Plotting the Articular Disease Impact of Juvenile Idiopathic Arthritis: Discernments into Clinical Phenotypes and Demographic Tide in a Pakistani Cohort
DOI:
https://doi.org/10.51253/pafmj.v76iSUPPL-9.14480Keywords:
Autoimmune Profile, Joint Involvement, Juvenile Idiopathic ArthritisAbstract
Objective: To investigate into the pattern of joint engagement along with the laboratory markers in Juvenile Idiopathic Arthritis (JIA) amongst the Pakistani cohort.
Study Design: Cross-sectional study.
Place and Duration of Study: Pak-Emirates Military Hospital, Rawalpindi Pakistan from Dec 2023 to Dec 2025.
Methodology: Demographic profile, clinical, and serological statistics were collected focusing on joint distributions, autoimmune biomarkers, inflammatory parameters and treatment strategies. Statistical tests were performed to equate these variables among patient subgroups.
Results: A total of 151 pediatric patients with Juvenile Idiopathic Arthritis (JIA) were included in the study. Polyarticular disease was the most common pattern of joint involvement (64.2%), followed by oligoarticular (33.8%) and monoarticular (2.0%). Antinuclear Antibodies (ANA) were the most frequently detected serological marker (13.2%), followed by Anti-Cyclic Citrullinated Peptide (Anti-CCP, 12.6%), Human leukocyte Antigen B27 (HLA-B27, 4.0%), and Rheumatoid Factor (2.6%). Growth retardation was observed in 26.5% of patients, while uveitis was seen in 2.6%. Methotrexate was the predominant treatment modality (69.5%). Significant differences were observed in Erythrocyte Sedimentation Rate (ESR, p=0.025), C-Reactive Protein (CRP, p=0.006), and Anti-CCP antibody positivity (p<0.001) across joint patterns, while other serological markers showed no significant association.
Conclusion: Polyarticular disease was the most common pattern of joint involvement, followed by oligoarticular and monoarticular. Antinuclear Antibodies were the most frequently detected serological marker, followed by Anti-Cyclic Citrullinated Peptide, Human leukocyte Antigen B27, and Rheumatoid Factor.
Downloads
References
1. Hinze CH, Foell D, Kessel C. Treatment of systemic juvenile idiopathic arthritis. Nat Rev Rheumatol 2023; 19(12): 778-789.
https://doi.org/10.1038/s41584-023-01034-9
2. Martini A, Lovell DJ, Albani S, Brunner HI, Hyrich KL, Thompson SD, et al. Juvenile idiopathic arthritis. Nat Rev Dis Primers 2022; 8(1):5.
https://doi.org/10.1038/s41572-021-00332-2
3. Agarwal M, Freychet C, Jain S, Shivpuri A, Singh A, Dinand V, et al. Factors impacting referral of JIA patients to a tertiary level pediatric rheumatology center in North India: A retrospective cohort study. Pediatr Rheumatol 2020; 18(1): 1–11.
https://doi.org/10.1186/s12969-020-0408-4
4. Onel KB, Horton DB, Lovell DJ, Shenoi S, Cuello CA, Angeles‐Han ST, et al. 2021 American College of Rheumatology guideline for the treatment of juvenile idiopathic arthritis: therapeutic approaches for oligoarthritis, temporomandibular joint arthritis, and systemic juvenile idiopathic arthritis. Arthritis Rheumatol 2022; 74(4): 553-569.
https://doi.org/10.1002/art.42037
5. Hameed K, Amanullah F, Ullah S, Abbas S. Clinical and Biochemical Characteristics of Children with Juvenile Idiopathic Arthritis. J Coll Physicians Surg Pak 2014; 24(7): 487-491.
https://doi.org/10.2014/jcpsp.48749
6. Abrawan S, Sultana R, Akhter S, Islam M. Comparison of juvenile idiopathic arthritis subtype distribution among different countries. Bangl J Child Health 2020; 44(1): 34-39.
https://doi.org/10.3329/bjch.v44i1.48450
7. Al-Mayouf SM, Al Mutairi M, Bouayed K, Habjoka S, Hadef D, Lotfy HM, et al. Epidemiology and demographics of juvenile idiopathic arthritis in Africa and Middle East. Pediatric Rheumatology. 2021; 19(1): 1–30.
https://doi.org/10.1186/s12969-021-00650-x
8. Costello R, McDonagh J, Hyrich KL, Humphreys JH. Incidence and prevalence of juvenile idiopathic arthritis in the United Kingdom, 2000–2018: results from the Clinical Practice Research Datalink. Rheumatology 2022; 61(6): 2548–2554.
