Disability and disease-related damage in Thai children and adolescents with juvenile idiopathic arthritis
Issued Date
2023-07-10
Resource Type
eISSN
15460096
Scopus ID
2-s2.0-85164278991
Pubmed ID
37430274
Journal Title
Pediatric rheumatology online journal
Volume
21
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Pediatric rheumatology online journal Vol.21 No.1 (2023) , 68
Suggested Citation
Tangcheewinsirikul S., Sukharomana M., Charuvanij S. Disability and disease-related damage in Thai children and adolescents with juvenile idiopathic arthritis. Pediatric rheumatology online journal Vol.21 No.1 (2023) , 68. doi:10.1186/s12969-023-00852-5 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/88019
Title
Disability and disease-related damage in Thai children and adolescents with juvenile idiopathic arthritis
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
BACKGROUND: Children and adolescents with juvenile idiopathic arthritis (JIA) may suffer from disability and disease-related damage. This study aimed to investigate the prevalence of disability and damage, and identify the factors associated with articular and extra-articular damage in children and adolescents with JIA in a resource-restricted setting in Thailand. METHODS: This cross-sectional study enrolled JIA patients during June 2019-June 2021. Disability was assessed using the Child Health Assessment Questionnaire (CHAQ) and Steinbrocker classification criteria. Damage was evaluated using the Juvenile Arthritis Damage Index (JADI) and the modified-JADI (mJADI) tools. RESULTS: There were 101 patients (50.5% female) with median age of 11.8 years. Median disease duration was 32.7 months. Enthesitis-related arthritis (ERA) was the most common subtype (33.7%), followed by systemic JIA (25.7%). Thirty-three (32.7%) patients had delayed diagnosis ≥ 6 months. Moderate to severe disability was found in 20 (19.8%) patients. Patients with Steinbrocker functional classification > class I were seen in 17.9%. Thirty-seven (36.6%) patients had articular damage. Extra-articular complications were observed in 24.8%. Growth failure and striae were the most common complications in 7.8%. Leg-length discrepancy was documented in 5.0%. Ocular damage was found in 1 patient with ERA. Multivariable logistic regression analysis revealed Steinbrocker functional classification > class I (aOR: 18.1, 95% CI: 3.9-84.6; p < 0.001), delayed diagnosis ≥ 6 months (aOR: 8.5, 95%CI: 2.7-27.0; p < 0.001), and ERA (aOR: 5.7, 95%CI: 1.8-18.3; p = 0.004) as independent predictors of articular damage. Systemic corticosteroids use was the independent predictor of extra-articular damage (aOR: 3.8, 95%CI: 1.3-11.1; p = 0.013). CONCLUSIONS: Disability and disease-related damage was identified in one-fifth and one-third of JIA patients. Early detection and treatment are essential for preventing permanent damage.