TY - JOUR
T1 - Course of joint disease in patients with antinuclear antibody-positive juvenile idiopathic arthritis
AU - Felici, Enrico
AU - Novarini, Cristina
AU - Magni-Manzoni, Silvia
AU - Pistorio, Angela
AU - Magnani, Alessandra
AU - Bozzola, Elena
AU - Buoncompagni, Antonella
AU - Martini, Alberto
AU - Ravelli, Angelo
PY - 2005/9
Y1 - 2005/9
N2 - Objective. To describe the patterns and time course of arthritis in patients with antinuclear antibody (ANA)-positive juvenile idiopathic arthritis (JIA). Methods. We identified patients followed during a 16-year period who had JIA by ILAR criteria, were ANA-positive (i.e., had ≥ 2 positive ANA test results at titer ≥ 1:160), and had a disease duration ≥ 2 years. Demographic and clinical features, including ILAR category and cumulative number and type of joints affected over time, were recorded. Results. A total of 195 patients were studied. The ILAR category was oligoarthritis in 159 patients and rheumatoid factor-negative polyarthritis in 36 patients. The cumulative rate of polyarticular extension in patients with oligoarticular onset was 26%, 38%, 45%, 49%, and 51% at 1, 2, 3, 4, and 5 years, respectively. At disease onset, most patients had monoarthritis and 95% had ≤ 4 joints affected. The knee was the most frequently involved of all joints, followed by the ankle and proximal interphalangeal joints. Among patients with oligoarticular onset, the presence of ankle (in case of monoarticular disease) and/or wrist involvement in the first 6 months was more common in those who progressed to polyarthritis. Conclusion. The majority of our ANA-positive patients, including most of those who later developed polyarthritis, had monoarthritis at disease onset. Among patients with oligoarticular onset, polyarticular extension occurred in around 50% of cases within the first 3-4 years after disease onset, and tended to be less likely thereafter. The early occurrence of ankle and/or wrist disease may indicate a higher likelihood of arthritis progression.
AB - Objective. To describe the patterns and time course of arthritis in patients with antinuclear antibody (ANA)-positive juvenile idiopathic arthritis (JIA). Methods. We identified patients followed during a 16-year period who had JIA by ILAR criteria, were ANA-positive (i.e., had ≥ 2 positive ANA test results at titer ≥ 1:160), and had a disease duration ≥ 2 years. Demographic and clinical features, including ILAR category and cumulative number and type of joints affected over time, were recorded. Results. A total of 195 patients were studied. The ILAR category was oligoarthritis in 159 patients and rheumatoid factor-negative polyarthritis in 36 patients. The cumulative rate of polyarticular extension in patients with oligoarticular onset was 26%, 38%, 45%, 49%, and 51% at 1, 2, 3, 4, and 5 years, respectively. At disease onset, most patients had monoarthritis and 95% had ≤ 4 joints affected. The knee was the most frequently involved of all joints, followed by the ankle and proximal interphalangeal joints. Among patients with oligoarticular onset, the presence of ankle (in case of monoarticular disease) and/or wrist involvement in the first 6 months was more common in those who progressed to polyarthritis. Conclusion. The majority of our ANA-positive patients, including most of those who later developed polyarthritis, had monoarthritis at disease onset. Among patients with oligoarticular onset, polyarticular extension occurred in around 50% of cases within the first 3-4 years after disease onset, and tended to be less likely thereafter. The early occurrence of ankle and/or wrist disease may indicate a higher likelihood of arthritis progression.
KW - Antinuclear antibodies
KW - Juvenile chronic arthritis
KW - Juvenile idiopathic arthritis
KW - Juvenile rheumatoid arthritis
KW - Oligoarthritis
KW - Polyarthritis
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M3 - Article
C2 - 16142881
AN - SCOPUS:24944484996
VL - 32
SP - 1805
EP - 1810
JO - Journal of Rheumatology
JF - Journal of Rheumatology
SN - 0315-162X
IS - 9
ER -