engleski

Epidemiology of juvenile spondyloarthropathies in Croatia: a retrospective study over the last 6 years

The term spondyloarthropathy is used for a group of rheumatic diseases that affect the joints of the axial skeleton as well as peripheral joints and that differ from juvenile idioapthic arthritis in many ways. Juvenile spondyloarthropathies (JSpA) include: juvenile ankylosing spondylitis, juvenile psoriatic arthritis, the arthritis of inflammatory bowel disease, reactive arthritis and undifferentiated forms of spondyloarthropathies which are predominantly present during childhood and adolescence. The cause of JspA is still unknown. The strong association with HLA-B27 suggests that genetically determined mechanisam is central in the pathogenesis. The aim of our study was to determine: 1) the incidence of JSpA in Croatian population in the last 5 years in relation to other rheumatic diseases in children, and 2) the presence of HLA-B27 in children with JSpA. All patients aged from 1 to 18 years and diagnosed during the period 1997-2002 at the Department of Paediatric Rheumatology, University Hospital Zagreb, Croatia, as having JSpA were entered into study, following strict criteria of European Spondyloarthropathy Study Group. Using hospital and outpatient records, we identified 665 newly diagnosed patients with rheumatic diseases, out of which 65 patients were identified as having JSpA (9, 8%) amongst 7, 983 patients with rheumatic disorders examined in the period between 1997 and 2002. Sex ratio was 18 females against 47 males, mean age 13, 5 years. Undifferentiated spondyloarthropathy had 53 patients (81, 5%), 4 patients had Reiter’ s syndrome (6, 2%), 6 had arthritis of inlammatory bowel disease-Mb. Crohn (9, 3%), one patient had psoriatic arthritis (1, 5%) and only one had ankylosing spondilitis (1, 5%). Ocular complications were present in 23 patients (35, 4%), enthesitis in 50 (76, 9%), sacroileitis in 59 (90, 8%) and peripheral arthritis in all 65 patients (100%). HLA-B27 was present in 48 patients (73, 9%). Our epidemilogical study showed similar incidence of JSpA among other rheumatic diseases in childhood and adolescencets (9, 8%) compared to the results of American, Canadian and British studies in which this incidence is 7, 9-9, 8%. However, the presence of HLA-B27 antigene is lower (73, 9%) in relation to other studies (86-100%), which is probably due to a greater number of patients with undifferentiated spondyloarthropathies, who could later in some cases correlate with the evolution of idiopathic SEA syndrome.

spondyloarthropathies; incidence

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