Clinical characters of juvenile onset spondyloarthropathies
- VernacularTitle:幼年发病型脊柱关节病的临床特征
- Author:
Jianglin ZHANG
;
Feng HUANG
- Publication Type:Journal Article
- From:
Chinese Journal of Rheumatology
2001;5(2):113-116
- CountryChina
- Language:Chinese
-
Abstract:
Objective To better understand the clinical characters of juvenile onset spondyloarthropa-thies (JSpA).Methods The clinical and laboratory data of 190 in-patients with JSpA were analyzed and the diagnosis,classification and differentiation of juvenile onset arthritis were discussed.Results Among these 190 patients,163 were male,with a male to female ratio 6∶1.Of them 92.1% had the disease after the age of 8.Peak of age at onset was 12 to 15 years;157(82.6%) patients had peripheral arthritis and only 23(12.1%) patients felt low back pain at onset.During the disease course, peripheral arthritis was found in 187(98.4%) patients and the history of low back pain or buttock pain was recorded in 123(64.7%).The interval between peripheral arthritis and low back pain was from 0 to 20 years,with an average of (3.2±4.5)years.Extra-articular features including enthesitis in 67(35.3%)patients,dactylitis in 20(10.5%),iritis in 9(4.7%) were observed.HLA-B27 was positive in 87.9%(160/182) patients.Sacroiliitis on X-ray was observed in 76.0%(136/179) patients,and 106(55.8%) patients were diagnosed juvenile ankylosing spondylitis (JAS) according to 1984 New York modified criteria.The average disease course in JAS was (6.3±6.2) years,longer than that in JSpA (P＜0.01).Conclusion The concept of JSpA is helpful to early diagnosis and treatment of juvenile onset arthritis.The JSpA are characterized by asymmetric lower limb predominant oligoarthritis,a wide spectrum of extra-articular features,presence of HLA-B27 and familial history of SpA or psoriasis.It will take an average of 6.3 years for JSpA patients to fulfill the diagnostic criteria of adult AS.
