Juvenile chronic arthritis

A review of the clinical and immunological features of 72 children with chronic arthritis revealed a similar pattern of disease in Australian children when compared with overseas studies. Most of the children had pauciarticular disease, but polyarthritis and systemic forms were seen. Although HLA=B27 was identified in some patients, no florid example of ankylosing spondylitis in childhood was seen. A small, but significant, number of children had evidence of potentially blinding iritis which developed insidiously, and one child had acute uveitis. Although elevated antistreptolysin-O titres and raised total IgM levels were seen in a significant number of children, they were not confined to any particular clinical pattern and were not of any major prognostic value. Half the children were severely incapacitated at the height of their disease, but follow-up for periods of up to five years revealed that fewer than 5% had a significant permanent disability.