[Risk factors for pleural lung disease in children with juvenile idiopathic arthritis]

Area of Science:

• Pediatric Rheumatology
• Pulmonology
• Medical Imaging

Background:

• Juvenile idiopathic arthritis (JIA) is a chronic inflammatory condition affecting children.
• Pleural lung disease (PLD) is a potential complication of JIA, necessitating investigation into its risk factors and clinical presentation.
• Early diagnosis and treatment are vital for managing JIA-associated PLD and improving patient outcomes.

Purpose of the Study:

• To identify risk factors associated with pleural lung disease (PLD) in pediatric patients diagnosed with juvenile idiopathic arthritis (JIA).
• To establish a foundation for the early detection and prompt management of PLD in children with JIA.

Main Methods:

• Retrospective analysis of clinical data from 360 children diagnosed with JIA.
• Categorization of patients into PLD and non-PLD groups based on diagnostic criteria.
• Evaluation of clinical, imaging (chest X-ray, CT), and laboratory findings in JIA patients with PLD.

Main Results:

• Pleural lung disease (PLD) was identified in 11.9% of the JIA cohort.
• Interstitial pneumonitis and pleurisy/pleural effusion were the primary findings on chest imaging.
• Higher incidence of PLD observed in children with systemic JIA, those under 3 years, and those 12 years or older.
• PLD group showed increased rates of anemia, elevated white blood cell (WBC) count, elevated IgG levels, and positive rheumatoid factors or antinuclear antibodies compared to the non-PLD group.

Conclusions:

• Pleural lung disease (PLD) in juvenile idiopathic arthritis (JIA) is more prevalent in systemic JIA cases and specific age groups (<3 years, ≥12 years).
• Key indicators for PLD in JIA include anemia, elevated WBC count, elevated IgG, and positive autoimmune markers.
• High-resolution chest CT is recommended for early diagnosis of PLD in JIA patients, as respiratory symptoms may be absent and chest X-rays can be normal.