The Pattern of Juvenile Idiopathic Arthritis in a Single Tertiary Center in Saudi Arabia

Introduction.Juvenile Idiopathic Arthritis (JIA) is the most common chronic arthritis in children. Our aim is to describe demographic, clinical, and laboratory characteristics and treatment of JIA patients followed up in Pediatric Rheumatology clinic in a tertiary center in Saudi Arabia.Methods. Medical records of all patients who are followed up between January 2007 and January 2015 were retrospectively reviewed. Data were collected about demographic, clinical, and laboratory features and treatment.Results.Total patients were 82, males were 31 (37.8%), and mean age of JIA onset was 7.1 ± 3.6 yr. Mean follow-up duration was 2.67±1.6 yr. Systemic onset JIA (SoJIA) was the commonest (36.5%), followed by polyarticular in 29.2% and oligoarticular in 28%. Large and small joints are involved in 76 (92%) and 30 (36.6%), respectively. Main extra-articular feature was fever in 34 (41.4%). Uveitis was diagnosed in 7 (8.5%) and in 5 (21.7%) of oligoarticular JIA. Anemia was found in 49 (59.7%), high ESR in 45 (54.8%), and leukocytosis and thrombocytosis in 33 (40.2%). Positive ANA was found in 30 (36.5%) mainly in oligoarticular subtype as 12 (52%) patients (out of 23) had this positive test. 9 patients (10.9%) required NSAIDs only, 6 patients (7.3%) required NSAIDs and intra-articular steroids only, and 19 (23%) required NSAIDs, methotrexate, steroids, and biologics.Conclusion.SoJIA is the most common JIA subtype in our study. A population based rather than a single center study will give more details about JIA characteristics in Saudi Arabia

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Juvenile Idiopathic Arthritis in Jordan: Single-Center Experience

10.21203/rs.3.rs-103495/v1 ◽

2020 ◽

Author(s):

Raed Alzyoud ◽

Motasem O. Alsuweiti ◽

Heba Q. Almaaitah ◽

Bushra N. Aladaileh ◽

Mohammad K. Alnoubani ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Age At Onset ◽

Laboratory Data ◽

Population Based ◽

Single Center ◽

Rheumatology Clinic ◽

Single Center Experience ◽

Single Center Study ◽

Pediatric Rheumatology Clinic ◽

International League

Abstract Background: Juvenile idiopathic arthritis (JIA) is a heterogeneous group of disorders, including all forms of arthritis, begin in children who are less than 16 years old. This study aims to evaluate the clinical and laboratory features of JIA in Jordanian children in a single center.Methods: A retrospective analysis of the medical records of pediatric patients who were diagnosed as JIA based on the International League of Associations for Rheumatology (ILAR) criteria from 2015 through 2019 at a pediatric Rheumatology clinic in Queen Rania Children Hospital. All patients were below the age of 14 at the time of diagnosis. Collected data included age, gender, age at initial presentation and diagnosis, JIA subtypes, and laboratory data.Results: A total of 210 patients were included in this cohort (94 males and 116 females) with a mean age at diagnosis 5.33 ± 3.4 years and the mean age at onset of the disease was 5.08 ± 3.4 years (range 7 months – 14 years). Oligoarticular JIA was the commonest subtype (54.7%), followed by systemic arthritis (17.1%), polyarticular (12.3%). ANA was positive in 70 patients (33.6%). Uveitis occurred in thirty (14.2%) patientsConclusion: To the best of our knowledge, this cohort is the first report on JIA in Jordan, in comparison with other regional and international published reports, Oligoarticular JIA found to be the most common Subtype in our experience. To have more details about JIA characteristics, a population-based rather than a single-center study needs to be conducted in Jordan

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Juvenile idiopathic arthritis in Jordan: Single center experience

10.21203/rs.3.rs-103495/v2 ◽

2021 ◽

Author(s):

Raed M. Alzyoud ◽

Motasem O. Alsuweiti ◽

Heba Q. Almaaitah ◽

Bushra N. Aladaileh ◽

Mohammad K. Alnoubani ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Treatment Options ◽

