Title Antinuklearna protutijela u juvenilnom idiopatskom artritisu Title (english) Antinuclear antibodies in juvenile idiopathic arthritis Author Ivana Sabljak Mentor Marijan Frković (mentor) Committee member Ernest Bilić (predsjednik povjerenstva) Committee member Marija Jelušić (član povjerenstva) Committee member Marijan Frković (član povjerenstva) Granter University of Zagreb Defense date and country 2024-07-12, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Ivana Sabljak: Antinuklearna protutijela u juvenilnom idiopatskom artritisu
Uvod: Juvenilni idiopatski artritis (JIA) je kronična reumatska bolest, nepoznatog uzroka, koja
pogađa djecu u dobi do 16. godina, s prevalencijom od 1 – 2 / 1000 djece. Sukladno trenutno
važećoj klasifikaciji, bolest se dijeli u 7 različitih tipova. U sklopu dijagnostičke obrade određuju
se i antinuklearna protutijela (ANA) čiji pozitivni nalaz češći u pojedinim tipovima bolesti i primarno
ukazuje na povećani rizik razvoja kroničnog uveitisa. Standardizirani ANA obrasci određeni
metodom indirektne imunoflorescencije (IIF) na humanim epitelnim stanicama tipa 2 (Hep-2)
predstavljaju daljnji napredak u dijagnostici različitih autoimunosnih bolesti.
Ciljevi istraživanja: Utvrditi postoji li povezanost specifičnih ANA obrazaca s pojedinim tipovima
JIA i kroničnim uveitisom u sklopu osnovne bolesti. Dodatno su istražene demografske i kliničke
osobitosti bolesnika s JIA.
Metode: U retrospektivno istraživanje uključeni su svi bolesnici s dijagnozom JIA, praćeni u
reumatološkoj ambulanti Zavoda za kliničku imunologiju, respiracijske i alergološke bolesti i
reumatologiju Klinike za pedijatriju Kliničkog bolničkog centra Zagreb u periodu od rujna 2023 do
svibnja 2024. Pregledom medicinske dokumentacije prikupljeni su podaci o dobi bolesnika na
početku bolesti, spolu bolesnika, razvoju uveitisa, nalazu ANA te utvrđenim ANA obrascima.
Rezultati: U istraživanje je uključen 71 bolesnik s dijagnozom JIA. Gotovo 2/3 bolesnika bilo je
ženskog spola (60,6 %), u najvećeg broja bolesnika JIA je počeo u dobi između 12 - 24 mjeseca.
Najčešći tip JIA bio je oligoartikularni (oJIA) (53.5 %), dok je sistemski tip (sJIA) bio najmanje
zastupljen (8.5 %). Glavnina između 40 bolesnika s pozitivnim nalazom ANA bila je ženskog
spola, predškolske dobi, s oJIA tipom bolesti. Kronični uveitis registriran je u 8 bolesnika, od čega
je 7 imalo pozitivni nalaz ANA. ANA (AC) obrasci su određeni u 26 bolesnika među kojima je 20
bolesnika imalo 1, a 6 bolesnika 2 AC obrasca. Statistički značajna povezanost utvrđena je
između AC-1 obrasca i oJIA. Nije utvrđena povezanost AC-1 niti drugih obrazaca s drugim
tipovima bolesti niti razvojem kroničnog uveitisa. Analiza povezanosti AC obrazaca i spola
bolesnika pokazuje tendenciju češće pojavnosti AC-1 obrasca u djevojčica, generalno nije
utvrđena statistički značajna povezanost AC obrazaca i spola bolesnika.
Zaključak: Istraživanje provedeno na ograničenom uzorku bolesnika s JIA utvrdilo je statistički
značajnu povezanost AC-1 obrasca i oJIA tipa bolesti te time djelomično potvrdilo hipotezu o
povezanosti specifičnih AC obrazaca s pojedinim tipovima JIA. Potrebna su daljnja,
sistematizirana istraživanja, uz korelaciju AC obrazaca s većim brojem demografskih, kliničkih i
laboratorijskih karakteristika velikog broja bolesnika kako bi se utvrdila njihova definitivna
vrijednosti kao samostalnog parametra ili elementa statističkih modela za pretkazivanja ishoda
JIA i rizika razvoja uveitisa.
Abstract (english) Ivana Sabljak: Antinuclear antibodies in juvenile idiopathic arthritis
Introduction: Juvenile idiopathic arthritis (JIA) is a chronic rheumatic disease of unknown cause
that affects children up to the age of 16 years, with a prevalence of 1-2/1000 children. According
to the currently valid classification, the disease can be divided into 7 different types. As part of
diagnostic evaluation, the antinuclear antibody (ANA) test is usually performed, and a positive
result is associated with an increased risk of chronic uveitis. Standardised AC patterns determined
by indirect immunofluorescence (IIF) on human epithelial cells type 2 (Hep-2) represent further
progress in the diagnosis of various autoimmune diseases.
Aim: The study aims to identify particular ANA patterns linked with specific types of JIA and
chronic uveitis. The demographic and clinical characteristics of patients with JIA were additionally
investigated.
Methods: From September 2023 to May 2024, patients with a diagnosis of JIA followed in the
rheumatology outpatient clinics of the Division of Clinical Immunology, Respiratory and
Allergology Diseases and Rheumatology of Paediatric Department of Clinical Hospital Centre
Zagreb were included in the retrospective study. The patients' medical records were examined to
obtain information on age at disease onset, gender, occurrence of uveitis, ANA test results, and
specific ANA patterns.
Results: A total of 71 patients diagnosed with JIA were included in the study. Almost 2/3 of the
patients were females (60.6%). In the largest number of patients, JIA started between the ages
of 12 and 24 months. The most common type was oligoarticular (oJIA) (53.5%), whereas the
systemic type (sJIA) was the least common (8.5 %). The majority of the 40 patients with a positive
ANA result were females, of preschool age and with oJIA type of disease. Chronic uveitis was
registered in 8 patients, of which 7 had a positive ANA test. ANA (AC) patterns were determined
in 26 patients, among whom 20 and 6 patients had 1 and 2 AC patterns, respectively. A statistically
significant association was established between the AC-1 pattern and oJIA. The association
between AC1 and other patterns and the development of chronic uveitis has not been established.
The analysis of the association between AC patterns and gender sex revealed that the AC1
pattern occurs more frequently in female patients. In general, no statistically significant
association between the AC patterns and the patient's gender was established.
Conclusion: The significant association between the AC-1 pattern and oJIA type of JIA, as
identified through research on a limited patient sample, partially supports the hypothesis linking
specific ANA patterns to certain types of JIA. To determine the value of AC patterns as an
independent predictor of JIA and uveitis outcomes, larger-scale research is warranted to explore
their correlation with demographic, clinical, and laboratory variables.
Keywords
juvenilni idiopatski artritis
antinuklearna protutijela
AC obrasci
uveitis
Keywords (english)
juvenile idiopathic arthritis
antinuclear antibody
AC patterns
uveitis
Language croatian URN:NBN urn:nbn:hr:105:463522 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2024-07-02 18:17:41
