ASSOCIATION OF C-REACTIVE PROTEINS AND ERYTHROCYTE SEDIMENTATION RATE WITH DISEASE ONSET AMONG PATIENTS WITH JUVENILE RHEUMATOID ARTHRITIS

Aim: To determine the relationship between serum C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) and active disease in patients with juvenile rheumatoid arthritis (JRA).

Methods: This is a cross-sectional analytical study conducted over a year from October 2020 to October 2021 at Lady Reading Hospital, Peshawar Rheumatology and Pediatrics Unit. All MJA patients who met the criteria of the American College of Rheumatology (ACR) were enrolled in the study. The ACR 20 recovery criteria were used to define disease forgiveness, and those meeting the ACR 20 recovery criteria were included in the remission group. Laboratory tests such as PCR and ESR were done. Statistical analysis was performed using SAS software (version 10.3).

Results: 90 patients were enrolled in the study, 28 (31.2%) in the remission group and 62 (68.88%) in the active disease group. There were 61.11% (n = 55) of women, and the ratio of men to women was 3: 4. The mean age of the subjects was 10.12 ± 3.39 years (4-17 years). Age distribution at reporting by different subgroups, 13 patients (14.44%) 1-5 years old, 31 patients (34.44%) 5-10 years old, 40 patients 10-15 years old (44.44 %), and 6 patients (6.66) were over 15 years of age. The mean disease duration was 2.40 + 2.11 years (range = 0.3 to 7 years). The onset of the disease in 21 patients (23.33%) was after one year (22.9%), in 48 patients (53.33%) between years and 5 years from the onset of the disease, in 21 patients (23.33%) five years. The most common type of arthritis was polyarthritis in 43 patients (47.77%), followed by polyarthritis in 31 patients (34.44%), and systemic onset in 12 patients (13.33%). The mean ESR was 41.03 + 27.80 mm / h 1 (range = 07-128 mm / h 1) and the mean CRP was 16.1 + 13.80 mg / L (range = 6-47 mg / L). ESR was> 30 mm / 1 hour. in 50 (55.55%) of 90 patients, while 43 (86%) of these 50 patients were in the active disease group. Similarly positive CRP was detected in 58 (64.44%) patients, of which 52 (89.7%) belonged to the group with active disease. Compared to the remission and active disease groups, 33 of the patients with active disease were female. In the active disease group, the mean age was 11.01 + 3.30 years, and the duration of the disease in patients started after one year. Polyarthritis was detected in 26/62 (41.9%) of patients from the active group of the disease.

Conclusions: High CRP and ESR parameters are good in predicting active disease in JRA patients.

Key words: C-reactive protein, juvenile rheumatoid arthritis, JRA and erythrocyte activity.