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Classification of juvenile ankylosing spondylitis
Last reviewed: 04.07.2025
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Modern ideas about the relationship between diseases classified as spondyloarthritis can be reflected in the classification proposed in 1997 by Professor E.R. Agababova. Four groups of diseases are distinguished.
- Ankylosing spondylitis (primary, idiopathic) - Bechterew's disease.
- Spondyloarthritis (secondary) in the following diseases:
- urogenital Reiter's disease;
- postenterocolitic reactive arthritis;
- other intestinal and genitourinary infections;
- psoriatic arthritis;
- nonspecific ulcerative colitis and Crohn's disease;
- SAPHO syndrome.
- • Combined/cross-linked spondyloarthritis (indicating combinations of diseases).
- • Undifferentiated spondyloarthritis (with indication of symptoms).
The international classifications of JRA of the American College of Rheumatology and JHA of the European Anti-Rheumatism League provide for separate headings within the oligoarticular variant - subtype II, characterized by predominant incidence in boys, association with HLA-B27 antigen and high risk of developing JAS in the follow-up ( Juvenile rheumatoid arthritis ). In the new classification of juvenile idiopathic arthritis, adopted at the Congress of the World League of Rheumatological Associations in 1997 in Durban, clarified and supplemented at a similar congress in 2001 in Edmonton, a more specific place is defined for the prespondylic stages of juvenile spondyloarthritis.
The International Society of Pediatric Rheumatologists has decided to call all chronic inflammatory joint diseases in children juvenile idiopathic arthritis and to distinguish seven categories. The definition and list of exceptions for each of the seven categories do not allow for the possibility of overlap between the selected variants, and in the case of compliance with the criteria of two or more categories, they recommend assignment to the group "Undifferentiated arthritis".
Classification of juvenile idiopathic arthritis (ILAR 1997, 2001)
- Systemic arthritis.
- Polyarthritis, rheumatoid factor negative.
- Polyarthritis, positive for rheumatoid factor.
- Oligoarthritis:
- persistent;
- spread.
- Arthritis associated with enthesitis.
- Psoriatic arthritis.
- Undifferentiated arthritis:
- does not match any of the categories;
- meets the criteria of more than one category.
Diseases of the spondyloarthritides circle have their origins among the last three variants of juvenile idiopathic arthritis (JIA) (arthritis combined with enthesitis; psoriatic arthritis and undifferentiated arthritis), although in rare cases it is possible to develop spondyloarthritis in the follow-up of patients whose diseases are classified by debut in the headings systemic arthritis, polyarticular seronegative for rheumatoid factor and oligoarticular variants.
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