Serologic studies in juvenile rheumatoid arthritis: a review

Careful study of inflammatory and immunologic parameters in JRA and other connective tissue diseases of childhood has contributed to our current understanding of these diseases. Examination of serum for acute phase reactants, and antibodies to immunoglobulin antigens and nuclear antigens, combined with radiologic evaluation of symptomatic joints and, when indicated, examination of joint fluid or synovial membrane, may confirm the diagnosis of JRA. Changes in inflammatory indicators can be used as an index of adequacy of treatment. An ANA positivity in the child with pauciarticular arthritis should always prompt frequent slit-lamp examinations for asymptomatic iridocyclitis. The role played by auto-antibodies in the pathogenesis of JRA is unknown, as is the possible effect of proteins like CRP on the regulation of the inflammatory process in these children.