Comparison of uveitis in the course of juvenile idiopathic arthritis with isolated uveitis in children – own experiences
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Submission date: 2018-03-29
Final revision date: 2018-05-06
Acceptance date: 2018-05-07
Online publication date: 2018-06-30
Publication date: 2018-06-30
Reumatologia 2018;56(3):149-154
Uveitis and juvenile idiopathic arthritis (JIA) relatively often coexist. Inflammatory changes in the anterior segment of the eye are the most common extra-articular symptom in children with JIA, and JIA is, in turn, the main systemic cause of anterior uveitis in children. The aim of our study was to compare the course of anterior uveitis accompanying JIA and isolated uveitis.

Material and methods:
We analyzed 25 children with JIA and uveitis (group I) and 28 children with isolated uveitis (group II). The study population was retrospectively selected from the patients treated in our center in the years 1998–2016 through a search of the hospital database. All data were presented as descriptive statistics.

In group I there was a higher percentage of girls than in group II (64% vs. 50%) and uveitis occurred at a significantly younger age (8.7 years vs. 11.6). Patients from group I more often presented with immunological abnormalities (positive antinuclear antibodies or HLA-B27 antigen). The majority of children from group I developed uveitis prior to (44%) or simultaneously with (20%) arthritis. In patients who first presented with uveitis, arthritis appeared on average after 28 months (median 12 months). In children in whom arthritis developed first, uveitis appeared on average after 51 months (median 36 months). In some patients the time interval between the involvement of these two organs was as long as 9–10 years. Four children from group I and three from group II were qualified for biological treatment.

The results of our analysis indicate the need for constant cooperation between the pediatric rheumatologist and the ophthalmologist. Although the risk of uveitis in JIA decreases with the disease duration, in some cases this complication can develop after many years. Children with present antinuclear antibodies, at younger age and of female gender should be subject to particularly close observation.

Heiligenhaus A, Michels H, Schumacher C, et al. German Ophthalmological Society; Society for Childhood and Adolescent Rheumatology; German Society for Rheumatology. Evidence-based, interdisciplinary guidelines for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis. Rheumatol Int 2012; 32: 1121-1133.
Bou R, Adán A, Borrás F, et al. Clinical management algorithm of uveitis associated with juvenile idiopathic arthritis: interdisciplinary panel consensus. Rheumatol Int 2015; 35: 777-785.
Yu HH, Chen PC, Wang LC, et al. Juvenile idiopathic arthritis-associated uveitis: a nationwide population-based study in Taiwan. PLoS One 2013; 8: 1-7.
Angeles-Han ST, Pelajo CF, Vogler LB, et al. CARRA Registry Investigators. Risk markers of juvenile idiopathic arthritis-associated uveitis in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry. J Rheumatol 2013; 40: 2088-2096.
Vitale AT, Graham E, de Boer JH. Juvenile Idiopathic Arthritis-Associated Uveitis: Clinical Features and Complications, Risk Factors for Severe Course, and Visual Outcome. Ocul Immunol Inflamm 2013; 21: 478-485.
Angeles-Han ST, McCracken C, Yeh S, et al. Characteristics of a cohort of children with Juvenile Idiopathic Arthritis and JIA-associated Uveitis. Pediatr Rheumatol Online J 2015; 13: 19.
Clarke SL, Sen ES, Ramanan AV. Juvenile idiopathic arthritis-associated uveitis. Pediatr Rheumatol Online J 2016; 14: 27.
Woreta F, Thorne JE, Jabs DA, et al. Risk factors for ocular complications and poor visual acuity at presentation among patients with uveitis associated with juvenile idiopathic arthritis. Am J Ophthalmol 2007; 143: 647-655.
Campanilho-Marques R, Bogas M, Ramos F, et al. Prognostic value of antinuclear antibodies in juvenile idiopathic arthritis and anterior uveitis. Results from a systematic literature review. Acta Reumatol Port 2014; 39: 116-122.
Hoeve M, Kalinina AV, Schalij-Delfos NE, et al. The clinical course of juvenile idiopathic arthritis-associated uveitis in childhood and puberty. Br J Ophthalmol 2012; 96: 852-856.
Rodriguez-Garcia A. The Importance of an Ophthalmologic Examination in Patients with Juvenile Idiopathic Arthritis. Reumatol Clin 2015; 11: 133-138.
Manzotti F, Orsoni JG, Zavota L, et al. Autoimmune uveitis in children: clinical correlation between antinuclear antibody positivity and ocular recurrences. Rheumatol Int 2002; 21: 127-132.
Heiligenhaus A, Minden K, Föll D, et al. Uveitis in juvenile idiopathic arthritis. Dtsch Arztebl Int 2015; 112: 92-100.
Angeles-Han ST, Yeh S, Vogler LB. Updates on the risk markers and outcomes of severe juvenile idiopathic arthritis-associated uveitis. Int J Clin Rheumtol 2013; 8: 1-20.
Moradi A, Amin RM, Thorne JE. The role of gender in juvenile idiopathic arthritis – associated uveitis. J Ophthalmol 2014; 2014: 461078.
Saurenmann RK, Levin AV, Feldman BM, et al. Prevalance, Risk Factors, and Outcome of Uveitis in Juvenile Idiopathic Arthritis. Arthritis Rheum 2007; 56: 647-657.
Semeraro F, Arcidiacono B, Nascimbeni G, et al. Anti-TNF therapy for juvenile idiopathic arthritis-related uveitis. Drug Des Devel Ther 2014; 8: 341-348.
Wells JM, Smith JR. Uveitis in juvenile idiopathic arthritis: recent therapeutic advances. Ophthalmic Res 2015; 54: 124-127.
Heinz C, Mingels A, Goebel C, et al. Chronic Uveitis in Children with and without Juvenile Idiopathic Arthritis: Differences in Patient Characteristics and Clinical Course. J Rheumatol 2008; 35: 1403-1407.
Iglesias E, Torrente-Segarra V, Bou R, et al. Non-systemic juvenile idiopathic arthritis outcome after reaching clinical remission with anti-TNF-α therapy: a clinical practice observational study of patients who discontinued treatment. Rheumatol Int 2014; 34: 1053-1057.
Postępski J, Kobusińska K, Olesińska E, et al. Clinical remission in juvenile idiopathic arthritis after termination of etanercept. Rheumatol Int 2013; 33: 2657-2660.
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