PROINFLAMMATORY CYTOKINES IN JUVENILE ARTHRITIS WITH KIDNEY INVOLVEMENT

Abstract

Research Objective: To determine the role of pro-inflammatory cytokines in the early diagnosis of juvenile idiopathic arthritis (JIA) and kidney involvement. Materials and Methods: The study included data on patients treated at the cardio rheumatological department of a multidisciplinary clinic of TMA from 2021 to 2023. Among them, there were 105 children with the articular form of juvenile idiopathic arthritis, who comprised the main study group. The control group consisted of 30 practically healthy children of similar age undergoing dispensary observation at Family Polyclinic No. 35 in the Chilanzar district. All subjects underwent comprehensive clinical-immunological and laboratory-instrumental examinations. Results: The findings indicate that the duration of JIA in children ranges from 3 months to 8 years, with more frequent involvement of large and medium-sized joints—knee, ankle, wrist, elbow, and hip joints. Persistent disease was observed in 28.9% of the patients, while 71% exhibited progressive disease. Gender-specific analysis of the joint syndrome showed boys had a less pronounced exudative component (39%), with productive-dystrophic changes predominating (61%) in the lower limb joints. In girls, exudation was predominant in the upper limb joints (85%). The average age of patients was 7 years. Radiologically, the severity was mostly assessed as grade II according to Steinbrocker's classification. In children with JIA, an increase in the levels of pro-inflammatory cytokines was noted to be 5-10 times higher, depending on whether the disease had an articular or systemic variant. Conclusions: The analysis of clinical variants and the course of juvenile idiopathic arthritis indicates the aggressive and progressive nature of the disease, reflecting the contemporary age evolution of the condition, as well as kidney involvement among internal organs. This underscores the necessity to seek effective methods for optimizing treatment and preventing the toxic effects of medications on the kidneys. The increase in pro-inflammatory cytokines (IL-17A) in serum is more than twofold, and it can be utilized to diagnose JIA early.