The aim of this study is to measure serum and synovial fluid levels of IL 33 and its relative mRNA expression in peripheral blood mononuclear cells in juvenile idiopathic arthritis (JIA) patients and to correlate it with the clinical and laboratory characteristics, disease activity and musculoskeletal ultrasound findings.
SUBJECTS AND METHODS Subjects:This study will be a case-control study including sixty children with juvenile idiopathic arthritis attending pediatric rheumatology clinic of Benha University Hospital and Benha children hospital and thirty apparently healthy children as controls. They will be classified into: * Group (I) study group:60 cases of children with juvenile idiopathic arthritis. * Group (II) Control group:60 of apparently healthy children matched for age and sex A)Full history taking B) Full clinical examination C) Clinical assessment of disease activity D) Laboratory Investigations: All subjects will be investigated by 1. complete blood count. 2. Erythrocyte sedmentation rate. 3. C-reactive protein . 4. Liver enzymes: ALT and AST. 5. Rheumatoid factor. 6. Antinuclear antibody (ANA). 7. serum ferritin 8. serum and synovial fluid Interleukin 33 by ELISA and its relative expression in peripheral blood mononuclear cells by PCR E) Musculoskeletal Ultrasound examination
Study Type
OBSERVATIONAL
Enrollment
120
serum and synovial fluid samples will be obtained from patients and serum samples from controls to measure interleukin 33 and its relative mRNA expression in peripheral blood mononuclear cells by PCR
Benha University Hospital
Banhā, Qalyubia Governorate, Egypt
27 active joints count
active arthritis, defined as joint swelling or limitation of movement accompanied by pain and tenderness, assessed in 27 joints
Time frame: through study completion, an average of 4 months
physician's global assessment of disease activity scale
physician's global assessment of disease activity on a 0- 10 cm visual analogue scale (VAS). Higher value indicates worse outcome
Time frame: through study completion, an average of 4 months.
parent/patient global assessment of well-being scale
parent/patient global assessment of well-being on a 0-10 cm visual analogue scale .Higher value indicates worse outcome
Time frame: through study completion, an average of 4 months.isit to measure IL33
Erythrocyte sedimentation rate (ESR)
ESR measured in mm/1st hour by westergren method
Time frame: through study completion, an average of 4 months
The 27-joint Juvenile Arthritis Disease Activity Score (JADAS-27)
The JADAS-27 (range 0-57) was computed by summing the scores of four core-set criteria \[3\]: physician's global assessment of disease activity (PGA) on a 10 cm visual analogue scale (VAS); parent/patient global assessment of well-being on a 10 cm VAS \[7\]; active arthritis, defined as joint swelling or limitation of movement accompanied by pain and tenderness, assessed in 27 joints; and ESR (mm/h) normalized to a 0-10 scale, using the formula ESR - 20/10, whereby, before the calculation, ESR values \<20 mm/h were converted to 0 and ESR values \>120 mm/h were converted to 120. A higher JADAS-27 indicates higher disease activity and a lower JADAS-27 indicates lower disease activity
Time frame: through study completion, an average of 4 months
C reactive protein (CRP)
CRP measured in mg/L using nephlometry
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: through study completion, an average of 4 months
Serum ferritin level
Serum ferritin level measured in ng/mL using elisa
Time frame: through study completion, an average of 4 months
grey scale 10 joint score
grey scale musculoskeletal ultrasound including 10-joints (bilateral knee, ankle, wrist, elbow and the 2nd metacarpophalangeal (MCP) joints)
Time frame: through study completion, an average of 4 months
power Doppler 10 joint score
power Doppler musculoskeletal ultrasound including 10-joints (bilateral knee, ankle, wrist, elbow and the 2nd metacarpophalangeal (MCP) joints)
Time frame: through study completion, an average of 4 months
rheumatoid factor
rheumatoid factor measured in U/ml using latex agglutination test
Time frame: through study completion, an average of 4 months
disease activity for systemic arthritis with active systemic features (and without active arthritis)
DISEASE ACTIVITY LEVELS (2 levels) Active fever AND physician global assessment of overall disease activity 7 of 10 Active fever AND systemic features of high disease activity (e.g., significant serositis) that result in physician global assessment of overall disease activity 7 of 10
Time frame: through study completion, an average of 4 months
The Juvenile Arthritis Multidimensional Assessment Report
The JAMAR is a questionnaire includes the following 15 sections: Assessment of physical function (PF) using 15-items with score 0-45. Higher scores indicating higher degree of disability 2. 21-numbered circle Visual Analogue Scale (VAS) for pain 3. Assessment of the presence of joint pain or swelling.4.Assessment of morning stiffness 5. extra-articular symptoms (fever and rash) 6.disease activity on a 21-circle VAS. 7.disease status. 8. course. 9.medications . 10. side effects. 11.difficulties with medication 12. school/university/work problems. 13. HRQoL 14.patient's overall well-being on a 21-numbered circle VAS. 15. satisfaction with outcome.
Time frame: through study completion, an average of 4 months
disease activity for systemic arthritis with active arthritis (and without active systemic features)
Low disease activity (must satisfy all) 4 or fewer active joints, ESR or CRP level normal PGA of disease activity less than4 of, 10 PAGA of well-being 2 of 10 Moderate disease activity (does not satisfy criteria for low or high disease activity) High disease activity (must satisfy at least 3) 8 or more active joints,ESR or CRP level greater than twice upper limit of normal, PGA of disease activity 7 of 10, PAGA of well-being 5 of 10
Time frame: through study completion, an average of 4 months