Filipe Oliveira Pinheiro, Mariana Leuzinger-Dias, Bruno Miguel Fernandes, Diogo Fonseca, Joana Vilaça, Luís Figueira, Iva Brito
{"title":"青少年特发性关节炎和脊椎关节炎患者葡萄膜炎的预后-一项5年随访研究。","authors":"Filipe Oliveira Pinheiro, Mariana Leuzinger-Dias, Bruno Miguel Fernandes, Diogo Fonseca, Joana Vilaça, Luís Figueira, Iva Brito","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Uveitis is a frequent complication of juvenile idiopathic arthritis (JIA) and spondyloarthritis (SpA). The aim of this study is to evaluate the prevalence and risk factors for complications associated with uveitis in patients with JIA and SpA.</p><p><strong>Methods: </strong>A longitudinal, monocentric cohort study that included patients diagnosed with JIA and SpA who developed uveitis. Demographic, laboratory, and clinical data were collected including complications of uveitis, HLA-B27, antinuclear antibodies, erythrocyte sedimentation rate, C-reactive protein, visual acuity and DMARD treatment. Comparison between groups (complicated versus uncomplicated uveitis) was evaluated using chi-square, t test and Mann-Whitney U test. Logistic regression was performed to determine predictors of complications.</p><p><strong>Results: </strong>A total of 270 patients were evaluated, of which 37 patients (13.7%) had uveitis and were included in this study. Twenty patients were female (54.1%), aged 11.9±8.7 years at diagnosis of SpA/JIA and 15.3±9.9 years at diagnosis of uveitis. Twenty-seven patients (73.0%) had a diagnosis of JIA (23 with oligoarticular disease) and in 12 patients (32.4%) uveitis was the first manifestation. Fifteen (40.5%) patients exhibited complications during follow-up period. Eleven patients (29.7%) underwent ophthalmologic surgery. Complications were significantly higher in patients with JIA (51.9% vs 10.0% in SpA, p=0.03), as was the need for surgery (40.7% vs 0%, p=0.02). Complications in JIA were significantly more frequent in patients who had uveitis as the initial presentation (50.0% vs 7.7%, p=0.03); no significant differences were found between the groups in the other variables studied. Univariate logistic regression analysis showed that uveitis as the first manifestation of JIA (OR 12.0, confidence interval 95% 1.21-118.89, p=0.03) is a significant predictor of complications.</p><p><strong>Conclusion: </strong>We found higher rates of complications and need for ophthalmologic surgery in patients with JIA-associated uveitis. The initial presentation of JIA as uveitis is significantly associated with the occurrence of uveitis complications, so it is essential that there is a collaboration between ophthalmologist and rheumatologist in the diagnosis and treatment of these patients.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"2 1","pages":"17-21"},"PeriodicalIF":1.4000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcome of Uveitis in Juvenile Idiopathic Arthritis and Spondyloarthritis Patients - A 5-Year Follow-Up Study.\",\"authors\":\"Filipe Oliveira Pinheiro, Mariana Leuzinger-Dias, Bruno Miguel Fernandes, Diogo Fonseca, Joana Vilaça, Luís Figueira, Iva Brito\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Uveitis is a frequent complication of juvenile idiopathic arthritis (JIA) and spondyloarthritis (SpA). The aim of this study is to evaluate the prevalence and risk factors for complications associated with uveitis in patients with JIA and SpA.</p><p><strong>Methods: </strong>A longitudinal, monocentric cohort study that included patients diagnosed with JIA and SpA who developed uveitis. Demographic, laboratory, and clinical data were collected including complications of uveitis, HLA-B27, antinuclear antibodies, erythrocyte sedimentation rate, C-reactive protein, visual acuity and DMARD treatment. Comparison between groups (complicated versus uncomplicated uveitis) was evaluated using chi-square, t test and Mann-Whitney U test. Logistic regression was performed to determine predictors of complications.