BMC pediatrics · 2026
Oligoarticular juvenile idiopathic arthritis: epidemiological, clinical, therapeutic and outcome profile of a Tunisian cohort.
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Hrizi Houcem, Trifa Imen, Jrad Mohamed, Ltaeif Maha Hadj, Essadam Leila, Fitouri Zohra
Аннотация
BACKGROUND: Oligoarticular juvenile idiopathic arthritis (oJIA) is the most common subtype of juvenile idiopathic arthritis and is associated with a risk of chronic anterior uveitis and disease extension. Data from North Africa remain limited. This study aimed to describe the epidemiological, clinical, therapeutic, and outcome profile of Tunisian children with oJIA.
METHODS: We conducted a retrospective longitudinal study of children diagnosed with oJIA and followed at a tertiary pediatric rheumatology center in Tunisia between January 1999 and December 2022. Demographic, clinical, ophthalmologic, laboratory, imaging, treatment, and outcome data were collected from medical records. Disease activity was assessed using the Juvenile Arthritis Disease Activity Score based on 10 joints (JADAS-10).
RESULTS: Eighty-two children were included, with a female predominance (67.1%). The mean age at disease onset was 4.4 years and the mean diagnostic delay was 9 months. Antinuclear antibodies were positive in 71% of patients, whereas rheumatoid factor was negative in all tested cases. Uveitis occurred in 20 patients (24.4%) and was asymptomatic in most cases; 85% of affected patients were ANA-positive. Ocular complications developed in 13 of the 20 patients with uveitis, most commonly posterior synechiae and cataract. Disease extension occurred in 18 patients (22%) and was confined to the first two years after disease onset. Methotrexate was prescribed in 52 patients (63.4%), while biologic therapy was indicated in 11 patients and administered to 8 (etanercept, n = 6; adalimumab, n = 2). After a mean follow-up of 5.8 years, disease activity progressively improved, with 88.3% of patients achieving inactive disease at 24 months. Articular complications were uncommon, and acceptable visual acuity was preserved in 14 of the 20 patients with uveitis.
CONCLUSIONS: In this single-center North African cohort, oJIA was characterized by early onset, frequent ANA positivity, and a substantial burden of chronic anterior uveitis. Disease extension occurred in approximately one-fifth of patients and was limited to the first two years of disease. Most patients achieved inactive disease despite restricted access to biologic therapies. These findings provide additional data on oJIA from North Africa and highlight the importance of systematic ophthalmologic screening and long-term monitoring.
METHODS: We conducted a retrospective longitudinal study of children diagnosed with oJIA and followed at a tertiary pediatric rheumatology center in Tunisia between January 1999 and December 2022. Demographic, clinical, ophthalmologic, laboratory, imaging, treatment, and outcome data were collected from medical records. Disease activity was assessed using the Juvenile Arthritis Disease Activity Score based on 10 joints (JADAS-10).
RESULTS: Eighty-two children were included, with a female predominance (67.1%). The mean age at disease onset was 4.4 years and the mean diagnostic delay was 9 months. Antinuclear antibodies were positive in 71% of patients, whereas rheumatoid factor was negative in all tested cases. Uveitis occurred in 20 patients (24.4%) and was asymptomatic in most cases; 85% of affected patients were ANA-positive. Ocular complications developed in 13 of the 20 patients with uveitis, most commonly posterior synechiae and cataract. Disease extension occurred in 18 patients (22%) and was confined to the first two years after disease onset. Methotrexate was prescribed in 52 patients (63.4%), while biologic therapy was indicated in 11 patients and administered to 8 (etanercept, n = 6; adalimumab, n = 2). After a mean follow-up of 5.8 years, disease activity progressively improved, with 88.3% of patients achieving inactive disease at 24 months. Articular complications were uncommon, and acceptable visual acuity was preserved in 14 of the 20 patients with uveitis.
CONCLUSIONS: In this single-center North African cohort, oJIA was characterized by early onset, frequent ANA positivity, and a substantial burden of chronic anterior uveitis. Disease extension occurred in approximately one-fifth of patients and was limited to the first two years of disease. Most patients achieved inactive disease despite restricted access to biologic therapies. These findings provide additional data on oJIA from North Africa and highlight the importance of systematic ophthalmologic screening and long-term monitoring.