Clinical and biochemical characteristics of children with juvenile idiopathic arthritis

To determine the clinical and biochemical characteristics of children with Juvenile Idiopathic Arthritis [JIA] at a tertiary care centre in Karachi, Pakistan. A descriptive study. Paediatric Rheumatology Clinic of The Aga Khan University Hospital [AKUH], Karachi, from January 2008 to December 2011. Clinical and laboratory profile and outcome of children less than 15 years of age attending the Paediatric Rheumatology Clinic of the Aga Khan University, Karachi with the diagnosis of Juvenile Idiopathic Arthritis according to International League against Rheumatism were studied. These children were classified into different types of JIA; their clinical and laboratory characteristics, response to therapy and outcome was evaluated. Sixty eight patients satisfying the criteria of International League against Rheumatism [ILAR] for Juvenile Idiopathic Arthritis were enrolled during the study period of four consecutive years, their age ranged from 9 months to 15 years. Mean age at onset was 6.45 +/- 4.03 years while mean age at diagnosis was 7.60 +/- 3.93 years. Polyarticular was the most predominant subtype with 37 [54%] patients, out of these, 9 [24%] were rheumatoid factor positive. An almost equal gender predisposition was observed. Fever and arthritis were the most common presenting symptoms, with only 2 patients presenting with uveitis. The clinico-biochemical characteristics of JIA at the study centre showed a pattern distinct with early onset of disease, high frequency of polyarticular type and a higher rheumatoid factor [QRA] and ANA positivity in girls

Juvenile dermatomyositis

Juvenile dermatomyositis [JDM] is an important subtype of dermatomyositis characterized by inflammation of muscle, skin and gastrointestinal tract. A 14-year-old girl, with a history of fever, joint pain, easy fatigability and a rash since the age of 3 years is described. Physical examination, laboratory evaluation, electromyography [EMG] and muscle biopsy were suggestive of a chronic inflammatory process involving the muscles, most likely dermatomyositis. The report highlights the importance of a muscle biopsy as the gold standard for diagnosing dermatomyositis