</p><p><strong>Results: </strong>A total of 270 patients were evaluated, of which 37 patients (13.7%) had uveitis and were included in this study. Twenty patients were female (54.1%), aged 11.9±8.7 years at diagnosis of SpA/JIA and 15.3±9.9 years at diagnosis of uveitis. Twenty-seven patients (73.0%) had a diagnosis of JIA (23 with oligoarticular disease) and in 12 patients (32.4%) uveitis was the first manifestation. Fifteen (40.5%) patients exhibited complications during follow-up period. Eleven patients (29.7%) underwent ophthalmologic surgery. Complications were significantly higher in patients with JIA (51.9% vs 10.0% in SpA, p=0.03), as was the need for surgery (40.7% vs 0%, p=0.02). Complications in JIA were significantly more frequent in patients who had uveitis as the initial presentation (50.0% vs 7.7%, p=0.03); no significant differences were found between the groups in the other variables studied. Univariate logistic regression analysis showed that uveitis as the first manifestation of JIA (OR 12.0, confidence interval 95% 1.21-118.89, p=0.03) is a significant predictor of complications.</p><p><strong>Conclusion: </strong>We found higher rates of complications and need for ophthalmologic surgery in patients with JIA-associated uveitis. The initial presentation of JIA as uveitis is significantly associated with the occurrence of uveitis complications, so it is essential that there is a collaboration between ophthalmologist and rheumatologist in the diagnosis and treatment of these patients.</p>\",\"PeriodicalId\":29669,\"journal\":{\"name\":\"ARP Rheumatology\",\"volume\":\"2 1\",\"pages\":\"17-21\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ARP Rheumatology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ARP Rheumatology","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:葡萄膜炎是青少年特发性关节炎(JIA)和脊椎关节炎(SpA)的常见并发症。本研究的目的是评估JIA和SpA患者与葡萄膜炎相关并发症的患病率和危险因素。方法:一项纵向、单中心队列研究,包括JIA和SpA诊断为葡萄膜炎的患者。收集人口统计学、实验室和临床数据,包括葡萄膜炎并发症、HLA-B27、抗核抗体、红细胞沉降率、c反应蛋白、视力和DMARD治疗。采用卡方检验、t检验和Mann-Whitney U检验评价两组间(复杂与非复杂葡萄膜炎)的比较。采用逻辑回归确定并发症的预测因素。结果:共评估270例患者,其中37例(13.7%)有葡萄膜炎纳入本研究。女性20例(54.1%),诊断为SpA/JIA时年龄11.9±8.7岁,诊断为葡萄膜炎时年龄15.3±9.9岁。27例(73.0%)被诊断为JIA(23例合并少关节病),12例(32.4%)以葡萄膜炎为首发表现。随访期间出现并发症15例(40.5%)。11例患者(29.7%)行眼科手术。JIA患者的并发症明显更高(51.9% vs 10.0%, SpA, p=0.03),手术需求也更高(40.7% vs 0%, p=0.02)。以葡萄膜炎为首发症状的JIA患者的并发症明显更频繁(50.0% vs 7.7%, p=0.03);在研究的其他变量中,两组之间没有发现显著差异。单因素logistic回归分析显示,葡萄膜炎作为JIA的首发表现(OR 12.0,置信区间95% 1.21-118.89,p=0.03)是并发症的重要预测因子。结论:jia相关性葡萄膜炎患者并发症发生率较高,需要眼科手术治疗。JIA最初表现为葡萄膜炎与葡萄膜炎并发症的发生显著相关,因此眼科医生和风湿病专家在诊断和治疗这些患者时的合作至关重要。
Outcome of Uveitis in Juvenile Idiopathic Arthritis and Spondyloarthritis Patients - A 5-Year Follow-Up Study.
Objective: Uveitis is a frequent complication of juvenile idiopathic arthritis (JIA) and spondyloarthritis (SpA). The aim of this study is to evaluate the prevalence and risk factors for complications associated with uveitis in patients with JIA and SpA.
Methods: A longitudinal, monocentric cohort study that included patients diagnosed with JIA and SpA who developed uveitis. Demographic, laboratory, and clinical data were collected including complications of uveitis, HLA-B27, antinuclear antibodies, erythrocyte sedimentation rate, C-reactive protein, visual acuity and DMARD treatment. Comparison between groups (complicated versus uncomplicated uveitis) was evaluated using chi-square, t test and Mann-Whitney U test. Logistic regression was performed to determine predictors of complications.
Results: A total of 270 patients were evaluated, of which 37 patients (13.7%) had uveitis and were included in this study. Twenty patients were female (54.1%), aged 11.9±8.7 years at diagnosis of SpA/JIA and 15.3±9.9 years at diagnosis of uveitis. Twenty-seven patients (73.0%) had a diagnosis of JIA (23 with oligoarticular disease) and in 12 patients (32.4%) uveitis was the first manifestation. Fifteen (40.5%) patients exhibited complications during follow-up period. Eleven patients (29.7%) underwent ophthalmologic surgery. Complications were significantly higher in patients with JIA (51.9% vs 10.0% in SpA, p=0.03), as was the need for surgery (40.7% vs 0%, p=0.02). Complications in JIA were significantly more frequent in patients who had uveitis as the initial presentation (50.0% vs 7.7%, p=0.03); no significant differences were found between the groups in the other variables studied. Univariate logistic regression analysis showed that uveitis as the first manifestation of JIA (OR 12.0, confidence interval 95% 1.21-118.89, p=0.03) is a significant predictor of complications.
Conclusion: We found higher rates of complications and need for ophthalmologic surgery in patients with JIA-associated uveitis. The initial presentation of JIA as uveitis is significantly associated with the occurrence of uveitis complications, so it is essential that there is a collaboration between ophthalmologist and rheumatologist in the diagnosis and treatment of these patients.