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Original Articles
NUMBER 3-4 YEAR 2011
Correlations Between Clinical Forms and Biomarkers in Juvenile Idiopathic Arthritis
First Pediatrics Clinic, Victor Babes University of Medicine and Pharmacy, Timisoara

Correspondence to:
Andrea Somogyi Militaru, First Pediatrics Clinic, Louis Turcanu Clinical Emergency Hospital,
2 Iosif Nemoianu Str., 300011 Timisoara, Romania,
Tel. +40-730-618838.
Email: andreamilitaru@yahoo.com
REZUMAT
Introducere: Artrita juvenila idiopatica este cea mai importanta boala reumatologica a copilariei. Obiective: Studiul corelatiilor dintre semnele clinice si markerii inflamatori in AJI. Material si metode: 58 de copii diagnosticati si clasificati conform criteriilor ILAR, au fost evaluati clinic si biologic. Rezultate: Distributia pacientilor a fost urmatoarea: 17 poliartrite, 18 oligoartrite, 1 AJI sistemica, 22 spondiloartropatii (SpA). În lotul studiat, am observat o corelatie buna intre valorile VSH, CRP si scorurile functionale. Anticorpii anti-CCP (ACPA) au fost pozitivi in doar 6 cazuri, dar in titru scazut, toate cazurile asociind sindrom inflamator important la debutul bolii, dar nu am gasit corelatie cu indicii functionali. Nivelul plasmatic al interleukinelor pro-inflamtorii IL-1alfa, IL-beta, IL-6 a fost determinat in 8 cazuri. Ambele fractiuni de IL-1 au avut nivele crescute in 3 cazuri de SpA (cu nivele normale de IL-6). Cresterea concentratiei plasmatice a IL-6 a fost inregistrata in 3 poliartrite (valori normale ale IL-1). Concluzii: În lotul studiat nu am gasit corelatie intre ACPA si forma clinica de AJI. IL ar putea fi corelate cu forma clinica de AJI (Il-1 cu spondilopatii, IL-6 cu poliartrite). Studii ulterioare trebuie sa confirme observatiile acestui studiu.

ABSTRACT
Introduction: Juvenile idiopathic arthritis (JIA) is the most important rheumatic disease of childhood. Aim: To study the correlations between clinical signs and inflammatory biomarkers in JIA. Material and methods: In 58 children, diagnosed and classified according to ILAR (International League of Associations for Rheumatology), evaluation consisted in clinical and laboratory examination (ESR, CRP, RF-rheumatoid factor, anticyclic citrullinated peptide antibody- ACPA, interleukins - ILs). Results: The distribution of patients was: 1 systemic JIA, 17 polyarthritis, 18 oligoarthritis, 22 spondyloarthropathies. There was a good correlation between the ESR, CRP values and the functional scores. ACPA was found positive in 6 cases, but borderline levels, all associating important inflammation at the onset, but no correlations with functional indexes. Plasma levels of IL-1alpha, IL-1betha, IL-6 pro-inflammatory interleukins was determined in 8 cases. Both fractions of IL-1 were increased in two cases of reactive arthritis and one juvenile spondylitis (with normal IL-6 levels). Enhancement of IL-6 (and normal IL-1 values) was observed in 3 children with polyarthritis. Conclusions: In the studied group, we found no correlations between clinical form of JIA and ACPA titre. Interleukins could be correlated with clinical form of JIA (IL-1 with spondyloarthropaty, IL-6 with polyarthritis). Further studies need to sustain these observations.


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