Demianenko M. Clinical and pathogenetic characteristics of extra-articular manifestations in children with juvenile idiopathic arthritis.

The thesis contains a new solution to the relevant problem of modern pediatrics to improve the prevention of organ`s and system`s extra-articular manifestations development in children with juvenile idiopathic arthritis based on the investigation of the cardiovascular system, kidneys and lungs, disorder of lipid metabolism, and coagulation system, as well development of a diagnostic algorithm of extra-articular lesions considering type, activity, duration, and therapy of the disease. There are presented the results of clinical and laboratory researches, activity index of inflammation, the presence of immunological biomarkers of the autoimmune process; the evaluation of the cardiovascular system, kidneys and lungs, lipid profile, and coagulation system in children from 3 to 18 years old with poli-, oligo articular types of JIA and uveitis-associated arthritis according to patient`s sex and age, age at onset, JADAS, positivity of rheumatoid factor and anti-nuclear antibodies and the dosage of methotrexate. The features of morpho-functional changes in the cardiovascular system and its adaptive capabilities in children with juvenile idiopathic arthritis are established, taking into account the features of clinical manifestations and therapy of the disease. The functional state of the kidneys and lungs in children with juvenile idiopathic arthritis was evaluated considering type, activity, duration, and therapy of the disease. The frequency and type of changes in the parameters of the lipid spectrum and the blood coagulation system in children with juvenile idiopathic arthritis were determined depending on the characteristics of the manifestations, duration, and activity of the disease. The measures to prevent the formation of extra-articular manifestationsof organs and systems in children with juvenile idiopathic arthritis are grounded. The diagnostic algorithm was developed for the identification of extra-articular manifestationsin children with juvenile idiopathic arthritis, taking into account the type, activity, duration, and therapy of the disease.