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- $Unique_ID{BRK03493}
- $Pretitle{}
- $Title{Arthritis, Juvenile}
- $Subject{Arthritis Juvenile Juvenile Rheumatoid Arthritis Juvenile Chronic
- Arthritis Still's Disease Systemic Onset Disease Polyarticular Onset Disease
- Pauciarticular Onset Disease Lyme Disease Ankylosing Spondylitis}
- $Volume{}
- $Log{}
-
- Copyright (C) 1992, 1993 National Organization for Rare Disorders, Inc.
-
- 899:
- Arthritis, Juvenile
-
- ** IMPORTANT **
- It is possible that the main title of the article (Juvenile Arthritis) is
- not the name you expected. Please check the SYNONYM listing to find the
- alternate names and disorder subdivisions covered by this article.
-
- Synonyms
-
- Juvenile Rheumatoid Arthritis
- Juvenile Chronic Arthritis
- Still's Disease
-
- Disorder Subdivisions:
-
- Systemic Onset Disease
- Polyarticular Onset Disease
- Pauciarticular Onset Disease
-
- Information on the following diseases can be found in the Related
- Disorders section of this report:
-
- Lyme Disease
- Ankylosing Spondylitis
-
- General Discussion
-
- ** REMINDER **
- The Information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources"
- section of this report.
-
- Juvenile Arthritis is a relatively rare disorder. However, it is the
- most common pediatric rheumatic disease and is responsible for the largest
- percentage of childhood disability. Major symptoms may include swollen and
- painful joints, fever, skin rash, swollen lymph glands and enlarged spleen
- and liver. There may also be associated blood disorders, and a feeling of
- being tired. The symptoms may be mild or severe.
-
- Symptoms
-
- There are several types of Juvenile Arthritis. It is characterized by
- morning joint stiffness, skin rash, tiredness and aching of joints. There
- may also be fever and blood problems. The patient may or may not show
- antibodies to the rheumatoid factor. The disease may have a mild effect or
- it may have extremely crippling effects requiring braces or surgery to
- replace joints. Juvenile Arthritis affects girls more often than boys.
-
- Systemic Onset Arthritis (Still's Disease) can occur at any age.
- Symptoms include blood problems, high fever, enlarged liver and spleen and
- swollen lymph glands. Twenty percent of childhood cases of arthritis are
- diagnosed as Still's Disease. This form of arthritis may develop into
- chronic polyarthritis.
-
- Polyarticular Onset Disease occurs most frequently in females and affects
- about forty percent of children with juvenile arthritis. Symptoms may
- include growth retardation, low-grade fever, tiredness and blood disorders.
- This type of arthritis usually will involve the spine.
-
- Pauciarticular Onset Disease is responsible for the other forty percent
- of juvenile arthritis cases. One type of this disease affects a higher
- percentage of females, the other type affects mostly males. Symptoms
- noticeable in the type of pauciarticular arthritis that affects females
- includes inflammation of the iris of the eye. If not treated promptly it may
- lead to blindness. Symptoms in males usually include the spine.
-
- Causes
-
- The exact cause of Juvenile Chronic Arthritis is not known. Scientists are
- studying reasons that set the process in motion. Some researchers are
- looking into a viral or other infectious cause of the disease. The Ross
- River virus can cause a syndrome that appears similar to Systemic Onset
- Juvenile Chronic Arthritis and Parvovirus may be linked to a rheumatic,
- arthritis-like disease.
-
- Children with JA in the active stage may have a defect of their T-cell
- (immune response) function. This condition may suggest that some JA patients
- have a condition where the body's natural defenses (antibodies, lymphocytes,
- etc.), against invading organisms mistakenly begin to attack healthy tissue
- instead of invading organisms. When this occurs it is known as an
- autoimmune disease. Most forms of arthritis are believed to be autoimmune
- diseases.
-
- Juvenile Chronic Arthritis may develop into serious illness that is
- apparent for the rest of the patient's life or, as in most cases (75%) of
- Juvenile Arthritis, disappear completely.
-
- Affected Population
-
- Juvenile Chronic Arthritis affects approximately 200,000, children in the
- United States. It affects a higher percentage of females than males. It can
- begin in infancy and continue throughout life or it can disappear after weeks
- or months of illness.
-
- Related Disorders
-
- Symptoms of the following disorders can be similar to those of Juvenile
- Chronic Arthritis. Comparisons may be useful for a differential diagnosis:
-
- Lyme Disease is a tick-transmitted inflammatory disorder characterized by
- an early skin rash, and later by neurological, joint and heart abnormalities.
