Rheumatoid Arthritis: de Inocencio J

Oliveira S, Ravelli A, Pistorio A, Castell E, Malattia C, Prieur AM, Saad-Magalhães C, Murray KJ, Bae SC, Joos R, Foeldvari I, Duarte-Salazar C, Wulffraat N, Lahdenne P, Dolezalova P, de Inocencio J, Kanakoudi-Tsakalidou F, Hofer M, Nikishina I, Ozdogan H, Hashkes PJ, Landgraf JM, Martini A, Ruperto N, Anonymous00868. · IRCCS G. Gaslini, Pediatria II, Reumatologia, Pediatric Rheumatology International Trials Organization, Genoa, Italy. · Arthritis Rheum. · Pubmed #17266064 links to  free full text

Abstract: OBJECTIVE: To investigate the proxy-reported health-related quality of life (HRQOL) and its determinants in patients with juvenile idiopathic arthritis (JIA). METHODS: In this multinational, multicenter, cross-sectional study, HRQOL of patients with JIA was assessed through the Child Health Questionnaire (CHQ) and was compared with that of healthy children of similar age from the same geographic area. Potential determinants of HRQOL included demographic data, physician's and parent's global assessments, measures of joint inflammation, Childhood Health Assessment Questionnaire (CHAQ), and erythrocyte sedimentation rate. RESULTS: A total of 6,639 participants (3,324 with JIA and 3,315 healthy) were enrolled from 32 countries. The mean +/- SD physical and psychosocial summary scores of the CHQ were significantly lower in patients with JIA than in healthy children (physical: 44.5 +/- 10.6 versus 54.6 +/- 4.0, P < 0.0001; psychosocial: 47.6 +/- 8.7 versus 51.9 +/- 7.5, P < 0.0001), with the physical well-being domain being most impaired. Patients with persistent oligoarthritis had better HRQOL compared with other subtypes, whereas HRQOL was similar across patients with systemic arthritis, polyarthritis, and extended oligoarthritis. A CHAQ score >1 and a pain intensity rating >3.4 cm on a 10-cm visual analog scale were the strongest determinants of poorer HRQOL in the physical and psychosocial domains, respectively. CONCLUSION: We found that patients with JIA have a significant impairment of their HRQOL compared with healthy peers, particularly in the physical domain. Physical well-being was mostly affected by the level of functional impairment, whereas the intensity of pain had the greatest influence on psychosocial health.

Merino R, de Inocencio J, García-Consuegra J. · Unit of Pediatric Rheumatology, University Hospital La Paz, and CS Estrecho de Corea, Imsalud Area 4, Po de la Castellana 265, 28046 Madrid, Spain. · J Rheumatol. · Pubmed #15742453 No free full text.

Abstract: OBJECTIVE: To evaluate the revised (Edmonton 2001) International League of Associations for Rheumatology (ILAR) classification criteria for Juvenile Idiopathic Arthritis (JIA) in a cohort of Spanish children. METHODS: One hundred twenty-five patients with chronic arthritis categorized according to traditional criteria and to the first revision of ILAR JIA criteria (Durban 1997) were reclassified according to the second JIA criteria revision (Edmonton 2001). RESULTS: Edmonton criteria allocated 92% of the patients classified by traditional criteria in their corresponding ILAR categories. Most patients with systemic (94%), pauciarticular (91%) and polyarticular (88%) juvenile chronic arthritis as well as those with juvenile spondyloarthropathy (94%) were reclassified in the corresponding ILAR categories. Two children with probable psoriatic arthritis (PsA) were reclassified in the rheumatoid factor-negative (RF-) polyarthritis category, whereas only one of 2 children with definite PsA could be allocated to the ILAR PsA class. Ten patients (8%) constituted the undifferentiated arthritis group, 8 because of psoriasis in a first-degree relative, one because of the presence of RF in a girl with oligoarthritis, and another because of psoriasis in a boy who was HLA-B27-positive. In comparison with the Durban JIA criteria the Edmonton revision decreased the number of patients whose arthritis fulfilled criteria in no category or in 2 or more categories (from 19 to 10), and delineated better the population included in the RF- polyarthritis category. CONCLUSION: The Edmonton criteria made the ILAR classification more transparent and easy to apply. Family history of psoriasis was responsible for most allocations to the undifferentiated arthritis category (8/10).

Merino R, de Inocencio J, García-Miguel P, García-Consuegra J. · Paediatric Rheumatology Unit, University Hospital La Paz, Madrid, Spain. · Clin Exp Rheumatol. · Pubmed #15485023 No free full text.

Abstract: Lymphoproliferative disorders (LPD) are reported with a much lower frequency in children with rheumatic diseases than in their adult counterparts. We describe 2 patients who developed a lymphoma during the course of the disease. The first is a 16-year-old girl diagnosed with systemic juvenile idiopathic arthritis 6 years before who developed a mucosa-associated lymphoid tissue (MALT) lymphoma. The second report involves a boy diagnosed with systemic lupus erythematosus at 9 years of age who developed a Hodgkin's lymphoma 9 years after the disease onset. In spite of the low frequency of LPD in children with rheumatic diseases, these processes do occur.