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Evaluation of Airway Resistance in Children with Juvenile Idiopathic Arthritis
Mehtap Haktanir Abul1, Yasin Abul2, Muferet Erguven3
1Department of Pediatric Immunology and Allergy, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Insights
Children with juvenile idiopathic arthritis (JIA) may have subtle airway abnormalities. The interrupter technique revealed lower expiratory flow and higher resistance in JIA patients, suggesting its utility in assessing pulmonary function.
Area of Science:
- Pediatric Rheumatology
- Pulmonary Medicine
- Respiratory Physiology
Background:
- Pulmonary involvement in juvenile idiopathic arthritis (JIA) is often subclinical, with limited research on pulmonary function in affected children.
- Existing studies on JIA and lung function are scarce, particularly those focusing on airway resistance and flow.
- Pneumonitis, pleuritis, and interstitial lung disease are known pulmonary complications of JIA, but their early detection remains challenging.
Purpose of the Study:
- To investigate potential airway resistance and flow impairments in children diagnosed with JIA.
- To evaluate the feasibility of the interrupter technique for assessing pulmonary function in pediatric JIA patients.
- To determine if the interrupter technique can detect subclinical airway abnormalities in children with JIA.
Main Methods:
- The study involved measuring interrupter resistance (Rint) in children with JIA and a healthy control group.
- Participants were children diagnosed with JIA (n=58) and healthy children (n=33) with no respiratory symptoms.
- The interrupter technique was employed to measure tidal peak flow, inspiratory Rint (Rint_insp), and expiratory Rint (Rint_exp).
Main Results:
- Children with JIA exhibited significantly lower mean tidal peak flow during expiration compared to healthy controls (p=0.01).
- The JIA group showed higher Rint values during both inspiration and expiration, although not statistically significant (p>0.05).
- A positive correlation was observed between C-reactive protein levels and median expiratory Rint in JIA patients (r=0.50, p=0.005).
Conclusions:
- The interrupter technique is a noninvasive and practical method for assessing airway abnormalities in children with JIA.
- This technique can identify subtle pulmonary function deficits in JIA patients who may not be able to perform spirometry.
- Findings suggest potential airway involvement in JIA, which may be detectable using the interrupter technique, especially when correlated with inflammatory markers.
Abstract:
Pneumonitis, pleuritis, and pulmonary interstitial infiltration have been described in patients with juvenile idiopathic arthritis (JIA). However, the pulmonary involvement of JIA is not often clinically apparent. There are few studies based on pulmonary function in children having only a diagnosis of JIA. The aim of the present study is to determine whether children with JIA have airway resistance and flow impairments measured by easily applied interrupter technique. We performed interrupter resistance (Rint) measurements in children with JIA and in healthy control subjects who had no respiratory symptoms or diseases. Fifty-eight children with the diagnosis of JIA (Mean age=12.5±2.75 years; range 7-17 years) and 33 healthy subjects (Mean age=11.8±2.62 years; range 6-16 years) were included in the study. The mean value of tidal peak flow during expiration measured by the interrupter technique was significantly lower in the JIA study group (0.73±0.11 L/s) compared to the healthy control group (0.79±0.08 L/s; p=0.01). Rint values measured during inspiration (Rintinsp) and during expiration (Rintexp) were higher in the JIA study group (Rintinsp=0.28±0.16 Kpa/L/s; Rintexp=0.30±0.50 Kpa/L/s) compared to the healthy control group (Rintinsp=0.26±0.11 Kpa/L/s; Rintexp=0.23±0.08 Kpa/L/s; p>0.05). There was also a positive correlation between C-reactive protein level and median expiratory interrupter resistance (Rintexp; r=0.50, p=0.005). The interrupter technique is a noninvasive and feasible technique and can be used to assess airway abnormalities in children with JIA who cannot successfully complete spirometry.
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