Pediatric Rheumatology Online Journal → June 2003 → Enthesitis-related arthritis and Psoriatic arthritis→ Abstract #24

JUVENILE PSORIATIC ARTHRITIS (JPsA):LONG-TERM FOLLOW UP AND ITS CLASSIFICATION IN TO ILAR CRITERIA

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

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

JPsA is characterized by the presence of inflammatory arthritis, usually seronegative,associated to cutaneous psoriasis.  Cutaneous disease can precede or follow joint involvement.  Vancouver Criteria were done in order to facilitate earlier diagnosis and diferenciate it from other types of arthritis.ILAR criteria redefine JPsA incorporating exclusion criteria: + RF and systemic disease.
Objectives: 1) to describe clinical, serological, radiological and functional characteristics in JPsA pts, 2) to determine the course of disease and long term follow up, 3) to test the applicability of ILAR criteria. Methods: clinical files of 31 patients with JPsA were evaluated (Vancouver 89).Clinical, serological, radiological and functional variables were analyzed.Poor functional outcome was defined:CHAQ score 1 and/or Steinbroker Class III/ IV.Descriptive and bivariate analysis were used.Results:17 pts were males,mean age at articular onset 11 ys, mean age at cutaneous onset 6 ys, mean disease duration was 6 ys. In 18 out of 31(58%) skin disease preceded joint involvement.In spite that the oligoarticular pattern was the most frequently observed in14(44%) pts,16% started with a polyarticular disease and 13% of the oligoarticular type developped a polyarticular course on follow up. Radiological periostitis was observed in 13% of them.   Only 5 pts had a poor functional outcome.100% of the patients could be classified according to ILAR criteria: 80% as JPsA and 6 pts in other categories:5 pts as Oligoarticular JIA and 1 as a Polyarticular Rheumatoid factor positive JIA.Conclusions: in this series we could see that, although the majority of pts presented with oligoarthritis at onset,an important percentage developped polyarticular involvement during disease course. Long Term Functional capacity was good in most of the pts (84%).When we test the applicability of ILAR criteria,100% of the pts fit on it, mostly as JPsA.