Pediatric Rheumatology Online Journal → August 2003 → Epidemiology - International Studies → Abstract #184

TERTIARY LEVEL PEDIATRIC RHEUMATOLOGY IN INDIA

S. Sawhney

¹Pediatrics, Sir Ganga Ram Hospital, New Delhi, India

Aim: To study the referrals to a new tertiary pediatric rheumatology service in a post graduate teaching hospital in India, and compare the data to that from the West.
Method: Data was prospectively collected on patients over a 15-month period from 1st August 2001 to 31st October 2002. Information collected included demographic details, inpatient/outpatient care, referral source, diagnosis, local/outstation, follow up.
Results: 158 patients were referred over 15 months. Age range was 0.9 to 16 years. Sixty-six were females and 92 males. Of 158 patients 48 warranted in-patient care, 110 were out- patient consults. The referral source varied: 93 patients were referred from pediatricians, 46 from adult rheumatologists, 11 from orthopedic surgeons, 6 from physicians and 2 self referred. 80 patients attended from the national capital region of Delhi and 78 patients attended from afar---with two patients from Nepal and one from Sri Lanka.
Disease spectrum was as follows: Commonest diagnosis was juvenile idiopathic arthritis (JIA) which totaled 71.Other diagnoses were: lupus 12, vasculitis 8, juvenile dermatomyositis 2, scleroderma 3, idiopathic pain syndromes 7, benign joint hypermobility 10, reflex sympathetic dystrophy 1, diagnosis uncertain 6, reactive arthritis 11, osteoarticular tuberculosis 4, acute rheumatic fever 2, acute anterior uveitis 1, miscellaneous 20. Of 71 patients with JIA: 41 were males and 30 females. Age range was 0.9 to 16 years. 29 patients had systemic onset JIA, 20 enthesitis related arthritis, 11 oligoarticular disease, 5 Rf positive poly JIA, 4 Rf negative poly JIA, 1 psoriatic arthritis, 1 unclassifiable. There was only one girl under 5 years of age with ANA positive oligo articular JIA - the commonest subgroup of JIA in the West. Mechanical/pain syndromes at 17 patients is much lower than that reported in the West. Of the 158 patients seen, 34 did not attend follow up.
Conclusions:
Cases in Pediatric Rheumatology clinics in India are different from the West. JIA in Indian patients is more in boys, systemic onset JIA being the commonest. Follow up attendance is unsatisfactory.