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Prediction of long-term effects of olygo-articular variant of juvenile idiopathic arthritis
Summary. Although the oligo-articular variant of juvenile idiopathic arthritis (JIA) has a favorable course, in some cases, it can lead to the development of significant articular and extra-articular damages with predominant lesions of the hip and knee joints with limitation of their function and the development of ankylosis, requiring surgical intervention in these patients. The aim of the study was to evaluate the risk factors of articular and extra-articular damages in adults with the oligo-articular variant of the JIA and to work out a prognostic model for their development. Materials and methods. The study included 58 adult patients with oligo-ariticular (persistent and extended) variant of the JIA. Retrospective analysis of medical records of patients with oligoarticular variant of JIA was made, taking into account clinical manifestations in the onset of the disease, laboratory parameters and response to therapy. In adulthood, the integral index of articular (JADI-A) and extra-articular (JADI-E) damages was used to assess the long-term effects of JIA. Results. Unfavorable prognostic factors were revealed by method of binary logistic regression. Mathematical model for predicting the probability of long-term negative articular and extra-articular damages of oligo-articular JIA was developed. Conclusions. 1. The risk factors for the development of articular and extra-articular damages in adulthood in patients with a oligo-articular variant of the JIA are female sex, delayed diagnosis, the average duration of morning stiffness in childhood, the presence of symmetrical arthritis in childhood, dactylitis, pain in the cervical spine, fever, uveitis, level of ESR, HLA-B27 positivity, JADAS activity in childhood, glucocorticoid administration, need for intensified therapy. 2. A prognostic model for the development of articular and extra-articular damages in adult patients with a oligo-articular variant of the JIA is developed. This model is effective and allows determine the adverse course of the disease and can bethe basis for personalized treatment for the prevention of the development of significant articular and extra-articular damages of JIA.
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