Download PDF
Kinder- und Jugendmedizin 2021; 21(05): 315-321
DOI: 10.1055/a-1581-4600
Schwerpunkt

Neue Kriterien zur Klassifikation und Diagnose der juvenilen Arthritis

New criteria for the classification and diagnosis of juvenile arthritis
Kirsten Minden∗
1   Charité – Universitätsmedizin Berlin, Klinik für Pädiatrie m. S. Pneumologie, Immunologie und Intensivmedizin
2   Deutsches Rheuma-Forschungszentrum Berlin, ein Leibnizinstitut, Programmbereich Epidemiologie und Versorgungsforschung
,
Sae Lim von Stuckrad∗
1   Charité – Universitätsmedizin Berlin, Klinik für Pädiatrie m. S. Pneumologie, Immunologie und Intensivmedizin
› Author Affiliations
› Further Information
    Permissions and Reprints

ZUSAMMENFASSUNG

Seit Mitte der 1990er-Jahre wird die heterogene Gruppe der chronischen Arthritiden des Kindes- und Jugendalters auf Empfehlung eines Expertengremiums der ILAR unter dem Oberbegriff juvenile idiopathische Arthritis zusammengefasst, wobei die Klassifikation der einzelnen Formen der JIA auf der Basis klinischer Parameter erfolgt. Diese international akzeptierte und heutzutage üblicherweise angewandte Klassifikation der JIA definiert sieben verschiedene Erkrankungen bzw. Kategorien der JIA, die sich in ihrer klinischen Präsentation, ihrem Verlauf sowie z. T. genetischen Hintergrund voneinander unterscheiden. Trotz vieler Vorzüge im Vergleich zu früheren Klassifikationen weist die ILAR-Klassifikation auch Schwächen auf. Neue Vorschläge zur Klassifikation der chronischen Arthritiden des Kindes- und Jugendalters, u. a. von der PRINTO, wurden gemacht. Ob sie die ILAR-Klassifikation ablösen werden, bleibt abzuwarten. Evaluationen der neuen Klassifikationskriterien der PRINTO sind unterwegs.

ABSTRACT

Since the mid-1990s, the heterogeneous group of chronic arthritides of childhood and adolescence has been subsumed under the umbrella term juvenile idiopathic arthritis on the recommendation of an ILAR expert panel, with classification of the different forms of JIA based on clinical parameters. This internationally accepted and nowadays commonly used classification of JIA defines seven different disorders or categories of JIA, which differ in their phenotypes, disease courses as well as partly genetic background. Despite many advantages compared to previous classifications, the ILAR classification also has weaknesses. New proposals for the classification of chronic arthritides of childhood and adolescence, including those from PRINTO, have therefore been made. Whether they will replace the ILAR classification remains to be seen. Evaluations of the new PRINTO classification criteria are underway.

Schlüsselwörter

Juvenile idiopathische Arthritis - chronische Arthritis des Kindes- und Jugendalters - ILAR-Klassifikation

Keywords

Juvenile idiopathic arthritis - chronic arthritis of childhood and adolescence - ILAR-classification


