Serum Amyloid A Level in Patients with Juvenile Idiopathic Arthritis

Background and Aim of the Work: JIA is the commonest rheumatic disease in childhood characterized by inflammatory arthritis lasting more than 6 weeks before the 16th birthday. In addition to routine ESR and CRP, there are other inflammatory biomarkers as SAA. It is one of the major acute phase reactants which was found to be elevated in inflammatory arthritis and a good indicator of disease activity.This study assessed the value of SAA level in a cohort of patients with JIA.Subjects and Methods: 45 JIA patients and 40 healthy controls were recruited from the outpatient clinic of Rheumatology and Rehabilitation Department at MUCH. All patients underwent a thorough clinical evaluation. Assessment of JIA patients involved assessment of disease activity, tenderness and functional status. Laboratory tests were done including: CBC, ESR, CRP and SAA.Results: A significant rise in SAA levels was found in JIA patients compared to control group and it was significantly higher in SJIA subtype. SAA level was positively correlated with JADAS-27, VAS, physician global assessment, C-HAQ, Ritchie articular index score, platelet count and ESR in 1st hour and 2nd hour. The levels of SAA were significantly lower in JIA patients taking methotrexate while it was significantly higher in cyclosporine treated patients.Conclusion: SAA can be used as additional indicator of JIA disease activity. Moreover, it can help in differentiation between subtypes when combined with clinical features of the disease and it may be considered in assessment of patient, s response to therapy