Pediatric Rheumatology Online Journal → June 2003 → Enthesitis-related arthritis and Psoriatic arthritis→ Abstract #22

SERONEGATIVE ENTHESOPATHY AND ARTHROPATHY (SEA) SYNDROME IN CHILDHOOD: LONG-TERM FOLLOW UP AND ITS CLASSIFICATION INTO JIA (ILAR CRITERIA)

G. Espada,¹ K. Hekier,² P. Weissbrod,³ L. Leggire,⁴ J A Maldonado-Cocco.⁵

¹Rheumatology Section, Children's Hospital Ricardo Gutierrez, Buenos Aires, Buenos Aires, Argentina; ²Rheumatology Section, Children's Hospital, Buenos Aires, Buenos Aires, Argentina; ³Rheumatology Section, Children's Hospital, Buenos Aires, Buenos Aires, Argentina; ⁴Rheumatology Section, Children's Hospital, Buenos Aires, Buenos Aires, Argentina; ⁵Rheumatology Section, Rehabilitation Institute (IREP), Buenos Aires, Buenos Aires, Argentina

Juvenile spondylarthropathies are disorders associated to B27,synovial and enthesitic involvement of lower limbs, with latter development of spondylitis and sacroileitis. In childhood, includes 2 subgroups: an undifferentiated type (isolated forms or SEA syndrome), and specific diseases (Reiter synd, JPs arthritis and AS). In earlier stages, children present the first pattern. Clinical differences between adults and childhood disease precludes the use of adults diagnostic criteria.  ILAR Criteria seem not to efficiently classify these pts.
Objectives:
1) to describe clinical characteristics of SEA pts,2) to determine long term evolution and ultimate diagnosis,3) to test the applicability of ILAR criteria.
Methods:
47 clinical files with SEA Syndrome (Rosenberg-Petty82) were reviewed. Demographic, clinical variables, course and final diagnosis were analyzed, applying N York(68) and Vancouver Criteria(89).Descriptive and bivariate analysis were used.
Results:
45 were males, mean age of disease onset 12 ys, mean disease duration 69.5 m,100% pts had enthesitis,94% asymmetric oligoarthritis, all seronegative.  At last examination:15 (32%) met criteria for definite AS,6 were reactive arthritis,3 met criteria for JPs Arthritis and 23(49%) remained undifferentiated.  Lumbar pain was detected in 26 pts and 15 developed radiological sacroileitis.39 SEA pts could be classified into ILAR Criteria:12 in ERA category,1 in Ps Arthritis category and 26 stayed in the category.  Other arthritis, mostly of them due to combinations of more than one categories.
Conclusion:
In spite that the label SEA syndrome allows to identify earlier in time pts with spondylarthropathies, it is worth to note that in this series, only 32% of them developed criteria for definite AS.ILAR Criteria did not allow to classify 17% of our ptss cohort.