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Prevalence of sinonasal disease in children with Juvenile idiopathic arthritis
Carlotta Pipolo1, Federica Turati, Paolo Cressoni
1Otorhinolaryngology Unit, Head and Neck Department, San Paolo Hospital, University of Milan, Milan, Italy; Department of Epidemiology, Institutes for Research, Hospitalization and Health Care-Mario Negri Institute for Pharmacological Research, Milan, Italy.
Insights
Juvenile idiopathic arthritis (JIA) is linked to sinonasal inflammatory disease (SNID), particularly in treated patients. Children with JIA require ear, nose, and throat evaluations due to this association.
Area of Science:
- Pediatric Rheumatology
- Otolaryngology
- Medical Imaging
Background:
- Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic condition in children.
- The relationship between JIA, its treatments, and sinonasal inflammatory disease (SNID) has not been previously investigated.
- Understanding comorbidities associated with JIA is crucial for comprehensive patient care.
Purpose of the Study:
- To investigate the association between Juvenile Idiopathic Arthritis (JIA) and sinonasal inflammatory disease (SNID).
- To compare the prevalence of SNID and adenoid hypertrophy in children with JIA versus healthy controls.
- To assess the impact of JIA treatment on SNID.
Main Methods:
- Retrospective evaluation of cone-beam computed tomography (CBCT) scans.
- Utilized the Lund-Mackay scoring system for sinonasal assessment.
- Compared CBCT findings in 70 children with JIA against 124 healthy controls.
Main Results:
- A significant association was found between JIA and SNID (P = .030).
- 18.6% of JIA patients exhibited SNID compared to 8.1% in controls.
- Treated JIA patients had a higher odds ratio (5.38) for SNID, while untreated patients showed no significant association (0.92).
- No correlation was observed between adenoid hypertrophy and SNID (P = .816).
Conclusions:
- JIA is significantly associated with SNID, especially in patients undergoing immunosuppressive therapy.
- Routine ear, nose, and throat evaluations are recommended for JIA patients, particularly those on treatment.
- Further prospective studies with clinical evaluations are needed to establish definitive care guidelines.
Objectives/Hypothesis:
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children and is caused by a multitude of well-studied disorders. However, the association between JIA and/or its treatment and sinonasal inflammatory disease (SNID) has never been studied. We therefore investigated this relationship to gain more insight into burdening pathologies connected to JIA.
Study Design:
Retrospective evaluation.
Methods:
A retrospective evaluation according to the Lund-Mackay score of cone-beam computed tomography scans (CBCT) performed in 70 children affected by JIA and compared to CBCT scans of 124 healthy controls was conducted. The prevalence of sinonasal opacification and adenoid hypertrophy in patients affected with JIA was compared with findings obtained in unaffected children.
Results:
JIA was significantly associated with SNID (P = .030). Of patients with JIA, 18.6% had SNID, whereas in children without JIA, only 8.1% had SNID. The odds ratio values were 5.38 (95% confidence interval [CI]: 1.90-15.26) for treated and 0.92 (95% CI: 0.18-4.83) for untreated JIA. No clear difference was found depending on the duration of JIA. No association was found between adenoid hypertrophy and SNID (P = .816).
Conclusions:
Our data suggest that JIA patients, especially when undergoing immunosuppressive therapy, should be subjected to an ear, nose, and throat evaluation. A prospective study including clinical evaluation would be of the utmost importance to provide evidence on which to base comprehensive healthcare for these patients.
Level Of Evidence:
3b.
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