Терапевтический архив (May 2010)
Retrospective analysis of the course and outcomes of juvenile arthritis in adult patients
Abstract
Aim. To assess the course and outcomes, functional and social status in long ill patients with juvenile arthritis (JA). Subjects and methods. The study included 213 patients aged 16 to 60 years (mean age 23.9 ± 6.5 years) with JA with its duration of 10 to 53 years (mean 17.4 ± 6.8 years). Ninety-seven patients were examined at the Institute of Rheumatology; the others filled in the social status and health assessment questionnaires (HAQ). Results. Polyarthritis and oligoarthritis were found in 72.9 and 17.7%, respectively; no articular changes were seen in 9.4%. Systemic signs were noted in 3.1%. A fourth of the patients developed uveitis. Articular functional limitations were minimal or absent (functional class (FC) I, II and HAQ = 0-1.0 score) in 71-81.2%; 18.8-29% needed assistance by other persons (FC III, IV and HAQ = 2.1-3.0 scores). The FC correlated with the clinico-laboratory indicators. Mild or moderate JA persisted in 87.8% of the patients. A third of the patients were found to have erosions; 31.9% presented with ankylosis; 27.8% had aseptic necrosis of predominantly the femoral head. The health status was appraised as good or very good, satisfactory, or bad by 43.3, 39.8, and 16.9% of the patients, respectively. 78.9% of the patients worked or studied; 48.2% graduated from or continued their education at the institute; 31.7% were married; 46 patients had children. Conclusion. In most adult patients with childhood-onset JA, the activity of the disease reduced; a good functional outcome was noted. The health status made it possible to obtain profession and to be adapted to routine life and social environment. The patients with the severer course and outcome of the disease with the formation of significant functional limitations needed treatment and further medical follow-up.
