All issues > Volume 29(2); 1986

Original Article

J Korean Pediatr Soc. 1986;29(2):152-162. Published online February 28, 1986.

Clinical Observation on Juvenile Rheumatoid Arthritis.

Won Soon Park¹, Kwang Wook Ko²

¹Department of Pediatrics，College of Medicine，Seoul National University
²Seoul National University Children’s Hospital

Abstract

A clinical observation on 70 patients of juvenile rheumatoid arthritis who were admitted to S.N.U.H. during the 6 year period from Jan. 1979 to Dec. 1984, was assessed. The results were as follows; 1) On type classification, systemic type(37.2%) was most frequent, followed by RF negative polyarticular type, pauciarticular type H, RF positive polyarticular type and pauciarticular type I in order of frequency. The ratio of boys to girls was 1.2 : 1. In RF positive polyarticular type, girls were predominant, while in systemic type, pauciarticular type II, and RF negative polyarticular type, boys were more frequent. In pauciarticular type I， there was no sexual difference. 2) The range of age at onset was between 6 months and 15 years of age. The peak age at onset was between 10 and 12 years of age for the total group, between 4 and 6 years for girls and between 10 and 12 years for boy. 3) In seasonal incidence, there was no seasonal predilection. 4) The frequently involved joints .were knee(74.3%), ankle(51.4%), hand(42.9%) and wrist (40.0%) in order of frequency. Small joints of hand and foot were frequently involved in polyarticular and systemic type, but not involved in pauciarticular type. 5) Fever, rheumatoid rash, lymphadenopathy and hepatosplenomegaly were common extraarticular manifestations and were most prominent in systemic type. 6) In the active disease, anemia(57.1%), increased ESR(55.7%), CRP( + )(68.6%), leukocytosis (35. 7%), increased ferritin and thrombocytosis were observed and the above laboratory abnormalities were most prominent in systemic type. Increased ASO(47.1%), elevated liver enzyme(10.0%), RF(+)(12.9%), and ANA(+)(4.3%) were also observed. 7) Radiological changes were present in 36 cases(51.4%). The frequently observed findi- ngs were osteoporosis, soft tissue swelling, joint destruction and joint space widening. Abn- ormal bone scan was present in 58.3% of cases. 8) Patients were treated with salicylate only (41.4%), salicylate and steroid(25.8%) and other drugs(21.4%). Synovectomy was done in 3 patients and resurfacing arthroplasty was carried out in 4 patients. 9) On follow up, complete remission was achieved in 21.9% and severe functional disabilities were present in 15.7%, Death occurred in 1 patient (3.8%).

Keywords :Juvenile rheumatoid arthritis.