DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20150980

Functional health assessment of children suffering from juvenile idiopathic arthritis

Kishore Narayan, Mahesh Kumar Muthuraja

Abstract


Background: Juvenile idiopathic arthritis (JIA) is an autoimmune, non-infective, inflammatory joint disease of more than 6 weeks duration in children less than 16 years of age. The disease commonly occurs in children from the ages of 7 to 12, but it may occur in adolescents as old as 15 years of age, as well as in infants. The aim of this study was to assess health and functional status of children suffering from juvenile idiopathic arthritis for a period of one year using childhood health assessment questionnaire and disease activity score.

Methods: In the present study, children less than 12 years with JIA attending the rheumatology OP (out- patient) and general ward of the Institute of Child Health (Tamil Nadu, India), were selected. Thus a total of 54 cases were enrolled in the study. They were investigated and assessed for functional status based on childhood health assessment questionnaire and disease activity score. They were followed up for one year and also re-assessed for their functional status after one year.

Results: The mean age of the study children was 7.83 ± 2.2 years. It was seen that systemic onset type of arthritis (55.6%) was the most common type. Joint pain was the presenting complaint among all the children (100%). Fever was present in 85.2% children. Almost every joint was involved in study population; knee (88.9%) was the commonest joint involved. 74.6% of children had wrist involvement and ankle involvement was found in 70.4% cases. The mean score of functional status was 1.03 ± 0.26; after a period of 1 year none had severe disability while the mean score was 0.89 ± 0.42. Disease activity index was 2.85 ± 0.84 and after a period of 1 year it was found to be 2.76 ± 0.68.

Conclusions: The mean age of children with JIA was 7.83 ± 2.2 years with joint pain and fever as most common presentation. Although all joints were involved, knee joint was the commonest. The childhood health assessment questionnaire for the assessment of the functional status and disease activity index were simple tools, with good ability to predict disease outcome.


Keywords


Childhood health assessment questionnaire, Juvenile idiopathic arthritis, Functional status

Full Text:

PDF

References


National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Questions and answers about juvenile arthritis (Juvenile idiopathic arthritis, juvenile rheumatoid arthritis, and other forms of arthritis affecting children). Information Clearinghouse National Institutes of Health, October 2012. Available at:

http://www.niams.nih.gov/Health_Info/Juv_Arthritis/defa ult.asp#1. Accessed 19 December 2012.

Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I. Arthritis Rheum. 2008;58(1):15-25.

Burnham JM, Shults J, Dubner SE, Sembhi H, Zemel BS, Leonard MB. Bone density, structure, and strength in juvenile idiopathic arthritis: importance of disease severity and muscle deficits. Arthritis Rheum. 2008;58(8):2518-27.

Chen CY, Tsao CH, Ou LS, Yang MH, Kuo ML, Huang JL. Comparison of soluble adhesion molecules in juvenile idiopathic arthritis between the active and remission stages. Ann Rheum Dis. 2002;61(2):167-70.

Singh G, Athreya BH, Fries JF, Goldsmith DP. Measurement of health status in children with juvenile rheumatoid arthritis. Arthritis Rheum. 1994;37(12):1761-9.

Ruperto N, Ravelli A, Pistorio A, Malattia C, Cavuto S, Gado-West L, et al. Cross-cultural adaptation and psychometric evaluation of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ) in 32 countries. Review of the general methodology. Clin Exp Rheumatol. 2001;19:S1.

Ruperto N, Martini A. International research networks in pediatric rheumatology: the Printo perspective. Curr Opin Rheumatol. 2004;16:566.

Rider LG, Feldman BM, Perez MD, Rennebohm RM, Lindsley CB, Zemel LS, et al. Development of validated disease activity and damage indices for the juvenile idiopathic inflammatory myopathies: I. Physician, parent, and patient global assessments. Juvenile Dermatomyositis Disease Activity Collaborative Study Group. Arthritis Rheum. 1997;40(11):1976-83.

Feldman BM, Rider LG, Reed AM, Pachman LM. Juvenile dermatomyositis and other idiopathic inflammatory myopathies of childhood. Lancet. 2008;371(9631):2201-12.

Groen W, Unal E, Norgaard M, Maillard S, Scott J, Berggren K, et al. Comparing different revisions of the Childhood Health Assessment Questionnaire to reduce the ceiling effect and improve score distribution: Data from a multi-center European cohort study of children with JIA. Pediatr Rheumatol. 2010;8:16.

Gurkirpal Singh, V. Seth. Arthritis & rheumatology. Indian Rheum Association, 1985. Available at: www.indianrheumatology.org.

Singh S, Salaria M, Kumar L, Minz R, Datta U, Sehgal S. Clinico-immunological profile of juvenile rheumatoid arthritis at Chandigarh. Indian Pediatr. 1999;36:449-54.

Sircar D, Ghosh B, Ghosh A, Haldar S. Juvenile idiopathic arthritis. Indian Paediatr. 2006;43:429-33.

Hyrich KL, Lal SD, Foster HE, Thornton J, Adib N, Baildam E, et al. Disease activity and disability in children with juvenile idiopathic arthritis one year following presentation to paediatric rheumatology. Rheumatol Oxford. 2010;49(1):116-22.

Susicć G, Stojanović R, Djurović N. Ability of the Childhood Health Assessment Questionnaire in predicting outcome of patients with juvenile idiopathic arthritis. Srp Arh Celok Lek. 2012;140(7-8):475-81.

Jansena LMA, van Schaardenburga D, van der Horst-Bruinsmab IE, Bezemerc PD, Dijkmansb BAC. Predictors of functional status in patients with early rheumatoid arthritis. Ann Rheum Dis. 2000;59:223-6.