juvenile idiopathic arthritis

Introduction

Juvenile idiopathic arthritis is a persistent type of arthritis with no defined cause that develops before the age of 16 years and lasts for at least 6 weeks. The aim of the study was to evaluate cardiovascular risk factors (homocysteine, total cholesterol, and triglycerides) in juvenile idiopathic arthritis.

Material and methods

The study was carried out in the Rheumatology Department of the Mother and Child Institute,Chisinau, Republic of Moldova. The patients’ parents signed the written consent to participate in the study. The study was approved by the Ethics Committee of the Nicolae Testemițanu State University of Medicine and Pharmacy. The study included 90 children with JIA. The number of painful and swollen joints, the global evaluation of the disease by both the physician and patient, as well as the Childhood Health Assessment Questionnaire, were determined. Paraclinical tests included a complete blood count, acute-phase markers of inflammation (erythrocyte sedimentation rate, C-reactive protein) and the cardiovascular risk factors of interest (homocysteine, total cholesterol, and triglycerides).

Results

Patients with JIA exhibit a relatively higher risk of hyperhomocysteinemia compared to controls. Additionally, individuals with JIA display a relatively moderate risk of hypercholesterolemia and a relatively lower risk of hypertriglyceridemia. Thus, a correlation was noted between JIA and hypercholesterolemia, with a slight inclination towards increased triglyceride levels in these children.

Conclusions

Patients with juvenile idiopathic arthritis are at risk for hyperhomocysteinemia, hypercholesterolemia, and hypertriglyceridemia.

Background

Pachydermoperiostosis (or primary hypertrophic osteoarthropathy) is a rare genetic disease that usually begins in childhood or adolescence, is characterized by certain clinical signs (pachydermia, periostosis, drum sticks) that gradually progress over many years until the disease stabilizes. Currently, there are 2 genes in which mutations are associated with the development of pachydermoperiostosis - HPGD and SLCO2A1. The functions of these genes are not fully understood, but their influence on the metabolism of prostaglandin E2 is known.

Case presentation

We present a case of a 20-year-old patient mistakenly diagnosed as juvenile idiopathic arthritis. Symptoms on admission to the hospital: pain accompanied by swelling in the hands and feet, arthralgias in the talocrural joints, knees with slight swelling, paresthesia in the extremities, hyperhidrosis, fatigue. Clinical and paraclinical examinations confirmed the diagnosis of pachydermoperiostosis.

Conclusions

Pachydermoperiostosis should be considered as a differential diagnosis when a patient presents with hypertrophic osteoarthropathy and acromegalic features.