[Prognosis of the systemic forms of juvenile chronic arthritis. Apropos of 100 cases]

Area of Science:

• Pediatrics
• Rheumatology
• Clinical Medicine

Background:

• Systemic juvenile rheumatoid arthritis (SJRA) is a chronic autoimmune disease affecting children.
• Understanding SJRA's long-term prognosis and factors influencing outcomes is crucial for patient management.

Purpose of the Study:

• To retrospectively analyze the clinical course and long-term outcomes of 100 children diagnosed with SJRA.
• To identify factors associated with disease severity and prognosis in pediatric patients with SJRA.

Main Methods:

• Retrospective review of medical records from 100 children with SJRA.
• Analysis of initial disease presentation, extra-articular signs, joint involvement patterns, and long-term clinical outcomes over a 10-year evolution.

Main Results:

• Early onset and intense extra-articular signs did not correlate with a more severe outcome.
• Oligo- or abarticular forms showed a better prognosis compared to polyarticular involvement.
• Girls experienced earlier onset and more frequent remissions than boys.
• Hip joint involvement showed potential for radiological improvement in 25% of cases.
• After 10 years, 50% of patients achieved clinical remission, 25% had persistent systemic symptoms, and 25% presented with active polyarthritis.

Conclusions:

• The number of affected joints in the initial 6 months is a significant prognostic factor in SJRA.
• While some patients achieve remission, a substantial proportion experience persistent symptoms or active polyarthritis, highlighting the chronic nature of the disease.
• Hip involvement can lead to severe sequelae, despite potential for radiological improvement.