AB1078 Applicability of the caspar criteria of psoriasic arthritis in a cohort of children patients following in a paediatric rheumatology unit of a tertiary hospital
Authors: A. Alía Jiménez, A. Lucica Boteanu, B.A. Blanco Cáceres, M. Blázquez Cañamero
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The ILAR consensus establishes classification criteria, dividing the JIA into 7 subcategories, with juvenile psoriatic arthritis (APsJ) being one of them. In the adult population, the CASPAR classification criteria are usually used to classify a patient with psoriatic arthritis. However, the two classifications have some differences that sometimes produce confusion <h3>Objectives</h3> To assess the applicability of the CASPAR classification criteria in a series of patients previously diagnosed in paediatric age of JPAs or undifferentiated arthritis by exclusion criteria to be male &gt;6 years old and HLA B27 positive, comparing these with the ILAR classification criteria, through the study of clinical features <h3>Methods</h3> Retrospective cross-sectional observational study. Clinical, epidemiological, sociodemographic and analytical variables were collected from 30 patients previously diagnosed with JPAs (&lt;16 years) or undifferentiated arthritis by exclusion criteria age &gt;6 years in HLA B27-carrying male. It was assessed whether the patients met the ILAR classification criteria as well as the CASPAR classification criteria, which, unlike the previous ones, did not exclude HLA B27 positive patients, considered the family history of the 2nd degree and added a test radiographic <h3>Results</h3> The mean age at diagnosis was 11.23±4.6 years; 15 of them being women and 15 men. 15 (15/30) patients presented cutaneous psoriasis at some point during the follow-up, in 5/15 patients psoriasis began before arthritis while 7/15 patients were previously diagnosed with arthritis than cutaneous psoriasis; in 3/15 patients the diagnosis was simultaneous during the medical visit. 9 (9/30) patients presented a family history of 1st degree cutaneous psoriasis and 7/30 of them had a family history of 2nd grade psoriasis. Of the total number of patients, 10 of them would not meet the ILAR classification criteria, 8 because they presented as exclusion criteria being male, HLA-B27 positive and &gt;6 years of age, among which, 7/8 would fulfil CASPAR criteria, and 2 other patients who were not classified according to ILAR criteria, did meet the CASPAR classification criteria, given the presence in these criteria of negative RF, family history of the 2nd degree and typical radiological alterations, which are not present in the ILAR criteria. 1 (1/30) patient did not meet CASPAR criteria, and belonged to the group of patients excluded from the ILAR criteria for being male &gt;6 years HLA-B27 +. If we did not take into account the negative FR of the CASPAR criteria, 14 patients would not meet these criteria and if we eliminated the 2nd grade AF, 5 patients would not be classified (among them 2 who meet CASPAR and do not ILAR) <h3>Conclusions</h3> In our series of patients despite the fact that the presence of current skin psoriasis contributes 2 points in the CASPAR criteria, only 1 patient would not meet the CASPAR criteria, since the majority of patients present other clinical or analytical manifestations, such as the presence of negative rheumatoid factor or 2nd degree family history. Patients who do not meet criteria for PsA by exclusion criteria, practically all of them would be diagnosed with psoriasic arthritis by CASPAR criteria. <h3>Disclosure of Interest</h3> None declared