Repost: Arthritis 101: Primer on JRA

[Guest guest]

Hi Teri,

For some reason I couldn't see this post ... until I hit the reply

button. Thanks for posting it. I've changed the subject title so it will

be easier to find when searching through the archives.

~Georgina

THep115@... wrote:

This is from Arthritis Today Magazine. Teri

>

> Arthritis 101

> Juvenile Rheumatoid Arthritis

> By Anne Dunkin

>

> Though often associated with aging, certain types of arthritis can actually

> occur as early as infancy. In children, the most common form is called

> juvenile rheumatoid arthritis (JRA), which, in some cases, is quite different

> from adult RA.

>

> Although the term JRA brings to mind a single disease similar to " adult "

> rheumatoid arthritis, it is actually an umbrella term for three forms of

> childhood arthritis (two of which have further subtypes), each with a

> different pattern and prognosis.

>

> Systemic Onset JRA (also called Still's disease)

>

> As the name suggests, systemic onset JRA affects many bodily systems. It

> often begins with a fever and chills that appear off and on for weeks and may

> be accompanied by a rash on the thighs and chest. In addition to inflamed

> joints, a child may experience enlargement of the spleen and lymph nodes;

> inflammation of the liver, heart and surrounding tissues; and anemia.

>

> Polyarticular JRA

>

> Meaning many joints, this type of JRA affects more than four joints. Joints

> most commonly affected are the small joints of the hands as well as the

> knees, ankles, hips and feet. Joint involvement is usually symmetrical,

> meaning if a joint on the left side is affected, its counterpart on the right

> side is affected as well.

>

> Polyarticular JRA has two subtypes. The first is characterized by the

> presence of rheumatoid factor, a type of autoantibody found in the blood of

> adults with RA, and the DR4 genetic type, also common in adults with RA. The

> pattern of this subtype resembles adult RA and has the potential to severely

> damage joints.The second subtype is characterized only by joint involvement.

> Children with this subtype do not have a positive rheumatoid factor and the

> arthritis is potentially less severe.

>

> Pauciarticular JRA

>

> Meaning few joints, pauciarticular JRA generally affects four or fewer joints

> in an asymmetrical fashion. (That is, if one elbow or knee is affected, the

> opposite elbow or knee isn't.) The joints most likely to be affected are the

> knees, elbows, wrist and ankles. Pauciarticular JRA has three subtypes.

>

> In the first subtype of pauciarticular JRA, children test positive for

> antinuclear antibodies and have a high risk of iridocyclitis, a potentially

> dangerous inflammation of the eye.

>

> In the second subtype, arthritis affects the spine as well as other joints,

> although spinal involvement may not occur until the child reaches his late

> teens. Children with this subtype may test positive for the HLA-B27 gene,

> which is common in adults with ankylosing spondylitis. In fact, some doctors

> refer to this subtype of JRA as juvenile ankylosing spondylitis.

>

> In the third subtype, joint involvement is the extent of the disease.

>

> What Causes JRA?

>

> The cause is not known; it's likely there are probably many causes, including

> genetics and environmental factors such as a virus or bacterium, that trigger

> the disease in children with a genetic predisposition.

>

> Who Gets It?

>

> JRA can occur in boys or girls of any age, but it most commonly begins during

> the toddler or early teenage years. Certain types and subtypes are more

> prevalent in boys than girls and vice versa. In general, it affects more

> girls than boys. Certain subtypes are more likely to occur in children of a

> particular age.

>

> How Is It Diagnosed?

>

> Diagnosing JRA involves a medical history, physical exam and possibly

> laboratory tests, including blood tests to measure inflammation and to detect

> antinuclear antibodies, rheumatoid factor or sometimes HLA-B27.

>

> How Is It Treated?

>

> In many ways, JRA is treated similarly to adult RA, although many drugs used

> to treat RA are not approved for children. Aspirin, in large doses, is

> generally the first line of defense in treating JRA. If the disease is

> progressive, your child's doctor may prescribe disease-modifying

> antirheumatic drugs, such as methotrexate, injectable gold or the new

> biologic agent etanercept (Enbrel), which was recently approved for treating

> JRA. Glucocorticoids, such as prednisone, are usually reserved for children

> with internal organ or eye inflammation because of the drugs' potential, at

> high doses, to stunt growth.

>

> How Common Is It?

>

> Juvenile rheumatoid arthritis affects an estimated 30,000 to 50,000 children

> in the United States. By type, 50 percent have pauciarticular JRA, 40 percent

> have polyarticular JRA and 10 percent have systemic onset JRA.

>

> Other Forms Of Childhood Arthritis

>

> Many forms of arthritis that affect adults occur less frequently in children.

> These include lupus, dermatomyositis and scleroderma.

>

> A Message from the Arthritis Foundation

>

> Juvenile arthritis awareness week is March 6-12. For more information contact

> your local Arthritis Foundation office. For a complimentary issue of the Kids

> Get Arthritis Too newsletter call 800/268-6942