Age At Onset ◽

Laboratory Data ◽

Population Based ◽

Detailed Knowledge ◽

Single Center ◽

Rheumatology Clinic ◽

Single Center Experience ◽

Single Center Study

Abstract Background: Juvenile idiopathic arthritis (JIA) is a heterogeneous group of disorders, including all forms of arthritis, which develops in children who are less than 16 years old. This study aimed to evaluate the clinical and laboratory features of JIA in a single center in Jordan.Methods: A retrospective analysis of the electronic medical records of pediatric patients diagnosed with JIA based on the International League of Associations for Rheumatology (ILAR) criteria during the period from 2015 to 2019 at the Pediatric Rheumatology Clinic in the Queen Rania Children’s Hospital. All patients were below the age of 14 years at the time of diagnosis and followed for at least six months. Collected data consisted of age, gender, age at initial presentation and diagnosis, JIA subtype, laboratory data, treatment options, and outcome.Results: A total of 210 patients were included in this cohort (94 males and 116 females) with the mean age at diagnosis and mean age at onset of 5.33 ± 3.40 years and 5.08 ± 3.40 years (range: 7 months – 14 years), respectively. Oligoarticular JIA was the commonest subtype (54.7%), followed by systemic arthritis (17.1%) and polyarticular arthritis (12.3%). ANA was positive in 70 patients (33.6%). Uveitis occurred in thirty (14.2%) patients.Conclusion: To the best of our knowledge, this study on this cohort is the first report on JIA in Jordan, in comparison with other regionally and internationally published reports. Oligoarticular JIA was found to be the most common subtype. For detailed knowledge on JIA characteristics and patterns, a population-based, rather than a single center study, should be conducted in Jordan.

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Juvenile idiopathic arthritis in Jordan: single center experience

Pediatric Rheumatology ◽

10.1186/s12969-021-00572-8 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Raed M. Alzyoud ◽

Motasem O. Alsuweiti ◽

Heba Q. Almaaitah ◽

Bushra N. Aladaileh ◽

Mohammad K. Alnoubani ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Treatment Options ◽

Age At Onset ◽

Laboratory Data ◽

Population Based ◽

Detailed Knowledge ◽

Single Center ◽

Rheumatology Clinic ◽

Single Center Experience ◽

Single Center Study

Abstract Background Juvenile idiopathic arthritis (JIA) is a heterogeneous group of disorders, including all forms of arthritis, which develops in children who are less than 16 years old. This study aimed to evaluate the clinical and laboratory features of JIA in a single center in Jordan. Methods A retrospective analysis of the electronic medical records of Pediatric patients diagnosed with JIA based on the International League of Associations for Rheumatology (ILAR) criteria during the period from 2015 to 2019 at the Pediatric Rheumatology Clinic in the Queen Rania Children’s Hospital. All patients were below the age of 14 years at the time of diagnosis and followed for at least 6 months. Collected data consisted of age, gender, age at initial presentation and diagnosis, JIA subtype, laboratory data, treatment options, and outcome. Results A total of 210 patients were included in this cohort (94 males and 116 females) with the mean age at diagnosis and mean age at onset of 5.33 ± 3.40 years and 5.08 ± 3.40 years (range: 7 months – 14 years), respectively. Oligoarticular JIA was the commonest subtype (54.7%), followed by systemic arthritis (17.1%) and polyarticular arthritis (12.3%). ANA was positive in 70 patients (33.6%). Uveitis occurred in 30 (14.2%) patients. Conclusion To the best of our knowledge, this study on this cohort is the first report on JIA in Jordan, in comparison with other regionally and internationally published reports. Oligoarticular JIA was found to be the most common subtype. For detailed knowledge on JIA characteristics and patterns, a population-based, rather than a single center study, should be conducted in Jordan.

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Outcome in juvenile idiopathic arthritis: a population-based study from Sweden

Arthritis Research & Therapy ◽

10.1186/s13075-019-1994-8 ◽

2019 ◽

Vol 21 (1) ◽

Cited By ~ 5

Author(s):

Elisabet Berthold ◽

Bengt Månsson ◽

Robin Kahn

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Disease Activity ◽

Orthopedic Surgery ◽

Population Based ◽

Annual Incidence ◽

Common Disease ◽

Necrosis Factor Alpha ◽

Systemic Jia ◽

Record Review

Abstract Background As the treatment arsenal for children with juvenile idiopathic arthritis (JIA) has expanded during the last decades, follow-up studies are needed on children diagnosed in the era of biological treatment to evaluate if this has improved the outcome. Our aim was to study the epidemiology and outcome of JIA in southern Sweden using a population-based cohort of children with a validated diagnosis of JIA collected over 9 years. Methods Potential cases of JIA between 2002 and 2010 were collected after a database search, using the ICD codes M08-M09. The study area was Skåne, the southernmost county of Sweden (population 1.24 million; 17.6% aged < 16 years). The JIA diagnosis was validated and subcategorized through medical record review based on the criteria defined by the International League of Associations for Rheumatism (ILAR). Parameters on disease activity and pharmacologic treatment were recorded annually until the end of the study period (December 31, 2015). Results In total, 251 cases of JIA were confirmed. The mean annual incidence rate for JIA was estimated to be 12.8/100,000 children < 16 years, with the highest age-specific annual incidence at the age of 2 years (36/100,000). Oligoarthritis was the largest subgroup (44.7%), and systemic JIA was the smallest subgroup (2.8%). Methotrexate was the most common disease-modifying anti-rheumatic drug prescribed (60.6%). Tumor necrosis factor alpha inhibitors were used as treatment for 23.9% of the children. Only 40.0% of the follow-up years, with a median follow-up time of 8 years, were free of arthritis or uveitis. Uveitis occurred in 10.8% of the children (8.0% chronic uveitis), and the need for joint corrective orthopedic surgery was 9.2%. Conclusions The incidence of JIA in this well-defined, population-based cohort is slightly lower than in previously published studies from Scandinavia. The need for orthopedic surgery and the presence of uveitis are diminished compared to studies with patients diagnosed more than 20 years ago. Children with JIA however still experience disease activity more than 50% of the time. In conclusion, we still have long-term challenges in the care for children with JIA, in spite of state-of-the-art treatment.

