Anemia in Juvenile Idiopathic Arthritis (JIA) and Other Pediatric Rheumatologic Diseases: A Retrospective Study ()
ABSTRACT
Objectives: The present study estimated the prevalence of anemia among children and
adolescents with pediatric rheumatological diseases in a referral center, and
analyzed the associated clinical and biological parameters. Methods: A retrospective chart review included 49 children
with rheumatological diseases, who were diagnosed by a pediatric rheumatologist
and classified according to the International League of Associations for
Rheumatology (ILAR) guidelines and criteria endorsed by the American College of
Rheumatologists. Anemia was defined as hemoglobin level lower than the 5th
centile for the corresponding age and gender. Disease activity was indicated by
serum levels of C-reactive protein (CRP) and erythrocyte sedimentation rate
(ESR), where available. Results: Participants were aged 2 - 18 years
(mean ± SD = 10.41 ± 4.23 years), 38 (77.6%) of them had JIA, and 8 (16.3%) had
systemic lupus erythematosus. The most frequent subtype of JIA was the
polyarticular (16 out of 38, 42.1%), followed by systemic (14, 36.8%). The
prevalence of anemia was 46.9% (95% CI = 32.5% - 61.7%), with no significant
difference between JIA and other diseases or between the different JIA
subtypes. Nevertheless, anemia was more frequently observed in younger patients
(age 2 - 6 years: 69.2% vs <48%) and those with elevated ESR (68.8% vs
33.3%) or CRP (60.0% versus 45.2%), compared with their counterpart
respectively; however, only the association with ESR was statistically
significant (p = 0.049). No agreement was found between CRP and ESR (Kappa =
0.140). Conclusion: Anemia is
frequent in JIA and other rheumatologic diseases in children, concerning
approximately 50% of the patients and responding to anemia of inflammation as
the major pathophysiological mechanism. Further research is warranted to
provide more accurate insight into the pathophysiological mechanisms and
clinical characteristics of anemia in pediatric rheumatological disease and to
measure its morbidity, to provide efficient and evidence-based management
strategies.
Share and Cite:
Albokhari, S. and Muzaffer, M. (2021) Anemia in Juvenile Idiopathic Arthritis (JIA) and Other Pediatric Rheumatologic Diseases: A Retrospective Study.
Open Journal of Rheumatology and Autoimmune Diseases,
11, 188-202. doi:
10.4236/ojra.2021.114019.