Abstract
In a prospective study of 1,053 consecutive children who attended the Rheumatic Care Centre, Government General Hospital, Madras from 1991 to 1995, 331 children fulfilled the criteria proposed by the American Rheumatism Assocation as modified by Cassidyet al for the diagnosis of Juvenile Rheumatoid Arthritis. These children were thoroughly examined and investigated and classified into 3 onset types which was then sub-classified into early entry and late entry groups based on the duration of illness. Other arthritic conditions were excluded. There were 44 cases belonging to Systemic onset, 171 belonging to polyarticular onset and 116 belonging to oligoarticular onset type. In the systemic onset type 44/44 patients had fever, 40/44 had lymphadenopathy and 19/44 had skin rash; wrists and knees 31/44 were the most commonly involved joints; neck involvement was present in 13/44 of the cases; ANA was positive in 5/44 cases and anaemia was seen in 24/44 cases. In polyarticular onset type wrists 119/171, knees 143/171, hip joints 105/171 and ankles 113/171 were commonly involved; in the RF+ve subtype 3/23 had subcutaneous nodules and 7/23 were positive for ANA; in the Rf-ve subtype 59/148 were positive for ANA. In the oligoarticular subtype-1 ANA was positive in all cases but iridocyclitis was not seen in any case. In oligoarticular subtype-2 HLA B27 was positive in 13/26 cases while Sacroilitis was seen in 16/26 cases. In oligoarticular type-3 HLA B27 was negative.
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References
Brewer EJ Jr, Bass JC, Cassidy JTet al. Criteria for the classification of Juvenile Rheumatoid Arthritis.Bull. Rheumat Dis 1972; 23: 712–719.
Brewer EJ, Bass JC, Baum JRet al. Current proposed revision of JRA criteria.Arthritis Rheum (Suppl) 1977; 20: 195.
Bywaters EGL. Diagnostic criteria for Still's disese. (Juvenile RA) Population studies of Rheumatic diseases, Proceedings of the Third International Symposium. New York. June 1966, Edited by PH Bennet, PHN Wood. Amsterdam, Excerpta Medica Foundation 1968: 235–240.
Laaksonen AL. Juveniilin reumatoidiartriitin diagnostiset kriteerit.Duodecim 1970; 86: 333–339.
Kvien TK, Hoyeraal HM, Kass E. Diagnostic criteria of rheumatoid arthritis in children: Proposed criteria for controlled clinical studies.Scand J Rheumatol 1982; 11: 187–192.
Ansell BM. Chronic arthritis in childhood.Ann Rheum Dis 1978; 37: 107–120.
Cassidy JT, Levinson JE, Bass JC. A study of classification criteria for diagnosis of juvenile rheumatoid arthritis.Arthritis Rheum 1986; 29: 274–281.
Brewer EJ, Giannini EH, Person DA.Juvenile Rheumatoid Arthritis 2nd ed, Philadephila: WB Saunders, 1982: 5–8.
Cassidy JT, Petty RE.Text Book of Pediatric Rheumatology, Second Edition New York: Churchill Livingstone, 1990: 113–259.
Malaviya AN, Narayanan K. Juvenile Chronic Arthritis in India.Indian J Paediatr 1981; 48: 659–667.
Porkodi R, Ramakrisnan S, Chandrasekaran ANet al. Pattern of Rheumatic diseases in South India. IV. Clinical profile of juvenile rheumatoid arthritis.J Assoc Phys India 1990; 38: 771–773.
Rosenberg AM, Petty RE. A syndrome of seroengative enthesiopathy and arthropathy in children.Arthritis Rheum 1982; 25: 1041.
Ansell BM, Wood PHN. Prognosis in juvenile chronic polyarthritis.Clin Rheum Dis 1976; 2: 397–412.
Hanson V. From Still's disease and JRA to JCPA, JCA and JA. Medical progress or biased ascertainment.J Rheumatol 1982; 9: 819–820.
Radha Madhavan, Chandrasekaran AN, Parthiban Met al. Spectrum of autoantibodies in systemic rheumatic diseases in a referral hospital in South India: I. Fluorescent antinuclear antibodies and nnti dsDNA antibodies.Journal of Indian Rheumatism Association 1994; 2: 127–132.
Chandrasekaran AN, Rajendran CP, Radha Madhavan. Spectrum of clinical and immunological features of systemic rheumatic diseases in a referral hospital in south India: juvenile rheumatoid arthritis.Journal of Indian Rheumatism Association 1994; 2: 117–123.
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Chandrasekaran, A.N., Rajendran, C.P. & Madhavan, R. Juvenile Rheumatoid Arthritis—Madras experience. Indian J Pediatr 63, 501–510 (1996). https://doi.org/10.1007/BF02905724
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DOI: https://doi.org/10.1007/BF02905724