Juvenile idiopathic arthritis in adult patients: an analysis of clinical data
DOI:
https://doi.org/10.15587/2519-4798.2017.105403Keywords:
juvenile idiopathic arthritis, classification, remote results, rheumatoid factors, ANA, HLA-B27Abstract
Aim. To study the connection of the disease with social and clinical parameters of adult patients with JIA in the anamnesis for improve the observation of them and decrease remote results.
Methods. There were examined adults with JIA in the anamnesis, age – 24,3±8,3 years, the disease duration - 13,6±9,3 years, with the assessment of the diagnosis determination, disease activity in the child and adult age (JADAS, VAS), received treatment with glucocorticoids (GC) and its duration, life quality (SF-36), functional activity disorders (HAQ), psychological state, cardio-vascular risk, remote results of JIA (JADI-A, JADI-E).
Result. Adult women had the more active disease by JADAS (p<0,05) and JIA remote results by JADI-A took place in them more often (p<0,05). Patients with a higher education had the more disease duration (p<0,05). The influence of social factors on the health state was more (p<0,05) in patients with a finished higher education comparing with ones with an incomplete one, although the life quality (SF-36), anxiety and depression level didn’t differ in these groups. Patients with invalidism, developed as a result of JIA had the worse general state by VAS (p<0,05), glucocorticoids were prescribed longer (p<0,05), JADI-E extra-articular results developed more often (p<0,05), although their psychological state didn’t differ from patients without invalidism. Patients, divided in groups depending on ACCP/RF, ANA, HLA-B27 presence and negative by all markers, differed by the age of the disease start, SF-36, disease activity (DAS28), remote results by JADI-E and JADI-A. The treatment duration and GC cumulative dose didn’t differ in these groups.
Conclusions. 1. In female adult patients with JIA was reveled the more disease activity by JADAS and remote articular results of JIA took place more often that testify to the need of the more aggressive therapy and more accurate rheumatologists’ survey for decreasing the number of remote results of this disease. 2. Patients’ education level indicated that the influence of social factors on the health state was higher (p<0,05) in patients with a finished higher education comparing with ones with an incomplete one, although the anxiety and depression level and life quality didn’t differ in both groups, and the psychological state of adult patients with JIA invalidism was the same as in patients without invalidism that testifies to the good social adjustment of JIA patients in the adult age. 3. Clinical differences between groups of patients, divided by immunological parameters (ACCP/RF, HLA-B27, ANA), prove a hypothesis that their pathogenetic mechanisms of JIA development are different and need a differentiated approach to the diagnostics, treatment and observation
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Copyright (c) 2017 Marta Dzhus, Halina Mostbauer, Tetiana Karasevska, Oleksiy Ivashkivskyy, Yaryna Boyko
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