Systemic Form of Juvenile Idiopathic Arthritis: Epidemiological, Clinical, Paraclinical and Therapeutic Aspects of 13 Cases in Abidjan

摘要

Objective: To describe the epidemiological, clinical, paraclinical and therapeutic aspects of systemic juvenile idiopathic arthritis observed in Abidjan. Materials and Method: This retrospective and descriptive study covered 13 children suffering from systemic juvenile idiopathic arthritis selected in the Rheumatology Department of University Hospital Center of Cocody in Abidjan (Cote d’Ivoire) from January 2005 to December 2015. We were interested to the sociodemographical, clinical, paraclinical and therapeutic aspects. Results: The systemic form of the juvenile idiopathic arthritis represented 0.2% of the 4608 rheumatologic diseases and 70.58% of the JIA. We selected 6 boys and 7 girls, with an average age of 10.8 years and mostly going to school (84.61%). The diagnostic delay was 18 months. The main clinical signs were fever and joint damage observed each in 100% of cases, impaired general condition (92.30%) and tumor syndrome (83.33%). Biological signs were characterized by hyperleukocytosis (69.20%) and the presence of a biologic inflammatory syndrome (on average, erythrocyte sedimentation rate 59.6 mm and C Reactive Protein 56.4 mg/l). The cervical damage was the essential functional complication (38.46%). The major treatment has been a therapeutic combination based on corticotherapy and methotrexate (100%) with 1 death case by macrophage activation syndrome. Conclusion: Systemic juvenile idiopathic arthritis is rarely diagnosed in the rheumatologic practice in Abidjan. It concerns children relatively big, and is characterized by a febrile polyarthritis with impaired general condition and tumor syndrome. This systemic form is treated by corticotherapy and methotrexate.