Abstract
A total of 433 children, hospitalized in the Rheumatic Children's Hospital Garmisch-Partenkirchen, were followed on average for 15 years (range 10–22 years) after the onset of definite juvenile chronic arthritis. This paper reveals clearly that the different subgroups of chronic rheumatic disease in childhood with their different complications have a definite relationship to prognosis.
Severe limitation with inability to attend normal school or employment occurred in 13.4% of children with systemic polyarticular arthritis (Still's syndrome) and 11.4% of the non-systemic cases, but not in the pauci-articular group. In the latter group 82.5% of the children remained without disability or with only slight impairment: this is significantly better than in the systemic or non-systemic polyarticular groups. Although the high incidence of chronic rheumatic iridocyclitis is common in children with pauci-articular arthritis, none of this group had been handicapped by severe eye complications or blindness, in contrast to several early cases with systemic or non-systemic polyarthritis. This might be due to regular eye checks in the pauci-articular group.
Of the children in the systemic polyarticular group 10% were dwarfed. Mortality in the systemic group was 13.8%, in contrast to 1% in the non-systemic polyarticular and 0% in the pauci-articular arthritis group. Secondary amyloidosis was the most important cause of death, mainly in systemic cases. Of the children whose amyloidosis had been verified, 44% died in their second or third decades, mostly with uraemia.
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References
Ansell M, Wood Phil HN (1979) Prognosis in juv. chron. polyarthritis. Clinic in Rheumatic Diseases, vol 2. W. B. Saunders Comp. Ltd. London Philadelphia Toronto, p 397–425
The care of rheumatic children (1977) Eular Publishers, Basle No. 3, Monograph Series (Munthe E, ed.)
Steinbrocker O, Traeger CH, Battermann RC (1949) Therapeutic criteria in rheumatoid arthritis. I.A.M.A. 140:659
Stoeber E (1977) Juvenile chronic polyarthritis and Still's syndrome. Documenta Geigy, Folia rheumatologica. Ciba-Geigy Ltd. Basle
Kölle G (1971) Rheumadiagnostik im Kindesalter. Diagnostik 4:7
Kölle G (1975) Die juvenile rheumatoide Arthritis (juvenile chronische Polyarthritis) und das Still-Syndrom. G. Braun, Karlsruhe
Butenandt O (1979) Rheumatoid arthritis and growth retardation in children: Treatment with human growth hormone. Europ J Pediatr 130:15
Müller G (1942) Über die chronischen, nicht rheumatischen Polyartritiden im Kindesalter. Inaug.-Dissertation Ludwig-Maximilians-Universität München
Roström G, Gedda PO (1957) Clinic and prognosis of rheumatoid arthritis in children. Act Rheum Scand 3:129
Rostropowicz-Denisiewicz K, Matdyk E (1977) Amyoloidosis. In: Eular bull. No. 3, Eular Publishers Basel
Schnitzer TJ, Ansell BM (1977) Anlyoloidosis in juvenile chronic polyarthritis. Arthritis and Rheumatism 20:Suppl 2, 245
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The nomenclature used in this paper follows the recommendations of the symposium ‘The care of rheumatic children’, held in Oslo in 1977 [2]. These have been generally accepted in the international field of paediatric rheumatology. The general term ‘juvenile chronic arthritis’ corresponds to ‘juvenile rheumatoid arthritis’ and includes several subgroups such as: juvenile chronic poly-, mono-, pauci-oligoarthritis (less than five joints involved), with or without IgM rheumatoid factor and with non-systemic or systemic onset (Still's syndrome)
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Stoeber, E. Prognosis in juvenile chronic arthritis. Eur J Pediatr 135, 225–228 (1981). https://doi.org/10.1007/BF00442095
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DOI: https://doi.org/10.1007/BF00442095