ABSTRACT
BACKGROUND: Systemic juvenile idiopathic arthritis (systemic JIA) is a severe disease with both systemic and joint inflammation. This study aims to identify predictors of disease evolution within the systemic JIA population enrolled in the Juvenile Inflammatory Rheumatism cohort (JIRcohort). METHODS: Observational patient cohort study with 201 recruited children from 4 countries (3 European, 1 North Africa) from 2005 until 2019, using retrospectively (2005-2015) and prospectively (2015-2019) routine care collected data. RESULTS: Sixty-five patients with complete follow-up data for 24 months after first diagnosis were classified as monophasic (n = 23), polyphasic (n = 6) or persistent group (n = 36) corresponding to their evolution (unique flare, recurrent flares, or persistent disease activity respectively). The patients of the persistent group were more likely to have an earlier disease onset, before the age of 6 (OR 2.57, 95%-CI 0.70-9.46), persistence of arthritis at 12-months post-diagnosis (OR 4.45, 95%-CI 0.58-34.20) and higher use of synthetic DMARD (sDMARD, OR 5.28, 95%-CI 1.39-20.01). Other variables like global assessment by physician and by patient and C Reactive Protein levels at 12-months post-diagnosis were assessed but without any predictive value after adjusting for confounding factors. CONCLUSIONS: Our results suggest that the earlier disease onset, the persistence of arthritis throughout the first year of disease evolution and the need of sDMARD might predict a persistent disease course.
Subject(s)
Antirheumatic Agents , Arthritis, Juvenile , Child , Humans , Arthritis, Juvenile/drug therapy , Retrospective Studies , Antirheumatic Agents/therapeutic use , Cohort Studies , Data CollectionSubject(s)
Dermatomyositis/complications , Neuromyelitis Optica/complications , Adrenal Cortex Hormones/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Child , Dermatomyositis/drug therapy , Humans , Methotrexate/therapeutic use , Methylprednisolone/therapeutic use , Neuromyelitis Optica/drug therapy , PhotographySubject(s)
Hospital Units , Hospitals, Pediatric , Hospitals, University , Pediatrics , Rheumatic Diseases/therapy , Rheumatology , Child , Humans , Morocco , Retrospective StudiesSubject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Arthritis, Juvenile/complications , Glucosamine/analogs & derivatives , Indomethacin/therapeutic use , Lymphohistiocytosis, Hemophagocytic/diagnosis , Lymphohistiocytosis, Hemophagocytic/drug therapy , Sulfasalazine/therapeutic use , Arthritis, Juvenile/drug therapy , Child , Drug Combinations , Glucosamine/therapeutic use , Humans , Male , Treatment OutcomeABSTRACT
Recurrent fevers are characterized by fever lasting for a few days or few weeks and followed by a fever-free interval and state of well-being. It is first necessary to eliminate infections, which are the most common causes of fever. Several recurrent fevers belong to inflammatory diseases of unclear physiopathogeny. Recent advances are now available permitting to immunogenetically identify some of them. It also opens a better understanding and consequently the possibility of specific therapeutic approach.
