THE PLACE OF JUVENILE ONSET SPONDYLOARTHROPATHIES IN THE ILAR CLASSIFICATION CRITERIA OF JUVENILE IDIOPATHIC ARTHRITIS

Pediatric Rheumatology Online Journal → June 2003 → Enthesitis-related arthritis and Psoriatic arthritis→ Abstract #21

THE PLACE OF JUVENILE ONSET SPONDYLOARTHROPATHIES IN THE ILAR CLASSIFICATION CRITERIA OF JUVENILE IDIOPATHIC ARTHRITIS. A STUDY IN MEXICAN -MESTIZO CHILDREN

R. Gutierrez-Suarez,¹ R. Burgos-Vargas.¹

¹Research Division, Hospital General de Mexico, Mexico, DF, Mexico

Objective:
To evaluated the proposed International League of Associations for Rheumatology (ILAR) classification criteria for juvenile idiophatic arthritis, particularly in regard to the enthesitis related arthritis (ERA) subgroup, in Mexican-Mestizo children with spondyloarthrophaties (SpA).
Methods:
One hundred patients with juvenile spondyloarthropathies (JSpA) were evaluated retrospectively and categorized according to one of the traditional classifications: European Spondyloarthropathy Study Group (ESSG) for SpA, Vancouver Criteria for juvenile psoriatic arthritis (JpsA) and the ERA subgroup of the ILAR classification system.
Results:
Eigthy-three boys and 17 girls fulfilled ESSG criteria whose mean age (SD), mean age at onset and duration of disease were: 20.0 6.45, 11.3 2.5years and 9.5 5.5 years, respectively. Forty six patients (42 males and 4 females) fulfilled New York modified criteria for ankylosing spondylitis and only 49/100 (40 males and 9 females) were classified as ERA. Polyarthritis (rheumatoid factor negative) overlapping with ERA account for most of the cases classified asother arthritis[rdquo> in the ILAR classification system and only two cases because of a family history of psoriasis. Twenty five patients (49%) with sacroiliitis were included in the [ldquo>other arthritis[rdquo> subgroup of the ILAR criteria.
Conclusions:
The ILAR criteria results in reassignment of 51% of patients in the ERA subgroup because of exclusions. This Mexican-Mestizo children and adolescents with SpA are not being appropriately classified. The inclusion of all minor criteria for ERA in the exclusion list of polyarthritis can resolve this misclassification.