Risk Assessment of Liver Pathology in the Treatment of Juvenile Idiopathic Arthritis in Adolescence

Background: Juvenile idiopathic arthritis (JIA) is the most common type of arthritis in children under the age of 16. Liver disturbance has been attributed not only to the liver disease associated with rheumatoid diseases themselves but also with such factors as fatty infiltration, drug toxicity, thrombotic accidents, or autoimmune liver disease. AST to Platelet Ratio Index (APRI) is relevant for determining the cohort of children that requires further liver examination.

Objective: To study the most vulnerable contingent of patients with liver damage in the treatment of JIA methotrexate using the APRI index

Methods: A total of 73 children aged 10 to 18 years old, 43 girls and 30 boys were observed. The children were divided into five groups by treatment with methotrexate (MTX) (I - did not receive MTX (15 children), II - received up to 1 year (16 children), III - 1-3 years (13 children), IV - 3 -6 years (14 children); V - more than 6 years (15 children)). The APRI index was based on the generally accepted formula.

Results: In children with JIA, who did not receive methotrexate APRI index was 0.34 ± 0.04. Patients in group II - 0.61 ± 0.18 (p

Conclusion: Children receiving methotrexate up to 1 year have highest risk of liver damage. Use of methotrexate more than 1 year reduces risk of liver disease. For a clearer understanding of pathological changes in the liver, further research is needed.