Review for Disease of the Year: Epidemiology of Juvenile Idiopathic Arthritis and its Associated Uveitis: The Probable Risk Factors

Abstract

Juvenile idiopathic arthritis (JIA) is the most common systemic disease associated with uveitis in childhood. The frequency of JIA-associated uveitis (JIAU) varies geographically, and between ethnicities. Uveitis risk is high in JIA associated with oligoarthritis, young age at arthritis onset and ANA positivity. Gender alters risk for the incidence of JIA and the severity of JIAU. Familial cases support the possible role of genetic influences in the pathogenesis. Arthritis typically precedes the uveitis, but uveitis may occur up to seven years following the arthritis onset. Although complications still occur, the frequency of bilateral blindness has dropped, probably by both improved screening of high-risk patients with JIA, and the increased use of early immunosuppression. However, there is still continuing persistence of JIAU into adulthood. For improvement of epidemiological knowledge of this complicated disease, large, well-defined, long-term population-based registries are needed with the application of universally agreed case definitions and outcome measures.

Juvenile idiopathic arthritis-associated uveitis

“…When broken down by aetiology, the prevalence of JIA-U among all causes of paediatric uveitis varies widely by referral centre, ranging from 15-67 % across centres in Europe, North America and Israel [4,[6][7][8][9]. The variation in these figures may partly be due to the referral cohorts from which the patients are selected, however, it should also be noted that uveitis can precede a diagnosis of arthritis in 3-7 % of children with JIA [10] and thus children presenting with uveitis need careful assessment for underlying systemic or infectious disease. When looking specifically at the prevalence of uveitis in those patients already known to have JIA, estimates of prevalence ranges from 11.6 % [11] to 30 % [12] although overall it appears to be decreasing over the past decade.…”

“…These include gender, JIA category, age of onset, and ANA and HLA-B27 positivity [3,10,12,14]. A younger age, female gender, oligoarticular disease and presence of ANA are risk factors for chronic anterior uveitis.…”

Uveitis Events During Adalimumab, Etanercept, and Methotrexate Therapy in Juvenile Idiopathic Arthritis: Data From the Biologics in Pediatric Rheumatology Registry

“…JIA is classified into categories according to the International League of Associations for Rheumatology classification criteria (2). Chronic anterior uveitis is the most threatening comorbid condition of JIA, and it affects up to 20% of the patients with JIA, depending on the JIA category (3). JIA-associated uveitis is a chronic, nongranulomatous inflammation of the anterior chamber of…”

Effective Use of Monoclonal Antibodies Against TNF — Adalimumab — As a Switchover Drug in a Patient With Juvenile Idiopathic Polyarthritis and Uveitis

“…Увеит развивается у 12-24% детей с ЮИА, пре-имущественно с олигоартикулярным вариантом болезни. Частота необратимого снижения остроты зрения вслед-ствие развития осложнений увеита достигает 12% и при-водит к значительной инвалидизации детей [7].…”