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Juvenile Rheumatoid Arthritis

more about Juvenile Rheumatoid Arthritis

JRA (Juvenile Rheumatoid Arthritis)

  • A disease causing chronic inflammation of the joint linings, as well as systemic symptoms outside the joints.  Both the joint symptoms and the systemic symptoms differ in children and adults.
  • Three types exist:
    1. Polyarticular form, with disease in many joints.  This resembles the adult form of rheumatoid arthritis, but the following 2 forms do not resemble the adult form.
    2. Pauciarticular form, with disease in a few joints
    3. Systemic form, mainly with fever and rash
  • The disease is rarely fatal, and it may remit in teenage years.  The amount of disability is rarely severe.

  • The polyarticular form typically has swelling of the small joints of the hands, and often has minimal systemic symptoms.  The areas over these joints are often warm and edematous.
  • The pauciarticular form typically shows swelling of these large joints: elbows, knees, and ankles.  These children often develop iridocyclitis (inflammation of the iris and ciliary body (eyelashes), with cells and protein exuded into the anterior chamber of the eye.  Cataracts and Glaucoma may develop.  The iridocyclitis, which can cause loss of vision, is usually more incapacitating than the arthritic symptoms.
  • The systemic form of JRA typically has high fever and a pale, pink rash composed of numerous small spots; and enlargement of the liver and spleen.  Joint involvement usually develops later than the systemic symptoms.

  • The cause is unknown.  It sometimes occurs after a serious infection or after Trauma to a joint.
  • It is not a hereditary disease.

  • The diagnosis is based on the total picture of joint symptoms and systemic symptoms, both of which become persistent in JRA.  There are no specific laboratory tests, although commonly, the sedimentation rate and the white blood cell count are both elevated, and anemia is present.  Antinuclear antibodies may be present, as well as increased levels of alpha-2 globulin and gamma globulin.
  • Rheumatoid factors (particular kinds of antibodies) are usually present in adults with rheumatoid arthritis, but rarely found in those children whose disease starts in early childhood.

  • Female sex
  • Children over the age of 2

  • Salicylates, NSAID medications, corticosteroids, other drugs that reduce inflammation.
  • Corticosteroids suppress symptoms but do not prevent disease progression.  Steroids can suppress the adrenal glands and cause necrosis of bone, especially in the head of the femur.
  • Physical therapy

  • Iridocyclitis can cause vision loss.
  • Inflammation of joints can cause stiffness, and transient or permanent loss of function.
  • Joint deformities

  • Arthritis (joint inflammation), persistent fevers, and persistent rashes should be evaluated by a physician.

  • Infectious forms of arthritis
  • Acute Rheumatic Fever
  • Leukemia may show inflammation of the joints, elevated white blood cell counts, and anemia.

more about Juvenile Rheumatoid Arthritis

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