Riccomi G, Minozzi S, Aringhieri G, Giuffra V. A possible case of juvenile idiopathic arthritis from Renaissance Lucca (Tuscany, central Italy).
INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2021;
33:72-83. [PMID:
33744835 DOI:
10.1016/j.ijpp.2021.03.002]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 03/03/2021] [Accepted: 03/12/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE
The skeletal remains of a young individual (Guinigi US 1278) are described and a differential diagnosis is performed to determine the potential etiology of bone alterations.
MATERIALS
Archaeological excavations conducted at the private funerary chapel of the upper class members of the Guinigi family (14th-17th centuries AD) of Lucca (Tuscany, central Italy) brought to light the fragmented human skeletal remains of a young individual (Guinigi US 1278) with pathological osseous modifications.
METHODS
Morphological and radiological analyses were followed by differential diagnosis.
RESULTS
Guinigi US 1278 was a non-adult aged 16-20 years, who exhibited florid skeletal alterations in the form of vertebral fusion and extensive subchondral bone changes of the small and large joints of the appendicular skeleton. The severity of the resorptive process in the peripheral joints, as well as vertebral fusion, indicates a long-standing inflammatory process.
CONCLUSIONS
The features and the distribution of the skeletal lesions of Guinigi US 1278 are highly consistent with a form of juvenile idiopathic arthritis (JIA), leading to irreversible phenomena such as subchondral erosive lesions and axial ankylosis, with impairment of the gait and neck movements.
SIGNIFICANCE
While abundant clinical literature on JIA is available, paleopathological studies are scarce. The possible case of JIA from Lucca provides a direct opportunity to examine the chronic course of rheumatic disease in young individuals in the absence of appropriate medical therapies in the antiquity.
SUGGESTIONS FOR FURTHER RESEARCH
Future molecular analyses might be able to identify specific alleles of the HLA region responsible for JIA subtypes.
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