Comparison of paediatric and adult classification criteria in juvenile idiopathic arthritis during the transition from paediatric to adult care

Joint Bone Spine. 2021 Jan;88(1):105047. doi: 10.1016/j.jbspin.2020.06.020. Epub 2020 Jul 9.

Abstract

Objectives: To determine the characteristics of juvenile idiopathic arthritis (JIA) patients seen during the transition period in order to compare paediatric classification criteria with those for adults.

Methods: Patients with JIA according to the ILAR classification and who had a consultation at transition between 2010 and 2017 were included in a retrospective bi-centre (Lyon, Lausanne) study. JIA classification criteria were compared to ACR/EULAR 2010 criteria for rheumatoid arthritis (RA), Yamaguchi criteria for adult-onset Still's disease (AOSD), ASAS criteria for spondyloarthritis and CASPAR criteria for psoriatic arthritis.

Results: One hundred and thirty patients were included: 13.9% with systemic JIA, 22.3% with polyarticular JIA, 22.3% with oligoarticular JIA, 34.6% with enthesitis-related arthritis (ERA) and 6.9% with psoriatic arthritis; 13.1% had suffered from uveitis; 14.5% of patients had erosions or carpitis, mainly those with psoriatic arthritis, polyarticular or systemic JIA; 37.5% of patients with ERA displayed radiological sacroiliitis. When comparing paediatric JIA criteria with adult classifications, we found that: 66.6% of patients with systemic JIA fulfilled the criteria for AOSD, 87.5% of rheumatoid factor-positive polyarticular JIA and 9.5% of rheumatoid factor-negative polyarticular JIA met the criteria for RA, and 34.5% of oligoarticular JIA fulfilled the criteria for spondyloarthritis. Finally, 77.7% of patients with ERA met the criteria for spondyloarthritis, and 100% of patients with psoriatic arthritis JIA met the criteria for psoriatic arthritis.

Conclusion: Oligoarticular JIA and rheumatoid factor-negative polyarticular JIA seem to be paediatric entities, whereas the other types of JIA tended to meet the respective adult classification criteria.

Keywords: Classification criteria; Juvenile idiopathic arthritis; Transition period.

MeSH terms

  • Adult
  • Arthritis, Juvenile* / diagnosis
  • Arthritis, Juvenile* / epidemiology
  • Arthritis, Psoriatic* / diagnosis
  • Arthritis, Psoriatic* / epidemiology
  • Arthritis, Rheumatoid*
  • Child
  • Humans
  • Retrospective Studies
  • Transition to Adult Care*