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Juvenile chronic arthritis profile in Greek children
C Dracou1, N Constantinidou, A Constantopoulos
11st Department of Paediatrics, Aghia Sophia Children's Hospital, Athens, Greece.
Insights
Juvenile chronic arthritis (JCA) in Greek children shows similar clinical and immunological features to other Caucasian populations. Key findings include specific human leukocyte antigen (HLA) associations in pauciarticular subtypes.
Area of Science:
- Pediatric Rheumatology
- Immunogenetics
- Autoimmune Diseases
Background:
- Juvenile chronic arthritis (JCA) is a common childhood autoimmune rheumatic disease with diverse clinical subtypes.
- The genetic basis and specific population profiles of JCA require further investigation.
- The clinical and immunological characteristics of JCA in the Greek pediatric population were not fully elucidated.
Purpose of the Study:
- To retrospectively analyze the clinical and immunological features of JCA in Greek children.
- To identify human leukocyte antigen (HLA) associations within different JCA clinical subtypes.
- To compare findings in Greek children with data from other populations.
Main Methods:
- Retrospective analysis of JCA cases in Greek children (1989-1994).
- Assessment of antinuclear antibodies (ANA) using immunofluorescence and ELISA.
- Human leukocyte antigen (HLA) typing via microlymphocytotoxicity and immunobeads.
Main Results:
- Peak JCA onset occurred between ages 2-5 and 9-12 years, with female predominance in pauciarticular and polyarticular groups.
- Pauciarticular JCA was most common (58.7%), followed by systemic (25%). Eye involvement (12.5%) occurred exclusively in the pauciarticular group.
- ANA positivity was 53.7% overall, rising to 90% in pauciarticular cases with uveitis. HLA associations included DR11/DR8 in early-onset pauciarticular JCA and B27 in late-onset pauciarticular JCA.
Conclusions:
- The clinical and immunological profile of JCA in Greek children aligns with findings in other Caucasian series.
- Specific HLA allele associations were identified in distinct pauciarticular JCA subtypes within the studied Greek population.
Background:
Juvenile chronic arthritis (JCA) is the commonest autoimmune rheumatic disease in childhood and presents different clinical subtypes. Juvenile chronic arthritis is considered to be of a polygenic nature and its genetic background is still under investigation. The clinical profile of JCA in the Greek population has not been studied completely. This study retrospectively analyzed the clinical and immunological features of JCA in Greek children presented between 1989 and 1994. Human leukocyte antigen (HLA)-positive or -negative associations in the different clinical subtypes were also detected. The findings of this study were correlated with those reported from other populations.
Methods And Results:
Antinuclear antibodies (ANA) anti-ds DNA and anti-extractable nuclear antigen antibodies were estimated by immunofluorescent and ELISA assays. Human leukocyte antigen typing was performed by microlymphocytotoxicity, using immunobeads. The peak ages of JCA onset were between 2 and 5 years and also between 9 and 12 years. There was a high female predominance in pauciarticular and polyarticular groups. The most common disease was pauciarticular (58.7%) followed by systemic (25%) arthritis. The incidence of eye involvement was 12.5% and presented only in the pauciarticular group. Overall, ANA positivity was 53.7%, increasing to 90% in pauciarticular cases associated with chronic uveitis. In the early onset (EOPA) pauciarticular subtype, positive-HLA associations with alleles DR11 and DR8 were shown. In the late onset pauciarticular (LOPA) group only B27 allele was increased.
Conclusions:
The results of this retrospective study did not reveal major differences between JCA in Greek children compared with other Caucasian series.