Global damage in systemic juvenile idiopathic arthritis: preliminary early predictors

To assess damage in systemic juvenile idiopathic arthritis (sJIA) by the use of the Juvenile Arthritis Damage Index (JADI) and to identify early predictors of global, articular, and extraarticular damage.

Forty-seven consecutive patients with sJIA with a disease duration > 24 months were assessed for damage in a cross-sectional evaluation. The JADI was administered by 2 pediatric rheumatologists. Damage was defined as JADI score >or= 1. Early clinical variables were retrieved from clinical records, and they included demographic, clinical, and laboratory characteristics. Univariate analysis was used to select candidate predictors to be included in multiple logistic regression.

Twenty (43%) patients exhibited damage: 18 (38%) patients had articular and 9 (19%) extraarticular damage. JADI score ranged between 0 and 24. Cervical spine arthritis and corticosteroid usage occurring in the first 6 months of the disease course were found as predictors of damage. Damage scores correlated with number of joints with limited motion, and with functional disability.

Articular damage is the main component of global damage in patients with sJIA. Early cervical spine involvement and corticosteroid usage may identify patients with sJIA at risk of developing damage.