- Other symptoms may include tiredness, fatigue, chills, fever, backache,
- swollen lymph glands and an enlarged spleen. The symptoms of arthritis such
- as painful and swollen joints may occur within weeks or months following
- infection by a tick. Children with Juvenile Arthritis should have a Lyme
- disease test to rule out this treatable infection. (For more information on
- this disorder, choose "Lyme" as your search term in the Rare Disease
- Database).
-
- Ankylosing Spondylitis is a chronic progressive form of arthritis
- distinguished by inflammation and eventual immobility of a number of joints.
- It primarily involves the spine and paraspinal structures. Pain may occur in
- the back down to the buttock and a lower extremity. Symptoms usually become
- worse spreading from the lower back into the mid back and occasionally the
- neck. (For more information on this disorder, choose "Ankylosing
- Spondylitis" as your search term in the Rare Disease Database).
-
- Therapies: Standard
-
- Treatment of Juvenile Chronic Arthritis usually consists of oral doses of
- aspirin or other anti-inflammatory drugs. Physical Therapy plays a very
- important part in helping children maintain their mobility. Tolmetin is the
- only other drug therapy for Juvenile Arthritis approved by the FDA. Other
- nonsteroidal anti-inflammatory drugs (NSAIDs) include ibuprofin such as
- Motrin, Advil, etc. It is important that patients with pauciarticular onset
- disease have regular eye exams to avoid aridocyclitis and possible blindness.
-
- Therapies: Investigational
-
- Gold salts and corticosteroids may be tried in children with systemic disease
- who do not respond to aspirin or other nonsteroidal anti-inflammatory drugs.
- Penicillamine and hydroxychloroquine may be tried in patients who do not
- respond to gold therapy, but they are not often used in children.
-
- The drug Auranofin for the treatment of children with Juvenile Chronic
- Arthritis is being studied in the U.S. and U.S.S.R. Several other drugs are
- under investigation for treatment of Juvenile Arthritis, such as methotrexate
- and gamma-interferon. Further studies are necessary to establish the safety
- and effectiveness of these therapies over a long period of time.
-
- The orphan product Immune Globulin Intravenous (Human) is being used for
- the treatment of Juvenile Rheumatoid Arthritis. The product is manufactured
- by:
-
- Immuno Clinical Research Corp.
- 155 East 56th St.
- New York, NY 10022
-
- This disease entry is based upon medical information available through
- February 1993. Since NORD's resources are limited, it is not possible to
- keep every entry in the Rare Disease Database completely current and
- accurate. Please check with the agencies listed in the Resources section for
- the most current information about this disorder.
-
- Resources
-
- For more information on Juvenile Arthritis, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203 )746-6518
-
- Juvenile Arthritis Foundation
- 1314 Spring St., NW
- Atlanta, GA 30309
- (404) 872-7100
-
- The National Arthritis and Musculoskeletal and Skin Diseases Information
- Clearinghouse
- Box AMS
- Bethesda, MD 20892
- (301) 495-4484
-
- References
-
- CECIL TEXTBOOK OF MEDICINE, 19th Ed.: James B. Wyngaarden, and Lloyd H.
- Smith, Jr., Editors; W.B. Saunders Co., 1990. P. 1999.
-
- AURANOFIN IN THE TREATMENT OF JUVENILE RHEUMATOID ARTHRITIS. RESULTS OF
- THE USA-USSR DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL. THE USA PEDIATRIC
- RHEUMATOLOGY COLLABORATIVE STUDY GROUP. THE USSR COOPERATIVE CHILDREN'S
- STUDY GROUP, Giannini, E.H. et al.; April, 1990, (issue 33 (4)). Pp. 466-
- 476.
-
- TOXICITY AND SERUM LEVELS OF METHOTREXATE IN CHILDREN WITH JUVENILE
- RHEUMATOID ARTHRITIS, Wallace, C.A., Arthritis Rheum, June, 1989, (issue 32
- (6)). Pp. 677-681.
-
- THERAPY FOR SYSTEMIC JUVENILE RHEUMATOID ARTHRITIS WITH GAMMA-INTERFERON:
- A PILOT STUDY OF NINE PATIENTS., Pernice, W., et al.; Arthritis Rheum, May,
- 1989, (issue 32 (5)). Pp. 643-646.
-
- PHYSICAL THERAPY MANAGEMENT OF PATIENTS WITH JUVENILE RHEUMATOID
- ARTHRITIS, Rhodes, V.J., Phys Ther, December, 1991, (issue 71 (12)). Pp.
- 910-919.
-
-