Frequency of juvenile idiopathic arthritis and associated uveitis in pediatric rheumatology clinics in Turkey: A retrospective study, JUPITER

Abstract

Background Juvenile idiopathic arthritis (JIA), is the most common pediatric rheumatologic disorder with unknown etiology. Currently, no population-based data are available regarding the distribution of categories and frequency of uveitis in patients with JIA in Turkey. The purpose of this study was to evaluate the frequency of JIA-associated uveitis (JIAU) and distribution of JIA categories in a Turkish JIA cohort. Methods This was a retrospective study of 500 randomized patients in four pediatric rheumatology clinics in Turkey. Results Oligoarticular JIA (oJIA) was the most common JIA disease category in this study cohort (38.8%). The frequencies of the other categories were as follows: enthesitis-related arthritis (ERA), 23.2%; rheumatoid factor (RF)–negative polyarthritis, 15.6%; systemic arthritis, 12.2%; juvenile psoriatic arthritis, 5.2%; undifferentiated arthritis, 2.8%; and RF-positive polyarthritis, 2.2%. JIA-associated uveitis was observed in 6.8% of patients at a mean (Standard Deviation, SD) age of 9.1 (3.8) years over a mean JIA disease duration of 4 (1.9) years. Uveitis developed after joint disease, with a mean (SD) duration of 1.8 (1.9) years. Patients with oJIA had the highest rate of uveitis (12.9%) followed by patients with ERA (5.2%) and polyarticular RF-negative disease (3.8%). Compared with persistent oJIA, the extended oJIA category had a > 3-fold higher risk of uveitis (11.3% vs 27.7%; odds ratio, 3.38 [95% Confidence Interval, 1.09–10.4]). The most frequently administered drug after development of uveitis was tumor necrosis factor–alpha inhibitors (38.2%). Five patients (14.7%) had uveitis-related complications that required surgical intervention. Conclusions Turkish pediatric patients with JIA experience a lower frequency of oJIA and higher frequency of ERA than their white European counterparts; the occurrence of uveitis is also somewhat lower than expected. Geographic and ethnic factors may affect these differences and need further investigation.

Be aware of severe juvenile chronic iridocyclitis without evidence of arthritis: Juvenile chronic iridocyclitis revisited

“…JIA-associated uveitis is sometimes severe and carries a risk of poor visual outcomes. [5][6][7][8] Although our patients' ocular lesions were like those of patients with JIA-associated uveitis, none developed arthritis. Yasumura et al reported that 4.9% of the 41 patients with JIA-associated uveitis experienced ocular manifestations before JIA onset.…”

Evaluation of Patients with Juvenile Idiopathic Arthritis- Associated Uveitis from Rheumatology Perspective

“…Oligoarticular JIA was the most common JIA category (38.8%) in the JUPITER study cohort, which included four centers from Turkey. Other JIA subgroups and percentages in the JUPITER study were ERA, 23.2%; RF (-) polyarthritis, 15.6%; systemic arthritis, 12.2%; juvenile psoriatic arthritis, 5.2%; undifferentiated arthritis, 2.8%; and RF-positive polyarthritis, 2.2% (12). In our report, the most common type of JIA associated with uveitis was the persistent oligoarticular JIA with a rate of 55.9% and ERA was the second most common JIA subtype category with 32.4%.…”

Juvenile idiopathic arthritis in an adult Filipino female: A case report

“…The most common extra-articular complication of JIA is uveitis, an inflammation of the iris, ciliary body, and choroid that may progress to cataracts (78%) or secondary glaucoma (33%), as seen in the index patient. 8,9 Incidence of uveitis among patients with JIA reportedly differ among subgroups and ethnicities. Uveitis is relatively uncommon in RF negative polyarticular JIA (3.8%) and Asians, as noted in a study in Taiwan revealing a prevalence of only 0.25 cases of uveitis per 100 000 persons with JIA.…”

“…The most common extra‐articular complication of JIA is uveitis, an inflammation of the iris, ciliary body, and choroid that may progress to cataracts (78%) or secondary glaucoma (33%), as seen in the index patient 8,9 . Incidence of uveitis among patients with JIA reportedly differ among subgroups and ethnicities.…”