SAT0471 Pediatric Rheumatology in Southeast Asia: Juvenile Idiopathic Arthritis in Singapore
Authors: L. Das, S. F. Hoh, J. Tan, T. Arkachaisri
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Dedicated and comprehensive Pediatric Rheumatology (PR) Clinical Programs were recently established in 4 out of 11 countries in Southeast Asia. Little is known about rheumatic diseases in the region, making research difficult. A dedicated REgistry for Childhood Onset Rheumatic Diseases (RECORD) was established in 2009, at KK Women’s and Children’s Hospital, the only freestanding children’s hospital in Singapore. <h3>Objectives</h3> To describe and compare the regional characteristics of Juvenile Idiopathic Arthritis (JIA) from a PR cohort in Singapore. <h3>Methods</h3> All patients referred for PR evaluation and diagnosed with JIA were recruited from 01/2009 till 12/2012. Demographic and disease characteristic information were collected and median, interquartile range (IQR) &amp; percentiles were used to describe the data. <h3>Results</h3> A total of 1,374 patients were referred over the past 48 months, of which 177(12.9%) were diagnosed with JIA according to International League of Associations for Rheumatology (ILAR) criteria. Previously, we noted 58% of referrals were for rheumatologic disease. JIA was the 2<sup>nd</sup> most common diagnosis after systemic vasculitidies. The racial composition of patients seen were; Chinese 66.1%, Indian 10.7%, Malay 7.9% &amp; Mixed Race 2.8%, reflecting the expected distribution in Singapore. 12.5% of those seen were non-residents from nearby countries. There were 39% females &amp; 61% males. The median age at disease onset was 8.5 years (IQR 5.19-11.86) and median lag time to diagnosis was 2.7 months (IQR 9.5-16.0). Age by JIA subtype is defined in <i>Table 1</i>. Across the entire JIA cohort, Oligoarticular Persistent (OpJIA) 35% and Enthesitis Related JIA (ERA) 33% were the most common subtypes (<i>Table 1</i>). OpJIA patients had almost equal males as females affected while extended oligoarticular disease had 2 times more females. The majority of ERA patients were positive for HLA B27 (75.9%). ANA positivity ranged from 28.6–40% across subtypes excluding ERA 15.2% &amp; PsA 75%. Uveitis was only observed in 8 cases (6.9%) of patients. <h3>Conclusions</h3> JIA patients in Singapore differ from other countries in that males were diagnosed with JIA almost 2 times more than in females. This is likely a reflection of the increased number of ERA patients and HLA B27 positivity seen in Asians. Additionally, we had a lower incidence of Systemic JIA and Polyarticular RF negative JIA, similar to other published data on Asian children. ANA positivity was seen in all subtypes at a similar rate other than ERA and PsA. Uveitis was rarely encountered. <h3>References</h3> Tan JHT, Hoh SF, Arkachaisri T <i>et al.</i>: Paediatrics Rheumatology Clinic Population in Singapore: The KKH Experience. Proceedings of Singapore Healthcare Volume 21 Number 4 2012 Shen CC, Yeh KW, Ou LS <i>et al.</i>: Clinical features of children with juvenile idiopathic arthritis using the ILAR classification criteria. J Microbiol Immunol Infect. 2012 Jun 21. pii: S1684-1182(12)00044-8. <h3>Disclosure of Interest</h3> None Declared