Considerations on juvenile chronic arthritis with generalized (polysystemic) onset

A trial is presented of evaluation of the frequency of clinical symptoms and signs, activity of disease process, and course of the disease in a group of children with juvenile chronic arthritis with generalized manifestations at onset. The analysed group comprised 36 children aged from 2 to 15 years. The duration of the disease was from 6 months to 13 years. The evaluation of the most frequent symptoms and signs in the so called early period of the disease covered the first year after the beginning of the first clinical signs. During the disease involvement of many internal organs develops and establishing of correct diagnosis at the onset is difficult, particularly, since in this initial period the signs of articular involvement may be absent or slight. Arthritis in this early period was observed in only 7 of 36 children. The most frequent symptoms and signs in decreasing frequency were: fever, rash, arthralgias, lymphadenopathy, hepatosplenomegaly. Heart involvement was noted in 16 of 36 cases, and pneumonia in 7 of 36. Anaemia and leucocytosis were present in all cases. Amyloidosis was recognized in 6 of 36 cases. In view of the severe course of the disease all children were treated with glycocorticoids, and cytostatic agents were given to those with evidence of amyloidosis.