Growing up with chronic arthritis: the confusing matter of classification
| Autor: | Séverine Guillaume-Czitrom, Ellen Nordal, Jean Sibilia |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Pediatrics Immunology Psoriatic Arthritis Arthritis Rheumatoid Arthritis Disease 03 medical and health sciences Psoriatic arthritis 0302 clinical medicine Rheumatology Internal medicine Spondyloarthritis medicine Immunology and Allergy Rheumatoid factor 030212 general & internal medicine skin and connective tissue diseases Juvenile Idiopathic Arthritis 030203 arthritis & rheumatology business.industry Paediatric Rheumatology VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Rheumatology: 759 medicine.disease VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Reumatologi: 759 Outcomes research Rheumatoid arthritis Physical therapy Juvenile Psoriatic Arthritis business Rheumatism |
| Zdroj: | RMD Open |
| Popis: | Disease classification in rheumatology is a matter of debate, in paediatrics between International League Against Rheumatism (ILAR) classification ‘pros and cons’, as well as between paediatric and adult rheumatologists. Indeed, there is no consensus yet about how we should name the disease of adults with juvenile idiopathic arthritis (JIA) in childhood. The non-concordance of adult and paediatric classifications for chronic inflammatory rheumatic diseases is confusing for caregivers, and above all for our patients. Will they be ‘lost in transition’, as phrased by McDonagh and Viner,1 when their disease stays the same, but gets a new name? Will their treatment be modified according to this new name and the corresponding recommendations for adult disease management? Yes, it is definitely time to think about a thorough modification of the ILAR categories of childhood chronic arthritis.2 The ILAR agreed on a classification that comprises all types of idiopathic arthritis in children under the umbrella term of JIA, subdivided into seven categories comprising the systemic, oligoarticular, rheumatoid factor (RF)-negative polyarticular, RF-positive polyarticular, juvenile psoriatic arthritis (jPsA), enthesitis-related arthritis (ERA) and the undifferentiated form.3 This was the first time that Europeans and Americans agreed to speak the same language. However, since launched, the ILAR classification has been regularly criticised.4–6 It was revised in 2001, and the reduced emphasis on heredity resulted in a significant decrease in the rates of children with undifferentiated arthritis.7 Calls for further modifications are nevertheless still numerous. Martini8 recognised that dividing patients into groups according to the number of joints involved at disease onset (oligoarticular/polyarticular JIA) was not gathering homogeneous categories; others claimed that strict exclusion criteria of the present classification excluded many … |
| Databáze: | OpenAIRE |
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