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Clinical Aspects of Juvenile Idiopathic Arthritis: Extended Experience from Bangladesh

Received: 13 June 2013    Accepted:     Published: 10 July 2013
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Abstract

Objectives: To assess the different clinical aspects of JIA patients as well as the disease activity status during follow-up period. This study also compared its findings with the previous baseline study done in our country. Methodology: A prospective observational study carried out in the department of pediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the study period of January 2004 to December 2012. A total of 415 patients according to ILAR criteria were enrolled in the study. Patients who completed a 2 year follow-up period were assessed for disease activity status according to Wallace criteria. Data was collected in a predesigned questionnaire. Results: Among the 415 cases, M: F ratio was approximately 2:1. Age range of the patients was 14 months to 16 years. Highest number of patients were present in the age group 11-16 years (49%) followed by 6-10 years. The duration of illness was more than 12 months in the majority. Polyarticular RF negetive patients were most frequent (33%), followed by persistent oligo-arthritis (28 %). Among the patients who completed at least 2 years of follow-up, 68% achieved remission, of them 51% maintained remission and 16.3% had relapse. Conclusion: Late diagnosis with long duration of disease was still common. Clinical profile of this study was almost similar to our previous study but differed from western JIA cases mainly in term of sex, subtypes and duration of illness. Majority of the patients went into remission. Wrong diagnosis was gradually decreasing and it seems that awareness about JIA is gradually increasing among the medical professionals in our country.

Published in American Journal of Clinical and Experimental Medicine (Volume 1, Issue 1)
DOI 10.11648/j.ajcem.20130101.14
Page(s) 20-23
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Clinical Profile, Disease Activity Status, Remission, Relapse

References
[1] Jennifer EW, Norman TI. Juvenile idiopathic arthritis. Pediatr Clin N Am 2005; 52: 413–42.
[2] Hofer M, Southwood TR. Classification of childhood arthritis. Best Pract Res Clin Rheumatol 2002; 16, 379–89.
[3] Ramsey S, Bolaria R, Cabral D, Malleson P, Petty R. Comparison of Criteria for the Classification of childhood arthritis. J Rheumatol 2000; 27:1283-86.
[4] Merino R, De Inocencio J, Garcia-Consuegra J. Evaluation of ILAR classification criteria for juvenile idiopathic arthritis in Spanish children. J Rheutamol 2002:29: 2731-36.
[5] Kunjir V, Venugopalan A, Chopra A. Profile of Indian patients with juvenile onset chronic inflammatory joint disease using the ILAR classification criteria for JIA: a community based cohort study. The Journal of Rheumatology 2010; 37: 1756-62.
[6] Rahman SA, Islam M I, Hossain M, Talukder M K. Clinical presentation of juvenile idiopathic arthritis in Bangladesh: experience from a tertiary hospital. International Journal of Rheumatic Disease 2008; 11:50-54.
[7] Ravelli A, Martini A. Remission in juvenile idiopathic arthritis. Clin Exp Rheumatol 2006; 24 (Suppl. 43):S105-S110.
[8] Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J, et al. International League of Associations for rheumatology classification of juvenile idiopathic arthritis: 2nd revision, Edmonton, 2001. J Rheumatol 2004; 31:390-92.
[9] Wallace CA, Ruperto N, Giannini EH; Childhood Arthritis and Rheumatology Research Alliance; Paediatric Rheumatology International Trials Organization; Paediatric Rheumatology Collaborative Study Group. Preliminary criteria for clinical remission for select categories of juvenile idiopathic arthritis. J Rheumatol 2004; 31:2290-4.
[10] Cassidy JT, Petty RE .Chronic arthritis in childhood. In: Cassidy JT, Petty RE, Laxer RM, Lindsley CB. Editors. Text Book of Pediatric Rheumatology, 6th ed. Philadelphia: Saunders Elesvier; 2011. p 211–286.
[11] Agarwal A, Misra R. Juvenile chronic arthritis in India. It is different from that seen in the western countries. Rheumatol Int 1994; 14 :53-6.
[12] Eveline YW, Heather A, Van MC, Rabinovich CE. Juvenile idiopathic arthritis. In: Kliegman RM, Stanton BF, Schor NF, Geme JWS, Behrman RE. Nelson Textbook of Paediatrics, 19th ed. Philadelphia: Saunders; 2011. P 829-39.
[13] Boel A G. Juvenile arthrits- who gets it, where and when ?A review of current data on incidence and prevalence. Clin Exp Rheumatol 1999; 17: 367-374.
[14] Azam S, Dipti T, Rahman S. Prevalence and clinical pattern of juvenile idiopathic arthritis in a semi-urban area of Bangladesh. International Journal of Rheumatic Disease 2012; 15:116-20.
[15] Wallace CA, Huang B, Banderia M, Ravelli A, Giannini EH Patterns of clinical remission in select categories of juvenile idiopathic arthritis .Arthritis & Rheum 2005; 52:3544-62.
[16] Shenoi S, Wallace CA. Remission in juvenile idiopathic arthritis: Current facts. Cur Rheumatol Rep 2010; 12: 80-86.
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    Shahana A Rahman, Mohammad Imnul Islam, Manik Kumar Talukder. (2013). Clinical Aspects of Juvenile Idiopathic Arthritis: Extended Experience from Bangladesh. American Journal of Clinical and Experimental Medicine, 1(1), 20-23. https://doi.org/10.11648/j.ajcem.20130101.14

