Plotting the Articular Disease Impact of Juvenile Idiopathic Arthritis: Discernments into Clinical Phenotypes and Demographic Tide in a Pakistani Cohort

Abstract

Objective: To investigate into the pattern of joint engagement along with the laboratory markers in Juvenile Idiopathic Arthritis (JIA) amongst the Pakistani cohort. Study Design: Cross-sectional study. Place and Duration of Study: Pak-Emirates Military Hospital, Rawalpindi Pakistan from Dec 2023 to Dec 2025. Methodology: Demographic profile, clinical, and serological statistics were collected focusing on joint distributions, autoimmune biomarkers, inflammatory parameters and treatment strategies. Statistical tests were performed to equate these variables among patient subgroups. Results: A total of 151 pediatric patients with Juvenile Idiopathic Arthritis (JIA) were included in the study. Polyarticular disease was the most common pattern of joint involvement (64.2%), followed by oligoarticular (33.8%) and monoarticular (2.0%). Antinuclear Antibodies (ANA) were the most frequently detected serological marker (13.2%), followed by Anti-Cyclic Citrullinated Peptide (Anti-CCP, 12.6%), Human leukocyte Antigen B27 (HLA-B27, 4.0%), and Rheumatoid Factor (2.6%). Growth retardation was observed in 26.5% of patients, while uveitis was seen in 2.6%. Methotrexate was the predominant treatment modality (69.5%). Significant differences were observed in Erythrocyte Sedimentation Rate (ESR, p=0.025), C-Reactive Protein (CRP, p=0.006), and Anti-CCP antibody positivity (p<0.001) across joint patterns, while other serological markers showed no significant association. Conclusion: Polyarticular disease was the most common pattern of joint involvement, followed by oligoarticular and monoarticular. Antinuclear Antibodies were the most frequently detected serological marker, followed by Anti-Cyclic Citrullinated Peptide, Human leukocyte Antigen B27, and Rheumatoid Factor.