 5th year of the disease based on a rectal biopsy. Since the disease onset the boy has been taking prednisolone and sequentially cyclosporine A, methotrexate, chlorambucil, etanercept, and cyclophosphamide. Clinical and laboratory remission was observed after treatment with tocilizumab. After 42 months of treatment with tocilizumab the boy's condition is good. There is no pain or joint edema, and no signs of nephrotic syndrome.

BackgroundAtherosclerosis is a chronic inflammatory disease of the arteries. The clinical consequences of atherosclerosis are present in the adult population, however the beginning of atherosclerosis occurs in early childhood.ObjectivesThe aim of the study was to assess whether cardiovascular risk in patients with JIA is increased, as well as in patients with RA. We evaluated the lipid parameters as the traditional (classic) risk factors and new risk factors (homocysteine, fibrinogen, IL-6, IMT thickness) of cardiovascular risk in children with JIA compared with the control group.The same parameters were assessed in groups of children with JIA stratified according to the disease activity, the disease duration and the form of the disease compared with the control group. Particular attention was paid to the assessment of cardiovascular risk factors in the group of children with JIA meeting the criteria for overweight and obesity.MethodsThe study group comprised 60 children with JIA. The control group consisted of 25 children appropriately matched for age and sex.In all patients were measured: height, weight, BMI and BMI percentile, IMT.The analysis of total cholesterol, LDL cholesterol, HDL cholesterol, TG, homocysteine, fibrinogen, IL-6 were assessed in all examined children.ResultsIn children with JIA were found significantly lower: average body weight, height, BMI and BMI percentile compared to the corresponding mean values of the children of the control group. In children with JIA were found statistically higher concentrations of IL-6 compared with the control group. The average thickness of IMT observed in the group of children who were in the inactive phase was significantly higher than the mean values of IMT observed in children with a group of children in the active phase and the control group.The mean concentration of fibrinogen was significantly higher in the group of children in the active phase in relation to average fibrinogen levels observed in the group of children with the disease in the inactive phase and the control group. A positive correlation between IMT and body mass, BMI and BMI percentiles was found as well as between homocysteine and body weight and BMI. A negative correlation between the concentration of fibrinogen and HDL cholesterol was found. The IMT values in children with overweight and obesity were significantly higher compared with the IMT values in children without overweight and obesity. There were no statistically significant differences between the mean values of lipid parameters observed in the group of children with JIA and the control group. There were no statistically significant differences in the concentration of homocysteine, fibrinogen in children with JIA and the control group.ConclusionsThe cardiovascular risk in children in the active phase of JIA may be higher in relation to the children in the inactive phase. In these groups of children higher concentrations of fibrinogen, IL-6 are observed. This assessment of IMT should be taken into consideration as a noninvasive m...