https://doi.org/10.1093/rheumatology/keab714
9. Shiff NJ, Oen K, Kroeker K, Lix LM. Trends in Population-Based Incidence and Prevalence of Juvenile Idiopathic Arthritis in Manitoba, Canada. Arthritis Care Res 2019; 71(3): 413–418.
https://doi.org/10.1002/acr.23606
10. Abdwani R, Abdalla E, Al Abrawi S, Al-Zakwani I. Epidemiology of juvenile idiopathic arthritis in Oman. Pediatr Rheumatol Online J 2015; 13(1): 33.
https://doi.org/0.1186/s12969-015-0030-z
11. Lovell DJ, Huang B, Chen C, Angeles-Han ST, Simon TA, Brunner HI et al. Prevalence of autoimmune diseases and other associated conditions in children and young adults with juvenile idiopathic arthritis. RMD Open 2021; 7(1): e001558.
https://doi.org/10.1136/rmdopen-2020-001558
12. Consolaro A, Giancane G, Alongi A, van Dijkhuizen EHP, Aggarwal A, Al-Mayouf SM, et al. Phenotypic variability and disparities in treatment and outcomes of childhood arthritis throughout the world: an observational cohort study. Lancet Child Adolesc Health 2019; 3(4): 255–263.
https://doi.org/10.1016/S2352-4642(19)30027-6
13. Khodra B, Stevens A, Ferucci ED. Prevalence of Juvenile Idiopathic Arthritis in the Alaska Native Population. Arthritis Care Res 2020; 72(8): 1152–1158.
https://doi.org/10.1002/acr.23997
14. Bansal N, Pasricha C, Kumari P, Jangra S, Kaur R, Singh R. A comprehensive overview of juvenile idiopathic arthritis: From pathophysiology to management. Autoimmun Rev 2023; 22(7): 103337.
https://doi.org/10.1016/j.autrev.2023.103337
15. Ramanan AV, Dick AD, Jones AP, McKay A, Williamson PR, Compeyrot-Lacassagne S, et al. Adalimumab plus Methotrexate for Uveitis in Juvenile Idiopathic Arthritis. N Engl J Med 2017; 376(17): 1637–1646.
https://doi.org/10.1056/NEJMoa1614161
16. Ramanan AV, Quartier P, Okamoto N, Foeldvari I, Spindler A, Fingerhutová S, et al. Baricitinib in juvenile idiopathic arthritis: an international, phase 3, randomised, double-blind, placebo-controlled, withdrawal, efficacy, and safety trial. Lancet 2023; 402(10401): 555–570.
https://doi.org/10.1016/S0140-6736(23)00921-2
17. Meerwijk C, Kuiper J, Straalen J, Ayuso VK, Wennink R, Haasnoot AM, et al. Uveitis Associated with Juvenile Idiopathic Arthritis. Ocul Immunol Inflamm 2023; 31(9): 1848–1853.
https://doi.org/10.1080/09273948.2023.2278060
18. Angeles-Han ST, Ringold S, Beukelman T, Lovell D, Cuello CA, Becker ML, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Screening, Monitoring, and Treatment of Juvenile Idiopathic Arthritis–Associated Uveitis. Arthritis Care Res 2019; 71(6): 703–716. https://doi.org/10.1002/acr.23871
19. Kavadichanda CG, Seth G, Kumar G, Gulati R, Negi VS. Clinical correlates of HLA-B*27 and its subtypes in enthesitis-related arthritis variant of juvenile idiopathic arthritis in south Indian Tamil patients. Int J Rheum Dis 2019; 22(7): 1289–1296.
https://doi.org/10.1111/1756-185X.13551
20. Mitra S, Samui PP, Samanta M, Mondal RK, Hazra A, Mandal K, et al. Ultrasound detected changes in joint cartilage thickness in juvenile idiopathic arthritis. Int J Rheum Dis 2019; 22(7): 1263–1270. https://doi.org/10.1111/1756-185X.13584
21. García-Rodríguez F, Gamboa-Alonso A, Jiménez-Hernández S, Ochoa-Alderete L, Barrientos-Martínez VA, Alvarez-Villalobos NA, et al. Economic impact of Juvenile Idiopathic Arthritis: a systematic review. Pediatr Rheumatol 2021; 19(1): 1–10.
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2026 Annam Javed, Amer Fakhar, Sadia Ali, Amina Khurshid, Usama Zahid

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.





