الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The term juvenile idiopathic arthritis (JIA) includes all forms of arthritis that begin before the age of 16 years, last for more than 6 weeks, and are of unknown etiology. It encompasses a heterogeneous group of conditions, all presenting with joint inflammation, but with distinctive clinical manifestation, course, genetic background and pathophysiology. The current International League of Associations of Rheumatology (ILAR) classification of JIA, outlines seven disease categories: systemic arthritis, RF-positive polyarthritis, RF-negative polyarthritis, oligoarthritis, psoriatic arthritis, Enthesitis-related arthritis (ERA), and undifferentiated arthritis. Calprotectin, also known as MRP8/14 or S100A8/A9, is a heterodimeric complex of two S100 calcium-binding proteins: myeloid-related protein 8 (MRP-8 or S100A8) and MRP-14 (or S100A9). Calprotectin is an important proinflammatory factor of innate immunity. Musculoskeletal ultrasound (MSUS) demonstrated to be a valid and reliable tool in the assessment of chronic inflammatory arthropathies in adults. Therefore, it has been regarded as especially promising in the assessment of joints in children with JIA. Owing to the importance and significant impairment of JIA (short term and long term disabilities), the aim of our study was to detect the role of calprotectin as a mediator and to assess its correlation with parameters of disease activity and ultrasonographic synovitis. This study was carried out on thirty juvenile idiopathic arthritis patients diagnosed according to the Revised Classification Criteria of the International League of Associations for Rheumatology (ILAR). In addition, thirteen apparently healthy age & sex matched volunteers were studied as a control group. All patients were subjected to the following: A) History taking. B) Complete clinical examination, with special attention to musculoskeletal system. C) Disease activity assessment: By Juvenile Arthritis Disease Activity Score 27 (JADAS 27). D) Full laboratory investigations: -Complete blood count (CBC). -Erythrocyte sedimentation rate (ESR). -C-reactive protein (CRP). -Serum ferritin . -Rheumatoid factor (RF). -Antinuclear antibodies (ANA). -Anti cyclic citrullinated peptide antibodies (anti-CCP). -Serum calprotectin. E) Ultrasound examination: All patients were examined at ultrasonography unit of Physical medicine, Rehabilitation & Rheumatology Department in Tanta University Educational Hospital using SAMSUNG MEDISON (UGEO H60). The results of this study could be summarized as follows: -There was insignificant difference between JIA patients and controls as regard age and sex. -Oligoarticular was the most common type of JIA. - Methotrexate was the most common DMARD used either alone or with systemic corticosteroids. -There was significant difference between JIA patients and controls as regard haemoglobin, ESR and CRP. - Juvenile idiopathic arthritis patients had significantly higher serum calprotectin levels when compared to controls. -There was no relation between serum calprotectin level and duration of disease. - Systemic subtype was founded to have higher serum calprotectin levels. -There was significant positive correlation between serum calprotectin and clinical parameters of disease activity (JADAS 27), CRP, ESR, serum ferritin. There was insignificant correlation between serum calprotectin levels and RF, ANA and AntiCCP in patients group. -There was significant poitive correlation between serum calprotectin and ultrasound score (EULAR-OMERACT combined scoring system for grading synovitis). -There was positive significant correlation between ultrasound score (EULAR-OMERACT combined scoring system for grading synovitis) and disease activity (JADAS 27).