Robert Wood Johnson University Hospital
 

Juvenile Rheumatoid Arthritis

Juvenile Rheumatoid Arthritis

What is juvenile rheumatoid arthritis?

Juvenile rheumatoid arthritis (JRA) is a form of arthritis in children ages 16 or younger that causes inflammation and stiffness of joints for more than six weeks. Unlike adult rheumatoid arthritis, which is chronic and lasts a lifetime, children often outgrow juvenile rheumatoid arthritis. However, the disease can affect bone development in the growing child.

The disease can be classified into three categories based on the number of and which joints are involved, the symptoms present and their duration, and the presence of specific antibodies produced by the immune system. These three variables often help physicians determine the progression of JRA and include the following:

What causes juvenile rheumatoid arthritis?

Like adult rheumatoid arthritis, JRA is an autoimmune disease, which means the body's immune system attacks its own healthy cells and tissues.

JRA is considered to be a multifactorial condition. Multifactorial inheritance means that "many factors" are involved in causing a health problem. The factors are usually both genetic and environmental, where a combination of genes from both parents, in addition to unknown environmental factors, produce the trait or condition. Often one gender (either males or females) is affected more frequently than the other in multifactorial traits. Multifactorial traits do recur in families because they are partly caused by genes.

A group of genes on chromosome 6 codes for the HLA (human leukocyte antigens) antigens play a major role in susceptibility and resistance to disease. Specific HLA antigens influence the development of many common disorders. Some of these disorders, like JRA, are autoimmune related and inherited in a multifactorial manner. When a child has the specific HLA antigen type associated with the disease, he/she is thought to have an increased chance to develop the disorder. The HLA antigen associated with JRA is called DR4. Children with the DR4 HLA antigen are thought to have an increased chance (or "genetic susceptibility") to develop JRA; however, it is important to understand that a child without this antigen may also develop JRA. This means HLA antigen testing is not diagnostic or accurate for prediction of the condition. Females are affected with JRA more often than males.

What are the symptoms of juvenile rheumatoid arthritis?

Symptoms of juvenile rheumatoid arthritis may appear during episodes (flare-ups) or may be chronic and continuous. The following are the most common symptoms of juvenile rheumatoid arthritis. However, each child may experience symptoms differently. Symptoms may include:

Symptoms of juvenile rheumatoid arthritis may resemble other medical conditions or problems. Always consult your child's physician for a diagnosis.

How is juvenile rheumatoid arthritis diagnosed?

In addition to a complete medical history and physical examination your child's physician will obtain a complete prenatal and birth history of your child and ask if your child has had any recent colds or other infections.

Currently, there is no diagnostic test that definitively tells that a child has JRA. Diagnosis of juvenile rheumatoid arthritis is usually confirmed based on the presence of the following:

Imaging tests, to show the extent of damage to the bones, may include the following:

Aspirin and the risk of Reye syndrome in children

Do not give aspirin to a child without first contacting the child's physician. Aspirin, when given as treatment for children, has been associated with Reye syndrome, a potentially serious or deadly disorder in children. Therefore, pediatricians and other healthcare providers recommend that aspirin (or any medication that contains aspirin) not be used to treat any viral illnesses in children.

Treatment for juvenile rheumatoid arthritis:

The goal of treatment for juvenile rheumatoid arthritis is to maintain a normal activity level for your child. Specific treatment for juvenile rheumatoid arthritis will be determined by your child's physician based on:

Treatment may include:

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