Clinical Analysis Of Oligoarticular Juvenile Idiopathic Arthritis And Enthesitis-Related Arthritis

Objective To investigate characteristics of clinical manifestation,disease activity and therapy in children with oligoarticular juvenile idiopathic arthritis(oJIA)and enthesitis-related arthritis(ERA).Methods The medical records of 139 children with ERA or oJIA in Children’s Medical Center of University from 2013 to 2016 were retrospectively reviewed.The clinical,laboratory data,image examination and therapeutic effects of the patients were collected for analysis of characteristics.Besides,at the time point of 1mouth,3mouth,6mouth after treatment,The clinical、laboratory data and VAS of the patients were collected for analysis of characteristics and curative effects.Results In this study a total of 139 cases were included,there were 74(53.2%)cases of ERA,its mean age is 11.32 years,men take a dominant role(male : remale=8.25:1),and 65 cases of oJIA,no case of extended oligoarthritis.ERA predominantly involved legs,with the knee joints(63.5%)mostly affected,followed by the hips(50%),the ankles(44.6%)and low back pain(35.1%).oJIA also affected the large joints at onset knees(64.9%)and ankles(32.3%).The positive rate of HLA-B27 was higher than than oJIA(74.3% vs 12.3%,p <0.05).There was no statistically significant difference of the positive ANA in the two groups(16.2% vs 10.8%,p >0.05).Chronic uvitis was recognized in 2 cases in ERA,both with HLA-B27 positive and without ANA positive.Of 108 patients followed by 6 mouths,65(60.2%)were treated with a combination therapy of methotrexate(MTX)and sulfasalazine(SASP).In serious condition the treatment with Etanercept or prednisone was abtained.Before and after the treatment,the VAS of all patients with different treatments was significantly decreased(p<0.05);in groups with Etanercept and prednisone in ERA and the prednisone group in oJIA,ESR was significantly improved(P<0.05);in the prednisone group,CRP was also dropped significantly(p<0.05).All treatments were no serious adverse reactions.Conclusion The onset age of patients suffering from ERA are later than those with oJIA,and the males with ERA are significantly more than famales.In the oJIA group male is slightly higher than the female.In this data there are only 2 cases with uveitis in ERA,both with HLA B27 positive,and not associated with ANA positive.MRI in early diagnosis and classification of JIA has an important application value.MTX combined SASP can make most patients get disese remission.Etanercept or prednisone in short time for serious condition can help to abtain a good early curative effect and parts of patients can improve MRI changes.