[Juvenile rheumatoid arthritis: review and update]

Abstract

Major current clinical, laboratory, and etiopathogenic aspects of juvenile rheumatoid arthritis (JRA) are focused by this article. The authors make a comparison of data of their patients to those described in the literature. A retrospective clinicolaboratory study was performed of 130 patients with JRA followed in the Pediatric Rheumatology Department of the Division of Allergy, Rheumatology, and Clinical Immunology of the Service of Pediatrics of Escola Paulista de Medicina from 1982 to 1989. These patients (73 female and 57 male) were analyzed for the type and age of onset, clinical manifestations (articular and extraarticular), laboratory data, and prognosis. The findings of the authors are similar to those reported, with the exception of eye involvement (chronic iridocyclitis) and of the presence of the IgM rheumatoid factor (RF) and the antinuclear antibody (ANA), which were lower than those described by other authors. With respect to prognosis, the authors verified the greatest number of remissions (40%) with the pauciarticular type, whereas the polyarticular type presented the lowest number of remissions (27%). The two deaths occurred in the series were of children with the systemic type of the disease. Although etiology and the mechanism responsible for its release are not yet known, therefore, not allowing a definite type of treatment, experience gathered throughout the years has made it possible for physicians who attend to these patients not only to make an early diagnosis but also to resort to more efficient means of control.