Nassem Ghantous1, Merav Heshin-Bekenstein1,2,3, Kimberly Dequattro3, Yaniv Lakovsky1,4, Amir Moshe Hendel1, Nadav Rappoport3,5, Yonatan Butbul Aviel6, Irit Tirosh7, Liora Harel1,4, Pamela F Weiss8, Lianne Gensler3, John Mackenzie3, Gil Amarilyo9,10. 1. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 2. Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 3. School of Medicine, University of California, San Francisco, San Francisco, CA, USA. 4. Schneider Children's Medical Center of Israel, Petach Tikva, Israel. 5. Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, USA. 6. Rambam Medical Center, Haifa, Israel. 7. Sheba Medical Center, Tel Hashomer, Israel. 8. Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 9. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. gamarilyo@clalit.org.il. 10. Pediatric Rheumatology Unit, Schneider Children's Medical Center of Israel, 4920235, Petach Tikva, Israel. gamarilyo@clalit.org.il.
Abstract
BACKGROUND: Observations among Israeli pediatric rheumatologists reveal that pediatric Juvenile Spondyloarthritis (JSpA) may present differently compared to patients from the United States (US). This study is aimed to compare the demographic and clinical variables of Israeli and US JSpA patients upon presentation. METHODS: We performed a retrospective, cross-sectional, multicenter comparison of JSpA patients among 3 large Israeli pediatric rheumatology centers and a large US pediatric rheumatology center. Patients with diagnosis of Juvenile Ankylosing Spondylitis (JAS) and/or Enthesitis-related Arthritis (ERA) were included. The demographic, clinical and radiologic features were compared. RESULTS: Overall 87 patients were included (39 Israeli, 48 US patients). Upon presentation, inflammatory back pain, sacroiliac joint tenderness and abnormal modified Schober test, were significantly more prevalent among Israeli patients (59% vs. 35.4, 48.7% vs. 16.7, and 41.2% vs. 21.5%, respectively, all p < 0.05), whereas peripheral arthritis and enthesitis were significantly more prevalent among US patients (43.6% vs. 91.7 and 7.7% vs. 39.6% in Israeli patients vs. US patients, p < 0.05). In addition, 96.7% of the Israeli patients versus 29.7% of the US patients demonstrated sacroiliitis on MRI (p < 0.001, N = 67). Less than one-third of the Israeli patients (32%) were HLA-B27 positive vs. 66.7% of US patients (p = 0.007). CONCLUSION: Israeli children with JSpA presented almost exclusively with axial disease compared to US patients who were more likely to present with peripheral symptoms. HLA B27 prevalence was significantly lower in the Israeli cohort compared to the US cohort. Further studies are needed to unravel the genetic and possibly environmental factors associated with these findings.
BACKGROUND: Observations among Israeli pediatric rheumatologists reveal that pediatric Juvenile Spondyloarthritis (JSpA) may present differently compared to patients from the United States (US). This study is aimed to compare the demographic and clinical variables of Israeli and US JSpA patients upon presentation. METHODS: We performed a retrospective, cross-sectional, multicenter comparison of JSpA patients among 3 large Israeli pediatric rheumatology centers and a large US pediatric rheumatology center. Patients with diagnosis of Juvenile Ankylosing Spondylitis (JAS) and/or Enthesitis-related Arthritis (ERA) were included. The demographic, clinical and radiologic features were compared. RESULTS: Overall 87 patients were included (39 Israeli, 48 US patients). Upon presentation, inflammatory back pain, sacroiliac joint tenderness and abnormal modified Schober test, were significantly more prevalent among Israeli patients (59% vs. 35.4, 48.7% vs. 16.7, and 41.2% vs. 21.5%, respectively, all p < 0.05), whereas peripheral arthritis and enthesitis were significantly more prevalent among US patients (43.6% vs. 91.7 and 7.7% vs. 39.6% in Israeli patients vs. US patients, p < 0.05). In addition, 96.7% of the Israeli patients versus 29.7% of the US patients demonstrated sacroiliitis on MRI (p < 0.001, N = 67). Less than one-third of the Israeli patients (32%) were HLA-B27 positive vs. 66.7% of US patients (p = 0.007). CONCLUSION: Israeli children with JSpA presented almost exclusively with axial disease compared to US patients who were more likely to present with peripheral symptoms. HLA B27 prevalence was significantly lower in the Israeli cohort compared to the US cohort. Further studies are needed to unravel the genetic and possibly environmental factors associated with these findings.
Entities:
Keywords:
Enthesitis related arthritis; HLA B27; Juvenile Sacroiliitis; Juvenile Spondyloarthritis
Authors: Ross E Petty; Taunton R Southwood; Prudence Manners; John Baum; David N Glass; Jose Goldenberg; Xiaohu He; Jose Maldonado-Cocco; Javier Orozco-Alcala; Anne-Marie Prieur; Maria E Suarez-Almazor; Patricia Woo Journal: J Rheumatol Date: 2004-02 Impact factor: 4.666
Authors: R E Petty; T R Southwood; J Baum; E Bhettay; D N Glass; P Manners; J Maldonado-Cocco; M Suarez-Almazor; J Orozco-Alcala; A M Prieur Journal: J Rheumatol Date: 1998-10 Impact factor: 4.666
Authors: M Bollow; T Biedermann; J Kannenberg; S Paris; C Schauer-Petrowski; K Minden; M Schöntube; B Hamm; J Sieper; J Braun Journal: J Rheumatol Date: 1998-03 Impact factor: 4.666