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Efficacy and Safety of Thalidomide as Adjunct Therapy in Refractory Systemic Juvenile Idiopathic Arthritis Patients

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v42i1.32005 ◽

2017 ◽

Vol 42 (1) ◽

pp. 49-52

Author(s):

Mohammed Mahbubul Islam ◽

Mohammad Imnul Islam ◽

Manik Kumar Talukdar ◽

Mujammel Haque ◽

Shahana A Rahman

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Systemic Juvenile Idiopathic Arthritis ◽

Permanent Disability ◽

Systemic Jia ◽

Conventional Dmards ◽

Active Arthritis ◽

Transient Elevation ◽

Thalidomide Treatment ◽

Systemic Onset

About 50% of systemic onset juvenile idiopathic arthritis (sJIA) patients run a recalcitrant disease course and resistant to the conventional disease modifying anti inflammatoy drugs (DMARDs), ultimately resulting in permanent disability from joint destructions. Thalidomide has been reported as an effective and safe drug in the management of systemic JIA due to its immunomodulatory properties. This was an interventional study, aimed to evaluate the efficacy of thalidomide in refractory JIA patients. Twenty five systemic JIA patients who were refractory to conventional DMARDs were included in this study. These patients were prescribed thalidomide at a dose of 2-3mg/kg/day for 12 months. Efficacy of thalidomide was assessed by using Wallace criteria at 6th month and 12th month of thalidomide treatment. Active arthritis was improved in 55% and 73% of the patients at 6th and 12th month of thalidomide treatment respectively. Fever and rash subsided in 72.8% and 81.2% of patients respectively at 12th month of follow up. Hepatosplenomegaly and lymphadenopathy regressed in 100% of patients at 12th month follow up. ESR was also improved in 50% and 68.2% cases at 6th and 12th months respectively. Few minor side effects were observed like transient elevation of liver enzyme and somnolence in this study. It may be concluded that thalidomide is safe and effective in refractory JIA patients.

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Evaluation of the efficiency and safety of tocilizumab therapy in patients with systemic-onset juvenile idiopathic arthritis: results of a retrospective follow-up

Modern Rheumatology Journal ◽

10.14412/1996-7012-2017-4-30-39 ◽

2017 ◽

Vol 11 (4) ◽

pp. 30-39 ◽

Cited By ~ 1

Author(s):

M. M. Kostik ◽

E. A. Isupova ◽

I. A. Chikova ◽

M. F. Dubko ◽

V. V. Masalova ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Systemic Onset

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Utility of telemedicine in pediatric rheumatology during the COVID-19 pandemic

10.21203/rs.3.rs-387993/v1 ◽

2021 ◽

Author(s):

Ashley Perdue ◽

Charles Mullett ◽

Amna Umer ◽

Paul Rosen

Keyword(s):

Pediatric Rheumatology ◽

Chart Review ◽

Patient Characteristics ◽

Rapid Expansion ◽

Office Visits ◽

Chi Square ◽

Rheumatology Clinic ◽

Significant Difference ◽

Pediatric Rheumatology Clinic

Abstract Background: During the COVID-19 pandemic, telemedicine has provided an alternative to in-person visits for patients practicing social distancing and undergoing quarantine. During this time, there has been a rapid expansion of telemedicine and its implementation in various clinical specialties and settings. In this observational study we aim to examine the utility of telemedicine in a pediatric rheumatology clinic, for 3 months during the COVID-19 pandemic.Methods: A review of outpatient pediatric rheumatology telemedicine encounters were conducted from April-June 2020. Telemedicine visits (n=75) were compared to patients seen in practice over the prior year in office-based visits (March 2019-March 2020) (n=415). Patient characteristics, information on no-show visits, completed visits, new patient or follow-up status, and if new patients had received a visit within 2 weeks of calling to schedule an appointment were analyzed by chart review. An independent sample t-test and Chi Square statistic was used to determine statical significance between the two groups. A two-proportion z-test was used to compare visit metrics.Results: The percentage of new patients utilizing telemedicine (60%) was lower and statistically significant compared to the percentage of new patient office visits (84%) the previous year (p<0.0001). There was no change in no-show rate between groups and patient characteristics were similar.Conclusions: This study demonstrates a statistically significant decrease in new patient visits during the pandemic with telemedicine-only appointments compared to in-office visits over the previous year. This suggests a possible hesitation to seek care during this time. However, there was no significant difference among patient characteristics between telemedicine visits during the pandemic and during in-office visits in the previous year. In our experience, patient visits were able to be conducted via telemedicine with a limited physical exam using caregiver’s help during the pandemic. However, further studies will need to ascertain patient satisfaction and preference for telemedicine in the future.

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