Publication History

Article published online:
18 October 2021

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG,
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Luque Ramos A, Hoffmann F, Albrecht K. et al Transition to adult rheumatology care is necessary to maintain DMARD therapy in young people with juvenile idiopathic arthritis. Semin Arthritis Rheum 2017; 47: 269-275 DOI: 10.1016/j.semarthrit.2017.05.003.
    CrossrefPubMedGoogle Scholar
  • 2 Thierry S, Fautrel B, Lemelle I. et al. Prevalence and incidence of juvenile idiopathic arthritis: a systematic review. Joint Bone Spine 2014; 81: 112-117 S1297-319X(13)00211-X [pii]; DOI: 10.1016/j.jbspin.2013.09.003 [doi].
    CrossrefGoogle Scholar
  • 3 Bywaters EG. The history of pediatric rheumatology. Arthritis Rheum 1977; 20: 145-152
    PubMedGoogle Scholar
  • 4 Brewer Jr EJ, Bass J, Baum J. et al Current proposed revision of JRA criteria. JRA criteria subcommittee of the diagnostic and therapeutic criteria committee of the American rheumatism section of the Arthritis Foundation. Arthritis Rheum 1977; 20: 195-199
    PubMedGoogle Scholar
  • 5 Wood PHN. Special meeting on: nomenclature and classification of arthritis in children. The care of rheumatic children. EULAR Publishers 1978: 47-50
    PubMedGoogle Scholar
  • 6 Fink CW. Proposal for the development of classification criteria for idiopathic arthritides of childhood. J Rheumatol 1995; 22: 1566-1569
    Google Scholar
  • 7 Petty RE, Southwood TR, Baum J. et al Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. J Rheumatol 1998; 25: 1991-1994
    Google Scholar
  • 8 Petty RE, Southwood TR, Manners P. et al International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol 2004; 31: 390-392
    Google Scholar
  • 9 Martini A, Ravelli A, Avcin T. et al Toward new classification criteria for juvenile idiopathic arthritis: first steps, Pediatric Rheumatology International Trials Organization International Consensus. J Rheumatol 2019; 46: 190-197 DOI: 10.3899/jrheum.180168.
    CrossrefPubMedGoogle Scholar
  • 10 Foeldvari I, Bidde M. Validation of the proposed ILAR classification criteria for juvenile idiopathic arthritis. International League of Associations for Rheumatology. J Rheumatol 2000; 27: 1069-1072
    Google Scholar
  • 11 Ramsey SE, Bolaria RK, Cabral DA. et al Comparison of criteria for the classification of childhood arthritis. J Rheumatol 2000; 27: 1283-1286
    Google Scholar
  • 12 Hofer MF, Mouy R, Prieur AM. Juvenile idiopathic arthritides evaluated prospectively in a single center according to the Durban criteria. J Rheumatol 2001; 28: 1083-1090
    Google Scholar
  • 13 Krumrey-Langkammerer M, Hafner R. Evaluation of the ILAR criteria for juvenile idiopathic arthritis. J Rheumatol 2001; 28: 2544-2547
    Google Scholar
  • 14 Fantini F. Classification of chronic arthritides of childhood (juvenile idiopathic arthritis): criticisms and suggestions to improve the efficacy of the Santiago-Durban criteria. J Rheumatol 2001; 28: 456-459
    Google Scholar
  • 15 Merino R, De Inocencio J, Garcia-Consuegra J. Evaluation of ILAR classification criteria for juvenile idiopathic arthritis in Spanish children. J Rheumatol 2001; 28: 2731-2736
    Google Scholar
  • 16 Oen K, Duffy CM, Tse SM. et al Early outcomes and improvement of patients with juvenile idiopathic arthritis enrolled in a Canadian multicenter inception cohort. Arthritis Care Res (Hoboken) 2010; 62: 527-536 DOI: 10.1002/acr.20044 [doi].
    CrossrefGoogle Scholar
  • 17 Sengler C, Klotsche J, Niewerth M. et al The majority of newly diagnosed patients with juvenile idiopathic arthritis reach an inactive disease state within the first year of specialised care: data from a German inception cohort. RMD Open 2015; 01: e000074 DOI: 10.1136/rmdopen-2015-000074.
    CrossrefPubMedGoogle Scholar
  • 18 Berntson L, Fasth A, Andersson-Gare B. et al Construct validity of ILAR and EULAR criteria in juvenile idiopathic arthritis: a population based incidence study from the Nordic countries. International League of Associations for Rheumatology. European League Against Rheumatism. J Rheumatol 2001; 28: 2737-2743
    Google Scholar
  • 19 Nigrovic PA, Raychaudhuri S, Thompson SD. Review: Genetics and the classification of arthritis in adults and children. Arthritis Rheumatol 2018; 70: 7-17 DOI: 10.1002/art.40350.
    CrossrefPubMedGoogle Scholar
  • 20 Nordal E, Zak M, Aalto K. et al Ongoing disease activity and changing categories in a long-term nordic cohort study of juvenile idiopathic arthritis. Arthritis Rheum 2011; 63: 2809-2818 DOI: 10.1002/art.30426 [doi].
    CrossrefGoogle Scholar
  • 21 Ravelli A, Varnier GC, Oliveira S. et al Antinuclear antibody-positive patients should be grouped as a separate category in the classification of juvenile idiopathic arthritis. Arthritis Rheum 2011; 63: 267-275 DOI: 10.1002/art.30076 [doi].
    CrossrefGoogle Scholar
  • 22 Hinks A, Bowes J, Cobb J. et al Fine-mapping the MHC locus in juvenile idiopathic arthritis (JIA) reveals genetic heterogeneity corresponding to distinct adult inflammatory arthritic diseases. Ann Rheum Dis 2017; 76: 765-72 DOI: 10.1136/annrheumdis-2016-210025.
    CrossrefPubMedGoogle Scholar
  • 23 Gattorno M, Piccini A, Lasiglie D. et al The pattern of response to anti-interleukin-1 treatment distinguishes two subsets of patients with systemic-onset juvenile idiopathic arthritis. Arthritis Rheum 2008; 58: 1505-1515 DOI: 10.1002/art.23437 [doi].
    CrossrefGoogle Scholar
  • 24 Hollenbach JA, Thompson SD, Bugawan TL. et al Juvenile idiopathic arthritis and HLA class I and class II interactions and age-at-onset effects. Arthritis Rheum 2010; 62: 1781-1791 DOI: 10.1002/art.27424.
    CrossrefPubMedGoogle Scholar
  • 25 Stoll ML, Punaro M. Psoriatic juvenile idiopathic arthritis: a tale of two subgroups. Curr Opin Rheumatol 2011; 23: 437-443 DOI: 10.1097/BOR.0b013e328348b278.
    CrossrefPubMedGoogle Scholar
  • 26 Schinocca C, Rizzo C, Fasano S. et al Role of the IL-23/IL-17pathway in rheumatic diseases: an overview. Front Immunol 2021; 12: 637829 DOI: 10.3389/fimmu.2021.637829.
    CrossrefPubMedGoogle Scholar
  • 27 Beukelman T, Nigrovic PA. Juvenile idiopathic arthritis: an idea whose time has gone?. J Rheumatol 2019; 46: 124-126 DOI: 10.3899/jrheum.180922.
    CrossrefPubMedGoogle Scholar
  • 28 Eng SW, Duong TT, Rosenberg AM. et al The biologic basis of clinical heterogeneity in juvenile idiopathic arthritis. Arthritis Rheumatol 2014; 66: 3463-3475 DOI: 10.1002/art.38875.
    CrossrefPubMedGoogle Scholar
  • 29 Van Nieuwenhove E, Lagou V, Van Eyck L. et al Machine learning identifies an immunological pattern associated with multiple juvenile idiopathic arthritis subtypes. Ann Rheum Dis 2019; 78: 617-628 DOI: 10.1136/annrheumdis-2018-214354.
    CrossrefPubMedGoogle Scholar