Follow-up study of 100 cases of juvenile rheumatoid arthritis.

Goel, K M; Shanks, Robert A.

doi:10.1136/ard.33.1.25

Cited by 43 publications

(15 citation statements)

References 28 publications

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“…Localized growth disturbances in JCA recognized by many researchers include micrognathia, brachydactylia, small feet, premature and delayed epiphyseal development, increase in epiphyseal size, overgrowth and shortening of the bones especially the metacarps [10, 11, 12]. The degree and frequency of localized growth disturbances in JCA patients is difficult to assess from the available literature due to a significant variation in the reported findings.…”

Section: Introductionmentioning

confidence: 72%

“…Although the fraction of adults with a history of JCA and reduced height appears to be declining over the last decades [2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12], probably due to generally improved health status in the population and introduction of new improved JCA treatment regimens, clinicians are on a daily basis confronted with the challenge of treating children with retarded linear growth. Final height will therefore always remain an important disease outcome parameter in JCA.…”

Section: Introductionmentioning

confidence: 99%

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Final Height, Armspan, Subischial Leg Length and Body Proportions in Juvenile Chronic Arthritis

Žák

Müller²,

Pedersen³

1999

Horm Res Paediatr

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Objective: Assessment of growth disturbances in adults with a history of juvenile chronic arthritis (JCA). Material and Methods: Sixty-five subjects, 52 premenopausal females and 13 males with a mean age (range) of 32.2 years (22.3–49.4) participated. Mean age at disease onset was 5.7 years (0.8–15.8) and mean disease duration was 12.4 years (0.4–32). The follow-up time ranged from 18.7 to 46.9 years with a mean of 26.4 years. For each participant standard deviation scores (z-scores) for final height, delta-height (the difference between observed and expected height), armspan, subischial leg length and sitting height ratio, were calculated. Results: The study group as a whole did not exhibit linear growth impairment. The categorical distribution of heights differed significantly from a expected distribution in a healthy population (p < 0.001). A height z-score < –2 SD was present in 10.7% of the study group, of whom all had polyarticular course of JCA. Polyarticular and systemic course of JCA (versus pauciarticular) (p = 0.022), systemic steroid treatment (p = 0.006) and Steinbrocker functional class II–IV (vs. I) in 1979 (p = 0.043) were variables associated with reduced delta-height. In linear regression analyses, disease severity defining variables were statistically significant predictors of reduced final height and armspan. 27% of the study subjects had significantly reduced arm span (p < 0.001). Subischial leg length and body proportions (sitting height ratio) were normal. Conclusion: Our findings suggest that functionally impaired polyarticular and systemic JCA patients treated with systemic steroids may be at an increased risk of developing reduced final height and armspan. Disease control achieved by an aggressive therapeutic approach, if possible with a minimal use of systemic steroids, may reduce growth impairment in JCA.

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Section: Introductionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Final Height, Armspan, Subischial Leg Length and Body Proportions in Juvenile Chronic Arthritis

Žák

Müller²,

Pedersen³

1999

Horm Res Paediatr

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“…Although multiple studies have attempted to address the prognosis of children with JRA, these have been limited by uncontrolled designs, potential referral bias, and suboptimal measures of functional status (1,(3)(4)(5)(6)(7)(8)(9)(10)(11)19,20). One controlled study demonstrated significant psychosocial impairment among children with severe rheumatic disease compared with age-matched controls (21).…”

Section: Discussionmentioning

confidence: 99%

“…The suggestion that JRA is frequently a benign condition, however, has been questioned recently (2). Previous studies addressing the prognosis of children who have had JRA have been referral-based, uncontrolled series with limited followup into adulthood (1,(3)(4)(5)(6)(7)(8)(9)(10)(11). To date, there have been no population-based, controlled studies examining the long-term functional and socioeconomic outcomes in children with JRA who have been followed up into adulthood.…”

mentioning

confidence: 99%

Psychosocial outcomes and health status of adults who have had juvenile rheumatoid arthritis. A controlled, population‐based study

Peterson

Mason

Nelson

et al. 1997

Arthritis & Rheumatism

156

102

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Objective. The goal of this study was to evaluate the physical and psychosocial impact of juvenile rheumatoid arthritis (JRA) among a population‐based cohort of adults who had the disease during childhood, compared with a control cohort of subjects with no history of JRA. Methods. The Rochester Epidemiology Project database was used to identify all cases of JRA (based on the American College of Rheumatology [formerly, the American Rheumatism Association] 1977 criteria) among Rochester, Minnesota residents first diagnosed between January 1, 1960 and December 31, 1993. Controls were age‐ and sex‐matched to the cases as of the date of diagnosis of JRA. A pretested postal survey was mailed to all adult cases (whose date of birth was before December 31, 1975) and matched controls from the same population, to obtain information on socioeconomic issues and functional status (using the Health Assessment Questionnaire and the Health Status Questionnaire). The complete medical records of all cases and controls were reviewed to obtain information on demographics and clinical manifestations of JRA. Results. Of the 50 eligible cases, 44 (88%) responded to the survey. There were 102 age‐ and sexmatched controls (2–3 per case) who responded to the survey. Seventy‐three percent of the cases had pauciarticular‐onset JRA, 16% had polyarticular‐onset JRA, and 11% had systemic‐onset JRA. Average followup was 24.7 years and 24.5 years after the index date for cases and controls, respectively. Greater disability (P = 0.0002), more bodily pain (P = 0.0002), increased fatigue (P = 0.0112), poorer health perception (P = 0.0004), and decreased physical functioning (P = 0.0002) were reported by the cases compared with the controls. JRA cases reported significantly lower rates of employment (P = 0.015) and lower levels of exercise (P = 0.0002) than did controls. Level of educational achievement, annual income, health insurance status, and rate of pregnancy and childbirth were similar for both cases and controls. Conclusion. Adults who have had JRA during childhood experience long‐term physical and psychosocial impairment.

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“…Other studies place the incidence as high as 21% [14, 57, 58], with 67–89% of the patients having bilateral involvement [59, 60]. The prevalence of uveitis in JIA is reported to be between 9.3 and 14% [16, 61, 62].…”

Section: Epidemiology Of Uveitismentioning

confidence: 99%

Uveitis: A Potentially Blinding Disease

Durrani¹,

Meads

Murray³

2004

Ophthalmologica

262

170

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Uveitis (intraocular inflammation) is a potentially blinding group of, probably autoimmune, conditions predominantly occurring in the working age group. Although the aetiology is unknown in most cases, many patients have an associated underlying systemic disease. Central vision loss, in the form of cystoid macular oedema, is the commonest type of visual impairment. Although historical incidence and prevalence data exists, little is known about the degree of vision loss experienced, and the social and financial consequences of having temporary or permanent visual impairment in this age group. The literature is also full of uncontrolled studies and case reports of different modalities of drug therapy for uveitis. This article attempts to raise the awareness of uveitis as an important sight-threatening group of conditions by highlighting the paucity of evidence-based data on epidemiological, quality of life, socioeconomic, and therapeutic aspects.

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Follow-up study of 100 cases of juvenile rheumatoid arthritis.

Cited by 43 publications

References 28 publications

Final Height, Armspan, Subischial Leg Length and Body Proportions in Juvenile Chronic Arthritis

Final Height, Armspan, Subischial Leg Length and Body Proportions in Juvenile Chronic Arthritis

Psychosocial outcomes and health status of adults who have had juvenile rheumatoid arthritis. A controlled, population‐based study

Uveitis: A Potentially Blinding Disease

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