title: Prevalence and outcome of juvenile idiopathic arthritis-associated uveitis and relation to articular disease.
abstract: OBJECTIVE
  To determine prevalence and complications of juvenile idiopathic arthritis (JIA)-associated uveitis, and to evaluate risk factors for uveitis and its relation to articular disease.
  
  
  METHODS
  Records of 309 patients with JIA (244 female, 65 male, mean age at onset 4.9 yrs) were retrospectively reviewed. Occurrence of uveitis and complications were assessed among oligoarticular-onset JIA (193 patients), polyarticular-onset JIA (66 patients), and systemic-onset JIA (50 patients). The presence of antinuclear antibodies (ANA) was determined in patients with oligoarticular-onset JIA. Therapy and relapses of uveitis and arthritis were recorded at each visit during the followup (mean followup 7.6 yrs).
  
  
  RESULTS
  Sixty-two patients developed uveitis (20.1%); 57 patients had oligoarticular-, 3 polyarticular-, and 2 systemic-onset JIA. Uveitis was asymptomatic in 56/62 cases. Fifty-five of the 62 patients (88.7%) developed uveitis within 4 years from disease onset. In patients with oligoarticular-onset JIA, an early age at disease onset and the presence of ANA (p < 0.05) and DRB1*11 (p < 0.03) were the best predictors of uveitis, while a polyarticular course was not associated to uveitis (p > 0.05). Active arthritis was present at the first episode of uveitis in 46/62 patients. Forty-four of the 62 patients experienced relapses of uveitis: in 20/62, relapses were concomitant to arthritis relapses; in 24/62 relapses presented without active arthritis. Complications of uveitis developed in 35.5% of the patients (22/62), leading to visual impairment in 13 patients.
  
  
  CONCLUSIONS
  Current guidelines provide early identification of uveitis in 90% of patients. With the exception of the first episode of uveitis, uveitis and arthritis seem to run different courses; close ophthalmologic scrutiny then should also be maintained during arthritis remission.
authors.affiliation: Pediatric Rheumatology Centre, Clinica Pediatrica De Marchi, Milan, Italy. angela.grassi@libero.it
authors.forename: Angela
authors.initials: A
authors.lastname: Grassi
authors.forename: Fabrizia
authors.initials: F
authors.lastname: Corona
authors.forename: Aldo
authors.initials: A
authors.lastname: Casellato
authors.forename: Vittorio
authors.initials: V
authors.lastname: Carnelli
authors.forename: Maria
authors.initials: M
authors.lastname: Bardare
mesh_terms: D000974:Antibodies, Antinuclear / Q000097:blood; D001171:Arthritis, Juvenile / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006684:HLA-DR Antigens / Q000097:blood; D059811:HLA-DRB1 Chains; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012008:Recurrence; D012189:Retrospective Studies; D014605:Uveitis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D015354:Vision, Low / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology
chemical_list: D000974:Antibodies, Antinuclear; D015415:Biomarkers; D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains