Publication:

A study on disease activity and outcome in patients with juvenile idiopathic arthritis, aged 2 months to 16 years at a tertiary care institute in North India and compare JADA’S based on ESR to JADA’S based on CRP in newly diagnosed patients

Background Juvenile idiopathic arthritis is the most common chronic rheumatic disease of childhood. The clinical spectrum spans from time-limited mono-arthritis to ongoing aggressive poly-articular disease, and may include severe systemic features or sight-threatening uveitis.

Methods This was a prospective 2 years study conducted from September 2018 to August 2020 in the Department of Pediatrics, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, a tertiary care institute in North India. Patients were assessed individually by interview and clinical examination supported by Laboratory investigations. Patients were diagnosed and assigned to different JIA categories based on ILAR classification. Disease Activity and Outcome was measured based on JADAS-27.

Results A total of 51 patients were enrolled in our study, based on inclusion and exclusion criteria. The most common clinical features in studied subjects were: joint pain and swelling each found in 48 (94.1%) patients, restricted joint movement found in 42 (82.3%) patients, limp found in 36 (70.5%) patients, fever in 9 (17.6%) patients, rash in 6 (11.8%) patients and joint deformity in 3 (5.9%) patients. Of the 51 patients, 24 (47%) patients had no change in disease activity, 24 (47%) improved with significant reduction in disease activity and 3 (6%) patients worsened with increased disease activity during the course of study.

Conclusions Oligorthritis was the most common subtype of JIA observed. Joint pain and swelling were the most common presentations. Knee, ankle and hip joints were the most commonly involved joints. Disease activity was mostly moderate to high initially. Maximum improvement in disease activity on follow up was observed in oligorthritis persistent variant.