OBJECTIVE: To determine the prevalence of severe fatigue and fatigue-related limitations among adolescents with juvenile idiopathic arthritis (JIA) and other pediatric rheumatic diseases (PRDs). In addition, we assessed the effect of disease activity and pain on the severity of fatigue. METHODS: This cross-sectional study included 175 patients (ages 10-18 years) who visited the pediatric rheumatology and immunology outpatient clinic at Wilhelmina Children's Hospital from April through July 2013. Patients completed validated questionnaires regarding fatigue, physical functioning, and school attendance. Disease activity in JIA patients was measured using the Juvenile Arthritis Disease Activity Score including 27 joints. The results were compared against a healthy control group. RESULTS: The prevalence of severe fatigue among patients with PRDs was 25.1%, which was significantly higher than among the healthy control group (P < 0.001). Fatigued patients had significantly lower levels of physical functioning compared to nonfatigued patients (62.1% versus 89.0%, respectively; P < 0.001) and a significantly higher percentage of school absences (21.2% versus 11.6%, respectively; P = 0.005). Among JIA patients, the level of pain was significantly correlated with fatigue. Finally, disease activity was not a predictor for fatigue. CONCLUSION: Fatigue is a common problem among teenagers with PRDs, with a higher prevalence among these patients than in the general population. Severe fatigue leads to significant impairments, including increased school absences and decreased physical functioning. Interestingly, fatigue was associated with pain, but not with the disease activity. Therefore, in this patient population, fatigue may be a promising therapeutic target for improving functioning, school attendance, and possibly pain as well.
OBJECTIVE: To determine the prevalence of severe fatigue and fatigue-related limitations among adolescents with juvenile idiopathic arthritis (JIA) and other pediatric rheumatic diseases (PRDs). In addition, we assessed the effect of disease activity and pain on the severity of fatigue. METHODS: This cross-sectional study included 175 patients (ages 10-18 years) who visited the pediatric rheumatology and immunology outpatient clinic at Wilhelmina Children's Hospital from April through July 2013. Patients completed validated questionnaires regarding fatigue, physical functioning, and school attendance. Disease activity in JIA patients was measured using the Juvenile Arthritis Disease Activity Score including 27 joints. The results were compared against a healthy control group. RESULTS: The prevalence of severe fatigue among patients with PRDs was 25.1%, which was significantly higher than among the healthy control group (P < 0.001). Fatigued patients had significantly lower levels of physical functioning compared to nonfatigued patients (62.1% versus 89.0%, respectively; P < 0.001) and a significantly higher percentage of school absences (21.2% versus 11.6%, respectively; P = 0.005). Among JIA patients, the level of pain was significantly correlated with fatigue. Finally, disease activity was not a predictor for fatigue. CONCLUSION:Fatigue is a common problem among teenagers with PRDs, with a higher prevalence among these patients than in the general population. Severe fatigue leads to significant impairments, including increased school absences and decreased physical functioning. Interestingly, fatigue was associated with pain, but not with the disease activity. Therefore, in this patient population, fatigue may be a promising therapeutic target for improving functioning, school attendance, and possibly pain as well.
Authors: Merel M Nap-van der Vlist; Jan Houtveen; Geertje W Dalmeijer; Martha A Grootenhuis; Cornelis K van der Ent; Martine van Grotel; Joost F Swart; Joris M van Montfrans; Elise M van de Putte; Sanne L Nijhof Journal: Internet Interv Date: 2021-04-20
Authors: Wineke Armbrust; Otto H T M Lelieveld; Jolanda Tuinstra; Nico M Wulffraat; G J F Joyce Bos; Jeannette Cappon; Marion A J van Rossum; Pieter J J Sauer; Mariët Hagedoorn Journal: Pediatr Rheumatol Online J Date: 2016-12-06 Impact factor: 3.054
Authors: Davide Martorana; Francesco Bonatti; Paola Mozzoni; Augusto Vaglio; Antonio Percesepe Journal: Front Immunol Date: 2017-04-03 Impact factor: 7.561
Authors: Linde N Nijhof; Merel M Nap-van der Vlist; Elise M van de Putte; Annet van Royen-Kerkhof; Sanne L Nijhof Journal: Rheumatol Int Date: 2018-08-23 Impact factor: 2.631
Authors: Merel M Nap-van der Vlist; Geertje W Dalmeijer; Martha A Grootenhuis; Kors van der Ent; Marry M van den Heuvel-Eibrink; Joost F Swart; Elise M van de Putte; Sanne L Nijhof Journal: BMJ Paediatr Open Date: 2021-02-17
Authors: Niels Kramer; Sanne L Nijhof; Elise M van de Putte; Marjolijn Ketelaar; Martha A Grootenhuis; Kors van der Ent; Joost F Swart; Martine van Grotel; Geertje W Dalmeijer; Merel M Nap-van der Vlist Journal: BMJ Paediatr Open Date: 2021-05-21