ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 295

Uveitis In The Nordic Juvenile Idiopathic Arthritis Cohort; High Incidence, Frequent Complications, and Gender Associated Risk Factors

Ellen Nordal1,2, Lillemor Berntson3, Kristiina Aalto4, Suvi Peltoniemi5, Susan Nielsen6, Troels Herlin7, Anders Fasth8 and Marite Rygg9,10, 1Department of Pediatrics, University Hospital of North Norway, Tromsø, Norway, 2Department of Clinical Medicine, University of Tromsø, Tromsø, Norway, 3Department of Pediatrics, Uppsala University Hospital, Uppsala, Sweden, 4Department of Pediatrics,, Helsinki University Children's Hospital, Helsinki, Finland, 5Department of Pediatrics, Helsinki University Children's Hospital, Helsinki, Finland, 6Pediatric Rheumatology Unit, Juliane Marie Centret, Rigshospitalet, Copenhagen, Denmark, 7Pediatric Rheumatology Clinic, Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark, 8Department of Pediatrics, University of Gothenburg, Gothenburg, Sweden, 9Department of Laboratory Medicine, Children's and Women's health, Norwegian University of Science and Technology, Trondheim, Norway, 10Department of Pediatrics, St Olav University Hospital, Trondheim, Norway

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Pediatric Rheumatology - Clinical and Therapeutic Aspects I: Juvenile Idiopathic Arthritis

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Uveitis is the most common extra-articular manifestation of juvenile idiopathic arthritis (JIA). Both incidence and reported outcome varies, and population-based data are scarce. Early identification of asymptomatic cases is important in order to avoid complications and reduced vision. The pupose of the study was to identify incidence, risk factors and outcome of uveitis in a cohort of Nordic children with JIA followed for eight years in a population-based setting.

Methods:

Consecutive cases of JIA from defined geographical areas of Denmark, Finland, Sweden and Norway with disease onset in 1997-2000 were included. The incidence of JIA in the study area in 1997-98 was 15 per 100 000. The study aimed to be as close to population-based as possible, as centers participated only if they were able to include all children diagnosed with JIA in their catchment area. Clinical and ophthalmologic data were registered at regular follow-up visits.

Results:

Of 500 children included at baseline, 440 were followed for at least 7 years, and 389 (78%) had available ophtalmologic data. Uveitis developed in 89 (23%) of the 389 children; acute uveitis in 12 and chronic uveitis in 77 children. Fifty percent (6/12) of patients with acute uveitis were HLA-B27 positive. Young age at onset of JIA was a significant predictor of chronic uveitis in girls (p=0.0001), but not in boys (p=0.47). Also the presence of anti-nuclear antibodies (ANA Hep-2) (p=0.003) was a significant predictor in girls (p=0.003), but not in boys (p=0.05). Neither female gender nor oligoarticular onset JIA category was significantly associated with uveitis. Chronic uveitis was diagnosed at a median of 0.8 years after onset of disease, and in 88 % within the first four years after onset of disease. The longest interval between JIA onset and uveitis development was 8.6 years. Complications occurred in 39 eyes in 22 of the 89 patients with uveitis (25%), glaucoma occurred in 19 eyes and cataract in 14 eyes. At the last visit visus <0.5 in 10 eyes in 9 patients.

Conclusion:

We found high incidence of uveitis among Nordic children with JIA, and the majority develop early after onset of disease. Age at onset of JIA and presence of ANA Hep-2 were associated with development of uveitis in girls, but not in boys. Complications were present seven years after onset of arthritis in 25%, showing that uveitis contributes significantly to morbidity and disability in children with JIA.

Disclosure:

E. Nordal,
None;

L. Berntson,
None;

K. Aalto,
None;

S. Peltoniemi,
None;

S. Nielsen,
None;

T. Herlin,
None;

A. Fasth,
None;

M. Rygg,
None.

« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/uveitis-in-the-nordic-juvenile-idiopathic-arthritis-cohort-high-incidence-frequent-complications-and-gender-associated-risk-factors/