title: [Risk factors for pleural lung disease in children with juvenile idiopathic arthritis].
abstract: OBJECTIVE
  To investigate the risk factors for pleural lung disease (PLD) in children with juvenile idiopathic arthritis (JIA) and to provide a basis for the early diagnosis and timely treatment of this disease.
  
  
  METHODS
  A total of 360 children with a confirmed diagnosis of JIA were enrolled, and their clinical data were retrospectively analyzed. All patients underwent a chest X-ray. The patients with PLD were assigned to PLD group, while those without PLD were assigned to non-PLD group. The clinical, imaging, and laboratory results of JIA patients with PLD were analyzed.
  
  
  RESULTS
  Among the 360 JIA patients, 43 (11.9%) had PLD, and 9 (21%) of them had respiratory symptoms. Chest X-ray findings mainly included interstitial pneumonitis (53.5%) and pleurisy and/or pleural effusion (38.1%). In the 43 cases of JIA-PLD, 4 (9.3%) had normal chest X-ray findings but abnormal chest CT findings. The incidence of PLD was relatively high in patients aged under 3 years and those aged 12 years or above. Children with systemic JIA had a relatively high incidence of PLD. Compared with the non-PLD group, the PLD group had a significantly higher incidence of anemia, elevated white blood cell (WBC) count and IgG levels in peripheral blood, and positive rheumatoid factors or antinuclear antibodies (P<0.05).
  
  
  CONCLUSIONS
  Among children with JIA, PLD is mostly seen in patients with systemic JIA or aged <3 years or ≥ 12 years, especially those with anemia, elevated WBC count and IgG levels, and positive rheumatoid factors or antinuclear antibodies. For JIA patients with PLD, interstitial pneumonitis is usually seen on chest X-ray or CT, but respiratory symptoms are rarely observed. Routine use of high-resolution chest CT is recommended for early diagnosis and timely treatment of PLD in children with JIA.
authors.affiliation: Department of Rheumatology, Immunology and Allergy, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China. meipinglu@126.com.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Hu
authors.forename: Mei-Ping
authors.initials: MP
authors.lastname: Lu
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Teng
authors.forename: Li
authors.initials: L
authors.lastname: Guo
authors.forename: Li-Xia
authors.initials: LX
authors.lastname: Zou
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000150:complications*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D010995:Pleural Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D002097:C-Reactive Protein