الفهرس 
Course & PrognosisOnly 14 pages are availabe for public view
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Abstract
Dyslipoproteinemia is a feature of certain rheumatic diseases and it may explain the high mortality
from cardiovascu lar diseases reported in adults with rheumatoid arthritis. Therefore, this study
is aimed to outline the lipid profile patterns in patients with juvenile rheumatoid arthritis (JRA)
and their possible relation to disease activity and therapy.
The study comprised 24 children with JRA from the Ped iatric Allergy & Immunology Un it of Ain
Shams University Children’s Hospital. Ten of these suffered active disease wh ile 14 children
attained rem ission on several drug regimens. 1\velve healthy age and sex matched children were
included as controls. ’J11ey were subjected to clinical evaluat ion as well as ESR test ing,
rheumatoid factor determ i nat ion and scru m choleste rol, lipop rote i ns an d apolipoproteins A1
& H estimation.
Total cholesterol was normal in all studied groups as compared to cont rols. Serum H DL was low in
child ren with JRA as a whole group, in those under both cortisone and. NSAJ D and even in those in
remission. This finding, together with a high Apolipoprotein B in children with active JRA and high
triglyceride level in those under combined therapy, would suggest a high risk for atherosclerosis.
Howeve r, this is opposed by the finding of a high Apo Al in the JRA pat ients as one group, a low
LDL in the group receiving no med ications and normal athcrogen ic risk ratios in most groups. Neither disease activ ity nor rheumatoid factor posi tivity proved any impact on serum lipid
profiles of the patients except that the triglycerides positively correlated to the ESR in patients
with active disease.
Anti-rheumatic drug effects d isplayed nonnalization of serum lipoprotei ns in patients on NSAID
compared to a low LDL cholesterol in children not receiving any therapy. Children on both NSAID &
Conisone had widely disturbed lipid profiles with a low HDL cholesterol & high triglycerides and
apo B levels.
Worth ment ioning is that the atherogenic risk ratios were positi vely correlated to ages, weights
and heights & ESR of the patients and not controls.
Thus, it is of value that the influence of inflammatory disorders and on-going therapy on the
lipoprotein pattern be kept in mind.
We recommend evaluating other possible factors that may cause card iovascula r disease in
rheumatoid arthrit is and studying the cardiac function in these patients. We also recommend adding
these profiles to the list of investigation in rheumatoid children to modify d iets & physical
excercise accordingl y. Finally, we recommend sett ing local refere nce values of serum lipoprotei
ns & apolipoprotei ns for Egypt ian children to aid med ical research and investigations.