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[Juvenile rheumatoid arthritis. Study of 46 cases]
Insights
Juvenile rheumatoid arthritis (JRA) predominantly affects preschoolers, often presenting with polyarticular joint involvement and recurrent symptoms. Many children experience minimal long-term functional incapacity despite common clinical and laboratory findings.
Area of Science:
- Pediatric Rheumatology
- Immunology
Context:
- Juvenile rheumatoid arthritis (JRA), now known as juvenile idiopathic arthritis (JIA), is a chronic autoimmune disease affecting children.
- Understanding the epidemiology and clinical presentation of JRA is crucial for early diagnosis and management.
Purpose:
- To characterize the clinical, laboratory, and radiological features of juvenile rheumatoid arthritis in a cohort of 46 children.
- To analyze the course and outcomes of JRA, including sequelae and functional incapacity.
Summary:
- The study included 46 children diagnosed with JRA according to American Rheumatism Association (ARA) criteria.
- The poliarticular form was most frequent at onset, predominantly affecting preschool-aged children, with no sex predominance.
- Common manifestations included fever, arthralgia, visceromegaly, and exanthema, with knees being the most affected joints.
- Laboratory findings consistently showed elevated sedimentation rate and hypergammaglobulinemia; rheumatoid factor was positive in 33%.
- Radiological changes included soft tissue swelling and osteoporosis in 38% of cases.
- Sixty percent of cases followed a recurrent course, with 34% remaining without articular sequelae and minimal functional incapacity in approximately half.
Impact:
- Provides insights into the presentation and natural history of JRA in children.
- Highlights the importance of early identification of clinical and laboratory markers for JRA.
- Informs clinical practice regarding prognosis and potential long-term outcomes in pediatric autoimmune arthritis.
Abstract:
Forty-six children with the diagnosis of juvenile rheumatoid arthritis (JRA) were studied according to the criterion of the American Rheumatism Association (ARA). No predominance was seen in terms of sex. Preschool age was preferably affected and the poliarticular form was the most frequent at the initiation. Sixty per cent of the cases followed a recurrent course. The routine clinical manifestations were fever, arthralgia, visceromegalia and exanthema. The knees were found to be the joints most frequently affected in one half of the cases. The laboratory tests showed in all of the cases, increased sedimentation rate, hypergammaglobulinemia and in 33% of the cases, the rheumatoid factor was positive. The most frequent X-ray changes were: increase of soft parts and osteoporosis in 38% of the cases, without radiological changes in 25% of them. Thirty-four percent of the patients remained without articular sequelae and approximately in one half of the cases, functional incapacity was minimal.