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Arthritis and uveitis in children. A pediatric rheumatology perspective
Ross E Petty1, Justine R Smith, James T Rosenbaum
1Department of Pediatrics (Division of Rheumatology), University of British Columbia, Vancouver, Canada. rpetty@cw.bc.ca
Insights
Chronic arthritis in children can lead to anterior uveitis, a serious eye condition. Early detection and treatment are crucial for preserving vision in affected children.
Area of Science:
- Ophthalmology
- Pediatric Rheumatology
- Internal Medicine
Background:
- Anterior uveitis is a significant complication in various forms of juvenile idiopathic arthritis.
- Ophthalmologists play a crucial role in managing children with chronic arthritis.
Purpose of the Study:
- To outline key characteristics of childhood chronic arthritis associated with anterior uveitis.
- To provide insights for ophthalmologists managing pediatric arthritis patients.
Main Methods:
- Literature review of pertinent publications.
- Commentary based on investigators' clinical experience.
- Comparison of new and existing childhood arthritis classifications.
Main Results:
- Anterior uveitis affects up to 30% of children with chronic arthritis, especially oligoarticular juvenile idiopathic arthritis.
- Specific subtypes include oligoarthritis, rheumatoid factor-negative polyarthritis, psoriatic arthritis, and enthesitis-related arthritis.
Conclusions:
- Visual prognosis for children with chronic arthritis and uveitis is often guarded.
- Regular surveillance and prompt therapeutic interventions are essential for favorable outcomes.
Purpose:
We describe important characteristics of the chronic arthritides of childhood associated with anterior uveitis.
Design:
Literature review and commentary based on the investigators' experiences.
Method:
A review of pertinent publications provides a background of current understanding of those forms of childhood arthritis that are of interest to ophthalmologists caring for children. Recommendations regarding screening for asymptomatic anterior uveitis in this patient group are reviewed, and current advances in therapy are noted. A new classification of childhood arthritis is compared with existing classifications.
Results:
Uveitis complicates several forms of juvenile idiopathic arthritis (oligoarthritis, rheumatoid factor-negative polyarthritis, psoriatic arthritis, and enthesitis-related arthritis). Uveitis is a complication in up to 30% of children with chronic arthritis, particularly in those with oligoarticular disease.
Conclusions:
Visual prognosis is guarded for children with chronic arthritis and uveitis. Surveillance and early therapy are important factors for ensuring a good outcome.