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Chronic uveitis in children with and without juvenile idiopathic arthritis: differences in patient characteristics and clinical course.
J Rheumatol. 2008 Jul; 35(7):1403-7.JR

Abstract

OBJECTIVE

Anterior uveitis (AU) in childhood may be the first manifestation of juvenile idiopathic arthritis (JIA). We identified factors that may help to differentiate JIA-associated AU from the more common idiopathic AU (IAU) before the onset of arthritis.

METHODS

Children with IAU and with JIA-associated AU were analyzed for their demographics, age at onset of uveitis, uveitis course and complications, ocular surgery, antiinflammatory medication, and best corrected visual acuity (BCVA).

RESULTS

AU was associated with JIA in 88 cases, and was idiopathic in another 49. In the JIA group, 60% of patients were female compared to 47% in the IAU group (p = 0.154). Antinuclear antibody (ANA) was significantly more frequent in the JIA group (88% vs 33%; p < 0.001, OR 14.4, 95% CI 5.8-35.6). Insidious uveitis onset occurred more often in JIA than in IAU patients (67% vs 31%; p < 0.001, OR 4.6, 95% CI 2.2-9.8). Persistent uveitis was found in 82% of JIA patients, and in 57% of IAU patients (p = 0.003, OR 3.4, 95% CI 1.5-7.4). Median age of AU onset was 5 years in JIA and 9 years in IAU (p < 0.001). Uveitis complications at first presentation at our institutions were more frequent in JIA than in IAU patients (79% vs 61%; p = 0.027, OR 2.5, 95% CI 1.1-5.3). During followup, 69 surgical procedures (51% of patients, 1.31 per patient) were performed in the JIA group, and 18 in IAU patients (0.57 per patient) (p = 0.008). BCVA was better in the IAU patients at first presentation (p = 0.001).

CONCLUSION

The IAU and JIA-associated AU in childhood differ in their clinical course. ANA positivity, presence of uveitis complications at first manifestation, insidious onset, duration over 3 months, BCVA of 20/50 or less, and an age of 3 years or younger might help to detect AU associated with JIA. JIA uveitis manifests earlier, has more complications, and more often requires systemic immunosuppression and surgical intervention.

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Authors+Show Affiliations

Heinz C
Department of Ophthalmology, St. Franziskus-Hospital Muenster, Muenster, Germany. carsten.heinz@uveitis-zentrum.de
Mingels A
No affiliation info available
Goebel C
No affiliation info available
Fuchsluger T
No affiliation info available
Heiligenhaus A
No affiliation info available

MeSH

AdolescentAntibodies, AntinuclearArthritis, JuvenileChildChild, PreschoolCohort StudiesFemaleHumansMaleRetrospective StudiesUveitis, AnteriorVisual Acuity

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18484686

Citation

Heinz, Carsten, et al. "Chronic Uveitis in Children With and Without Juvenile Idiopathic Arthritis: Differences in Patient Characteristics and Clinical Course." The Journal of Rheumatology, vol. 35, no. 7, 2008, pp. 1403-7.
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(7):1403-7.
Heinz, C., Mingels, A., Goebel, C., Fuchsluger, T., & Heiligenhaus, A. (2008). Chronic uveitis in children with and without juvenile idiopathic arthritis: differences in patient characteristics and clinical course. The Journal of Rheumatology, 35(7), 1403-7.
Heinz C, et al. Chronic Uveitis in Children With and Without Juvenile Idiopathic Arthritis: Differences in Patient Characteristics and Clinical Course. J Rheumatol. 2008;35(7):1403-7. PubMed PMID: 18484686.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic uveitis in children with and without juvenile idiopathic arthritis: differences in patient characteristics and clinical course. AU - Heinz,Carsten, AU - Mingels,Anne, AU - Goebel,Christian, AU - Fuchsluger,Thomas, AU - Heiligenhaus,Arnd, Y1 - 2008/05/15/ PY - 2008/5/20/pubmed PY - 2008/12/17/medline PY - 2008/5/20/entrez SP - 1403 EP - 7 JF - The Journal of rheumatology JO - J Rheumatol VL - 35 IS - 7 N2 - OBJECTIVE: Anterior uveitis (AU) in childhood may be the first manifestation of juvenile idiopathic arthritis (JIA). We identified factors that may help to differentiate JIA-associated AU from the more common idiopathic AU (IAU) before the onset of arthritis. METHODS: Children with IAU and with JIA-associated AU were analyzed for their demographics, age at onset of uveitis, uveitis course and complications, ocular surgery, antiinflammatory medication, and best corrected visual acuity (BCVA). RESULTS: AU was associated with JIA in 88 cases, and was idiopathic in another 49. In the JIA group, 60% of patients were female compared to 47% in the IAU group (p = 0.154). Antinuclear antibody (ANA) was significantly more frequent in the JIA group (88% vs 33%; p < 0.001, OR 14.4, 95% CI 5.8-35.6). Insidious uveitis onset occurred more often in JIA than in IAU patients (67% vs 31%; p < 0.001, OR 4.6, 95% CI 2.2-9.8). Persistent uveitis was found in 82% of JIA patients, and in 57% of IAU patients (p = 0.003, OR 3.4, 95% CI 1.5-7.4). Median age of AU onset was 5 years in JIA and 9 years in IAU (p < 0.001). Uveitis complications at first presentation at our institutions were more frequent in JIA than in IAU patients (79% vs 61%; p = 0.027, OR 2.5, 95% CI 1.1-5.3). During followup, 69 surgical procedures (51% of patients, 1.31 per patient) were performed in the JIA group, and 18 in IAU patients (0.57 per patient) (p = 0.008). BCVA was better in the IAU patients at first presentation (p = 0.001). CONCLUSION: The IAU and JIA-associated AU in childhood differ in their clinical course. ANA positivity, presence of uveitis complications at first manifestation, insidious onset, duration over 3 months, BCVA of 20/50 or less, and an age of 3 years or younger might help to detect AU associated with JIA. JIA uveitis manifests earlier, has more complications, and more often requires systemic immunosuppression and surgical intervention. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/18484686/Chronic_uveitis_in_children_with_and_without_juvenile_idiopathic_arthritis:_differences_in_patient_characteristics_and_clinical_course_ L2 - http://www.jrheum.org/cgi/pmidlookup?view=long&amp;pmid=18484686 DB - PRIME DP - Unbound Medicine ER -