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Published on: September 20, 2018
Pediatric Rheumatological Diseases in a Tertiary Care Hospital of Central India: A Retrospective
Tushar B Jagzape1, Priyanka Pandey1, Turaka Silpa1
1Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Raipur, IND.
Insights
Juvenile idiopathic arthritis (JIA) was the most common rheumatological disorder in Indian children, presenting with fever and rash. Anemia and elevated inflammatory markers were frequent findings in pediatric rheumatology patients.
Area of Science:
- Pediatric Rheumatology
- Clinical Epidemiology
- Internal Medicine
Background:
- Rheumatological disorders present diagnostic challenges in developing countries due to varied presentations mimicking infections.
- Limited data exists on the specific burden and spectrum of pediatric rheumatological diseases in India compared to Western populations.
- Tertiary care hospitals are crucial for diagnosing and managing complex pediatric rheumatological conditions.
Purpose of the Study:
- To investigate the clinical, epidemiological, and laboratory characteristics of pediatric rheumatological disorders.
- To identify the most prevalent rheumatological conditions in children treated at a tertiary care center in India.
- To understand the common presenting symptoms and laboratory abnormalities in this patient group.
Main Methods:
- Retrospective review of patient data admitted with rheumatological diagnoses.
- Inclusion criteria: patients aged one month to 15 years.
- Data collected from June 2018 to December 2022.
Main Results:
- Juvenile idiopathic arthritis (JIA) was the most common diagnosis (28.57%), followed by systemic lupus erythematosus (SLE) (25.71%) and Kawasaki Disease (KD) (22.85%).
- Fever and rash were the most common presenting complaints; pallor and rash were the most frequent signs.
- Anemia was observed in 71.42% of patients, with elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in 57.14% and 62.85%, respectively.
Conclusions:
- Juvenile idiopathic arthritis (JIA) is the leading rheumatological disorder in the pediatric population studied.
- Fever and rash are key indicators for suspecting rheumatological conditions in children.
- Anemia is a significant hematological abnormality associated with pediatric rheumatological diseases.
Abstract:
Introduction: Infectious diseases account for the major health problem in developing countries like India. Though non-infectious diseases like rheumatological disorders are not very common, the burden of these disorders as a group is high in society due to the huge population size. The rheumatological disorders have varied presentations which may mimic other infectious pathologies leading to a significant time lag in the diagnosis. There is inadequate data on the exact burden of these diseases. The spectrum of rheumatological disorders in developing countries is different as compared to the Western world. Hence this study was carried out with the aim of studying the clinical, epidemiological, and laboratory profile of rheumatological disorders in the pediatric age group in a tertiary care hospital. Methods: It was a retrospective study. Data of patients admitted with the diagnosis of rheumatological disorder in the age group of one month to 15 years during the period from June 2018 to December 2022 were reviewed. Results: A total of 35 patients were identified with 20 being female. The mean age of the patients was 8.42± 3.95 years. The most common disease was juvenile idiopathic arthritis (JIA)- 10(28.57%) with an equal proportion of polyarticular JIA and systemic-onset JIA, followed by systemic lupus erythematosus (SLE) nine (25.71%) and Kawasaki Disease (KD)- eight (22.85%). The commonest presenting complaint was fever followed by a rash, whereas the most common findings were pallor and rash. Anemia was present in 25 (71.42%). C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were high in 20 (57.14%) and 22 (62.85%), respectively. Antinuclear antibodies (ANA) were positive in 10 (28.57%) and rheumatoid factor (RA) factor in only one (2.85%) case. Conclusions: The most common rheumatological disorder identified was JIA. Fever and rash were the common presenting complaints. Pallor was the commonest sign whereas anemia was the commonest hematological abnormality.