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    ACS Style

    Shahana A Rahman; Mohammad Imnul Islam; Manik Kumar Talukder. Clinical Aspects of Juvenile Idiopathic Arthritis: Extended Experience from Bangladesh. Am. J. Clin. Exp. Med. 2013, 1(1), 20-23. doi: 10.11648/j.ajcem.20130101.14

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    AMA Style

    Shahana A Rahman, Mohammad Imnul Islam, Manik Kumar Talukder. Clinical Aspects of Juvenile Idiopathic Arthritis: Extended Experience from Bangladesh. Am J Clin Exp Med. 2013;1(1):20-23. doi: 10.11648/j.ajcem.20130101.14

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  • @article{10.11648/j.ajcem.20130101.14,
      author = {Shahana A Rahman and Mohammad Imnul Islam and Manik Kumar Talukder},
      title = {Clinical Aspects of Juvenile Idiopathic Arthritis: Extended Experience from Bangladesh},
      journal = {American Journal of Clinical and Experimental Medicine},
      volume = {1},
      number = {1},
      pages = {20-23},
      doi = {10.11648/j.ajcem.20130101.14},
      url = {https://doi.org/10.11648/j.ajcem.20130101.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20130101.14},
      abstract = {Objectives: To assess the different clinical aspects of JIA patients as well as the disease activity status during follow-up period. This study also compared its findings with the previous baseline study done in our country. Methodology: A prospective observational study carried out in the department of pediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the study period of January 2004 to December 2012. A total of 415 patients according to ILAR criteria were enrolled in the study. Patients who completed a 2 year follow-up period were assessed for disease activity status according to Wallace criteria. Data was collected in a predesigned questionnaire. Results: Among the 415 cases, M: F ratio was approximately 2:1. Age range of the patients was 14 months to 16 years. Highest number of patients were present in the age group 11-16 years (49%) followed by 6-10 years. The duration of illness was more than 12 months in the majority. Polyarticular RF negetive patients were most frequent (33%), followed by persistent oligo-arthritis (28 %). Among the patients who completed at least 2 years of follow-up, 68% achieved remission, of them 51% maintained remission and 16.3% had relapse. Conclusion:  Late diagnosis with long duration of disease was still common. Clinical profile of this study was almost similar to our previous study but differed from western JIA cases mainly in term of sex, subtypes and duration of illness. Majority of the patients went into remission.  Wrong diagnosis was gradually decreasing and it seems that awareness about JIA is gradually increasing among the medical professionals in our country.},
     year = {2013}
    }
    

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    T1  - Clinical Aspects of Juvenile Idiopathic Arthritis: Extended Experience from Bangladesh
    AU  - Shahana A Rahman
    AU  - Mohammad Imnul Islam
    AU  - Manik Kumar Talukder
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    DO  - 10.11648/j.ajcem.20130101.14
    T2  - American Journal of Clinical and Experimental Medicine
    JF  - American Journal of Clinical and Experimental Medicine
    JO  - American Journal of Clinical and Experimental Medicine
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    UR  - https://doi.org/10.11648/j.ajcem.20130101.14
    AB  - Objectives: To assess the different clinical aspects of JIA patients as well as the disease activity status during follow-up period. This study also compared its findings with the previous baseline study done in our country. Methodology: A prospective observational study carried out in the department of pediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the study period of January 2004 to December 2012. A total of 415 patients according to ILAR criteria were enrolled in the study. Patients who completed a 2 year follow-up period were assessed for disease activity status according to Wallace criteria. Data was collected in a predesigned questionnaire. Results: Among the 415 cases, M: F ratio was approximately 2:1. Age range of the patients was 14 months to 16 years. Highest number of patients were present in the age group 11-16 years (49%) followed by 6-10 years. The duration of illness was more than 12 months in the majority. Polyarticular RF negetive patients were most frequent (33%), followed by persistent oligo-arthritis (28 %). Among the patients who completed at least 2 years of follow-up, 68% achieved remission, of them 51% maintained remission and 16.3% had relapse. Conclusion:  Late diagnosis with long duration of disease was still common. Clinical profile of this study was almost similar to our previous study but differed from western JIA cases mainly in term of sex, subtypes and duration of illness. Majority of the patients went into remission.  Wrong diagnosis was gradually decreasing and it seems that awareness about JIA is gradually increasing among the medical professionals in our country.
    VL  - 1
    IS  - 1
    ER  - 

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Author Information
  • Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

  • Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

  • Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

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