PERINATOLOGIYA AND PEDIATRIYA.2019.1(77):42-51; doi 10.15574/PP.2019.77.42

Oshlyanska O. A., Melanchuk N. A.
Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine», Kyiv

Purpose — to study of the features of the modern clinical course of juvenile idiopatic arthritis (JIA) in children.

Patients and methods. The statistical analysis conducted by means of multivariate correlation and linear disperse methods based on the history of diseases and outpatient cards, and additional questionnaires conducted an analysis of the clinical course of juvenile arthritis in 47 children (20 boys and 27 girls) aged 1 to 18 years who were on inpatient treatment in the department for older children with pathology of the respiratory organs, digestion, rheumatic and allergic diseases of the SI «IPOG named of academician O.M. Lukyanova NAMS of Ukraine» in 2017–2018 and pediatric department for children from 3 to 18 years old of the National Children's Specialized Hospital «OKHMATDIT» of the Ministry of Health of Ukraine.

Results. The most common variants among all age groups are polyarthritis (38.3%) and oligoarthritis (31.9%). In the age group of 1–6 years and 13–17 years there is a polyarticular variant of the UIA, in the age group of 7–12 years — an oligoarthritis. In general, in the examined children, the average age of the debut of the disease was 5.5±1.0 years, the average duration of the disease was 4.5±1.0 grams. The more aggressive course and high activity of the disease in children with SUI also contributed to a significantly higher value of the number of joints from bone destruction in this group of patients in comparison with other groups. It is in them that the most disabling lesions are localized (joints of the brushes, tibia, foot, articular joint).

Conclusions. In general, in comparison with historical control, the average age of the debut of JIA today shifts to a younger age (5.5±1.0 years), which is explained by the improvement of primary diagnosis after the introduction of modern criteria for diagnosis in domestic health care practice. The obtained results also indicate that the overall activity of JIA is significantly reduced today, there are almost no cases with high disease activity, there is no persistence of visceral lesions. The more severe articular syndrome remains inherent in polyarticular variants of UIA. The analysis showed significant improvement and further course and degree of functional disorders in children with juvenile arthritis, which is explained by the introduction of modern methods of pathogenetic therapy in the clinical practice (storage of low values of JADAS and absence of patients with high JADI among patients with unfavourable disease prognosis in the appointment of GIBT).

Key words: children, juvenile arthritis, course.

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Article received: Nov 20, 2018. Accepted for publication: mar 10, 2019.