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Uveitis in sibling pairs with juvenile idiopathic arthritis
H Säilä1, K Kotaniemi, A Savolainen
1Rheumatism Foundation Hospital, Heinola, Finland.
Insights
Uveitis occurred in 26% of juvenile idiopathic arthritis (JIA) patients. While often chronic, JIA-associated uveitis typically had a mild course, with no significant difference in sibling concordance than expected.
Area of Science:
- Ophthalmology
- Rheumatology
- Genetics
Background:
- Juvenile idiopathic arthritis (JIA) is a common rheumatic disease in children.
- Uveitis is a known ocular complication of JIA.
- Understanding familial occurrence can provide insights into genetic predispositions.
Purpose of the Study:
- To determine the frequency and clinical features of uveitis in siblings with JIA.
- To investigate potential genetic factors, such as HLA-B27, in JIA-associated uveitis.
Main Methods:
- A cohort of 80 JIA patients from 37 families (2-3 children per family) was studied.
- Regular ophthalmological examinations were conducted over a follow-up period.
- HLA-B27 allele frequencies were analyzed in patients with and without uveitis.
Main Results:
- Uveitis was diagnosed in 26% of JIA patients.
- Three sibling pairs were concordant for asymptomatic uveitis.
- Chronic uveitis was observed in 13 patients, but vision impairment was rare.
- HLA-B27 was more frequent in patients with uveitis (52% vs 30%) and present in all concordant chronic uveitis cases.
Conclusions:
- The concordance rate for uveitis in JIA siblings was as expected.
- JIA-associated uveitis is frequently chronic but generally mild in its clinical course.
Objective:
To ascertain the occurrence and characteristics of uveitis in sibling pairs affected with juvenile idiopathic arthritis (JIA).
Methods:
The sibling series comprised 80 JIA patients from 37 families with two or three JIA children, seen at the paediatric department of the Rheumatism Foundation Hospital in Heinola, Finland. An ophthalmologist examined the children for uveitis two to four times a year and the course of the condition was recorded during the follow-up.
Results:
Uveitis was diagnosed in 21 of the 80 patients (26%). Three pairs (3.4 pairs expected) were concordant for the presence of asymptomatic uveitis. Two patients with enthesitis-related arthritis had acute unilateral uveitis. Among the remaining cases, uveitis was chronic and continuously active at the end of follow-up in 13 instances, but in spite of this only one patient had impaired vision. HLA allele B27 occurred more frequently in patients with uveitis than in those without uveitis (52 vs 30%, P=0.073) and all six subjects in the pairs concordant for chronic uveitis carried this allele.
Conclusions:
The observed concordance rate for uveitis did not differ from that expected. Although the uveitis was chronic in most instances, its course was usually mild.