Risk Markers of Juvenile Idiopathic Arthritis-associated Uveitis in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry
Risk Markers of Juvenile Idiopathic Arthritis-associated Uveitis in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry
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DOI：
10.3899/jrheum.130302
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发表时间：
2013-12-01
影响因子：
3.9
通讯作者：
Prahalad, Sampath
中科院分区：
文献类型：
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作者：
Angeles-Han, Sheila T.;Pelajo, Christina F.;Prahalad, Sampath
Objective.描述儿童关节炎和流变学研究联盟（CARRA）登记处中幼年特发性关节炎相关葡萄膜炎（MA-U）儿童的流行病学和临床病程，并探讨非裔美国人（AA）和非西班牙裔白色（NHW）儿童之间的差异。共有4983名JIA儿童入组CARRA登记研究。其中，3967名NHW和AA儿童被纳入本研究。从诊断到入组，收集人口统计学和疾病相关数据。将JIA儿童与MA-U儿童进行比较。MA-U儿童也按种族进行了比较。在我们的队列中，有459/3967名儿童（11.6%）患有MA-U，入组时的平均年龄（SD）为11.4岁（+/- 4.5）。与MA儿童相比，他们在关节炎发作时更年轻，更可能是女性，累及的关节< 5个，患有少关节MA，抗核抗体（ANA）阳性，类风湿因子（RF）阴性，抗瓜氨酸蛋白抗体阴性。葡萄膜炎发生的预测因素包括女性、关节炎发病年龄早和少关节型JIA。多关节RF阳性MA亚型具有保护作用。近3%的JIA-U儿童为AA。然而，在220例患有HA的AA儿童中，6%患有葡萄膜炎;相反，在3721例患有MA的NHW儿童中，12%患有葡萄膜炎。在CARRA登记研究中，AA和NHW儿童的JIA-U患病率为11.6%。我们确认了已知的葡萄膜炎风险标志物（ANA阳性、关节炎发病年龄较小和少关节HA）。我们描述了减少葡萄膜炎的可能性AA儿童，并建议进一步探讨种族作为一个危险因素，在更大的人口AA儿童。
Objective. To characterize the epidemiology and clinical course of children with juvenile idiopathic arthritis-associated uveitis (MA-U) in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry and explore differences between African American (AA) and non-Hispanic white (NHW) children.Methods. There were 4983 children with JIA enrolled in the CARRA Registry. Of those, 3967 NHW and AA children were included in this study. Demographic and disease-related data were collected from diagnosis to enrollment. Children with JIA were compared to those with MA-U. Children with MA-U were also compared by race.Results. There were 459/3967 children (11.6%) with MA-U in our cohort with a mean age (SD) of 11.4 years (+/- 4.5) at enrollment. Compared to children with MA, they were younger at arthritis onset, more likely to be female, had < 5 joints involved, had oligoarticular MA, and were antinuclear antibody (ANA)-positive, rheumatoid factor (RF)-negative, and anticitrullinated protein antibody-negative. Predictors of uveitis development included female sex, early age of arthritis onset, and oligoarticular JIA. Polyarticular RF-positive MA subtype was protective. Nearly 3% of children with JIA-U were AA. However, of the 220 AA children with HA, 6% had uveitis; in contrast, 12% of the 3721 NHW children with MA had uveitis.Conclusion. In the CARRA registry, the prevalence of JIA-U in AA and NHW children is 11.6%. We confirmed known uveitis risk markers (ANA positivity, younger age at arthritis onset, and oligoarticular HA). We describe a decreased likelihood of uveitis in AA children and recommend further exploration of race as a risk factor in a larger population of AA children.