Juvenile idiopathic arthritis: a preliminary study of 29 cases

Abstract Introduction Juvenile idiopathic arthritis (JIA) is a heterogeneous group of chronic inflammatory rheumatic diseases in children. It is defined as arthritis that began before the age of 16 years, lasting at least 6 weeks and without an identifiable cause. Our objective is to describe the clinical and immunologic profile of JIA. Patients and methods Descriptive, retrospective study of 9 years [2013– 2022] of rheumatology services at the CHU Fattouma Bourguiba Monastir. We retrieved 29 files of children diagnosed with JIA according to International League of Associations for Rheumatology (ILAR) criteria. Results There were 16 girls (55.17%) and 13 boys (44.83%). The mean age of onset of the disease was 9.38 ± 3,1 years with a range of 3–16 years. Five (19%) patients had a family history of chronic rheumatic diseases. Polyarthritis was seen in 16 (55.2%), oligoarthritis in 7 (24.1%) and mono-arthritis in 6 (20.6%). The forms of JIA in descending order: polyarticular in 11(37.9%), oligoarticular in 6 (20.7%), seropositive polyarticular form in 5 (17.2%), enthesitis related arthritis in 3 (10.3%), systemic JIA in 3(10.3%) and psoriatic arthritis in 1(3.4%). The presence of biological inflammatory syndrome in 82.7%: an accelerated ESR (68.9%) and positive CRP (65.5%), anaemia (51.72%), hyperleukocytosis (10.7%) and thrombocytosis (3.44%), and 2 patients presented with bicytopenia (10.3%). The immunological workup was marked by presence of: RF (7 cases), Anti-CCP (3 cases), Antinuclear antibodies (ANA) (4 cases). The symptomatic treatment included analgesics (91%), corticosteroids (62%), salazopyrine in 13.7%, methotrexate in 62% of cases and 3 patients under biotherapy. The evolution was good in most cases. The prognosis was life-threatening in two patients with a systemic JIA complicated by macrophagic activation syndrome. Conclusion Immunology was not sufficiently contributive. A cohort study in a general population is necessary to better to better elucidate the characteristics of JIA in Tunisia.