Clinico-immunological profile in juvenile rheumatoid arthritis—an Indian experience

Abstract

From a Pediatric Rheumatology Clinic 361 children diagnosed as juvenile rheumatoid arthritis (JRA) according to American Rheumatism Association-JRA criteria were studied retrospectively for their clinico-immunological profile. The mean age of onset in systemic, pauciarticular and polyarticular onset, JRA subtypes were 5.2, 6.8 and 7.2 years respectively. There was male preponderance in systemic and pauciarticular JRA. In seropositive polyarticular JRA, girls outnumbered boys. The frequency of occurrence of systemic, pauciarticular and polyarticular disease was 87 (24%), 108 (30%) and 166 (46%) respectively. The systemic onset disease was dominated by extra-articular manifestations in terms of fever (100%), rash (57%), hepatomegaly (51%) and lymphadenopathy (25%). The pauci- and polyarticular illnesses were commonly dominated by joint involvement, morning stiffness, and in few patients, by extra-articular manifestations also. The joints were involved symmetrically. Most commonly involved joints in order of decreasing frequency were knee, ankle, wrist and elbow in all the subtypes. Anemia and leucocytosis were observed in majority with higher frequency in systemic onset JRA. The rheumatoid factor (RF) was present in 15% of polyarticular JRA. RF was also present in 7 and 9% of patients with pauciarticular and systemic subtypes respectively. The antinuclear antibody was positive in only 3 out of 66 patients in whom the test was carried out. The demographic profile and trends in clinical features were similar to the studies reported on caucasian population with difference in the actual frequency of various clinical features.

Prevalence of arthritis in India and Pakistan: a review

“…A study of juvenile rheumatoid arthritis by Seth et al [25] reveals that majority of the cases were of polyarticular type (46%). While systemic and pauciarticular types were 24 and 30%, respectively.…”

Ocular manifestations of juvenile rheumatoid arthritis in Olmsted County, Minnesota: a population-based study

“…Similarly, in a Taiwanese population the cumulative incidence of JRA-associated uveitis was reported to be 5.7% [25], while in a South Korean population it was reported to be 5.0%. Finally, in populations from the Indian subcontinent, the cumulative incidence of JRA-associated uveitis has been reported at between 1.3% and 3.3% [20,22].…”

Advances in the pathogenesis and treatment of systemic juvenile idiopathic arthritis

“…In contrast, s-JIA comprises a much higher proportion of cases of JIA in Asian epidemiologic studies: e.g., a Japanese study conducted in 1994 revealed that s-JIA accounted for 54% of JIA cases (5). Additionally, early reports indicated that s-JIA comprised 24% of JIA cases in India (6), but more recent studies put this number at only 8%, similar to the proportion in most other countries (7). According to a population study conducted in Norway, the incidence of s-JIA is ~0.6 per 100,000/y (4).…”