Oligo JIA

Question 1

HLA genes associated

Answer 1

A locus antigen, A2
Antigen binding groove of HLA DRB1 at AA positive 13

HLA DPB1*0201

Question 2

Non HLA genes

Answer 2

IL-1A2 PTPN22, STAT4, PTPN2

Question 3

Differential for acute mono arthritis

Answer 3

Oligo
ERA
Psoratic 
Septic Arthritis
Reactive
Leukemia 
Neuroblastoma 
Hemophilia 
Trauma 
FMF

Question 4

Differential for chronic monoarthritis

Answer 4

Oligo 
ERA
Psoriatic 
Villonodular synovitis 
Sarcoid, Blau 
TB
Hemophilia 
Pseudo Arthroses : Hemiangioma, synovial chrondomatosis, lipoma arborescens 
Autoinflammatory diseases: Mevolante kinase def, NOMID

Question 5

Poor prognostic features

Answer 5

Young age (questionable)
DRB1*01, HLA DR1, low IL 10 production
Synovial fluid with higher levels of CCL5 and lower CD4:CD8 ratio
Wrist, ankle, hip, cervical spine involvement
marked or prolonged elevated of CRP/ESR
Radiographic evidence of joint damage

Question 6

Predictors of disability

Answer 6

Elevated ESR at onset
Early age at onset
Presence of hip disease in the first 6 months

Question 7

Positive Autoantibodies

Answer 7

ANA in 2/3, especially those with uveitis
Anticardiolipin positive in almost 1/2 but usually transient
IgA anti -CCP may be positive

Question 8

Complications of Oligo

Answer 8

1. Uveitis
2. Contractures
3. Limb length discrepancy