Author(s): Viswanathakumar H M, Kumar G V
Juvenile idiopathic arthritis (JIA) also called juvenile rheumatoid arthritis (JRA) is characterized by chronic synovitis of peripheral joints manifesting as soft tissue swelling and effusion. The incidence and prevalence vary among ethnic and geographically different population. The overall prevalence of JIA is estimated to be from 0.07 to 4.1 per 1000 children, with an incidence of 0.008 to 0.226 cases of JIA per 1000 children. It differs from adult rheumatoid arthritis because RF-factor usually absent and antinuclear antibody seropositivity is common. In children there is a 2:1 female predominance. The present study was carried out over a period of 4 years. All consecutive patients who fulfilled the American College of Rheumatology (ACR) criteria of JRA were enrolled in the study. Out of 112 children 46 (41%) were male and 66 (59%) were female children. Out of these children 10 (8.93%) had systemic onset, 62 children (55.36%) had poly-articular on set and 40 children (35.71%) had pauci-articular onset JIA. Predominant clinical features of systemic onset JIA was fever (100%), joint pain and swelling (100%), lymhadenopathy (70%), hepatomegaly (60%), spleenomegaly (40%), cardiac involvement (40%) and skin rashes was found in one case (10%). Polyarticular JIA sub-type is the commonest type in this hospital based study, followed by pauciarticular JIA. Recognition of these different subtypes is useful in the diagnosis and long-term management of these patients. Treatment according to the sub-types and induction of newer therapeutic agents in the management of JIA will prevent morbidity.