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Severe aortic regurgitation in RF positive polyarticular JIA
  1. I E M Bultink1,
  2. W F Lems1,
  3. B A C Dijkmans1,
  4. R M van Soesbergen1,
  5. J Lindeman2
  1. 1Department of Rheumatology, Slotervaart Hospital, Amsterdam, Jan van Breemen Institute, Amsterdam, and Vrije Universiteit Medical Centre, Amsterdam, The Netherlands
  2. 2Department of Pathology, Slotervaart Hospital, Amsterdam, The Netherlands
  1. Correspondence to:
    Dr I E M Bultink, Department of Rheumatology, Slotervaart Hospital, Louwesweg 6 1066 EC, Amsterdam, The Netherlands;
    iem_bultink{at}hotmail.com

https://doi.org/10.1136/ard.61.3.282

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    An 18 year old girl of Moroccan origin with a clear medical history was transferred to the Netherlands in February 1989 because of a two year history of untreated polyarthritis. The disease had pursued a rapidly destructive course, resulting in contractures and ankylosis of hips, knees, shoulders, and elbows and small joint deformation. A diagnosis of juvenile idiopathic arthritis (JIA) polyarticular type, functional class IV was made. No nodules were present. Laboratory analysis at that time showed borderline positive serum rheumatoid factor (RF) 30 IE/ml. Tests for antinuclear antibodies and HLA-B27 were negative. Treatment was started with intensive physiotherapy and intramuscular gold, the latter being replaced by sulfasalazine because of proteinuria. In 1990 she was treated for a unilateral uveitis. In 1992 her right elbow was replaced. Until 1993 cardiac examination showed no murmurs and chest roentgenogram was …

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