Juvenile idiopathic arthritis (JIA) is a broad spectrum of disease defined by the presence of arthritis of unknown etiology, lasting more than six weeks duration, and occurring in children less than 16 years of age. JIA encompasses several disease categories, each with distinct clinical manifestations, laboratory findings, genetic backgrounds, and pathogenesis. JIA is classified into seven subtypes by the International League of Associations for Rheumatology: systemic, oligoarticular, polyarticular with and without rheumatoid factor, enthesitis-related arthritis, psoriatic arthritis, and undifferentiated arthritis. Diagnosis of the precise subtype is an important requirement for management and research. JIA is a common chronic rheumatic disease in children and is an important cause of acute and chronic disability. Arthritis or arthritis-like symptoms may be present in many other conditions. Therefore, it is important to consider differential diagnoses for JIA that include infections, other connective tissue diseases, and malignancies. Leukemia and septic arthritis are the most important diseases that can be mistaken for JIA. The aim of this review is to provide a summary of the subtypes and differential diagnoses of JIA.
Arthritis ; Arthritis, Infectious ; Arthritis, Juvenile* ; Arthritis, Psoriatic ; Child ; Connective Tissue Diseases ; Diagnosis ; Diagnosis, Differential* ; Genetic Background ; Humans ; Leukemia ; Rheumatic Diseases ; Rheumatoid Factor ; Rheumatology

No abstract available.
Arthritis, Juvenile* ; Rheumatoid Factor*

No abstract available.
Arthritis, Juvenile Rheumatoid ; Herpesvirus 4, Human

Recently, gout prevalence is increasing, but in Vietnam the knowledge of gout is not enough. Objectives: (1) Describe clinical X-ray manifestations of bone and joint damage related to chronic gout. (2) Identify suggestive factors to make diagnosis of bone and joint damage related to chronic gout. Methods: The cross-study included 54 patients with chronic gout presented in the Rheumatology Department of Bach Mai Hospital from March-2003 to June-2004. All of them were diagnosed gout according to the criteria of Bennett and Wood-1968 and had tophi nodules. Results: The common findings are polyarthritis (79.6%), lower limbs are involved more common than upper limbs (75-80% of patients had ankle, knee, first metatarsophalangeal joint arthritis) and symmetric arthritis (60% to 70%). All patients had a history of acute gout. 80% of patients had chronic gout presented in X-ray images, including joint space narrowing, erosion, new bone formation at the edge of a gradually expanding tophus. Important factors can be considered of chronic gout were male, middle age, symmetric arthritis of lower limbs, tophi nodules. Conclusions: Suggestive factors and X-ray of bone and join contribute to earlier diagnosis of bone and joint damage in chronic gout.
Gout ; Arthritis ; Juvenile Rheumatoid ; Bone and Bones

Arthritis, Juvenile/complications* ; Humans ; Rheumatoid Nodule

Juvenile idiopathic arthritis (JIA) is a chronic inflammation of joints in pediatric patients. Assessment of JIA disease activity is very difficult, because children cannot definitely describe their pain by themselves due to development of cognitive function during the pediatric period. Assessment of JIA disease activity is useful for quantitative measurement of patient status, monitoring therapeutic response, and disease course over time. This article reviewed objective assessment tool for JIA disease activity and described differences in assessment between adult rheumatoid arthritis and JIA.
Adult ; Arthritis, Juvenile* ; Arthritis, Rheumatoid ; Child ; Humans ; Inflammation ; Joints

Secondary amyloidosis is one of the most serious complications in chronic inflammatory diseases such as rheumatoid arthritis. The extracellular deposit of aggregates of amyloid leads to target organ dysfunction. The mainstay treatment of secondary amyloidosis is the control of underlying disease activity. Many reports have reported that TNF-alpha inhibitors improve clinical outcomes. Here, we encountered a 34-year-old patient with juvenile rheumatoid arthritis who developed secondary amyloidosis despite treatment with TNF-alpha inhibitors. We present this case and include a review of the literature.
Adult ; Amyloid ; Amyloidosis ; Arthritis, Juvenile Rheumatoid ; Arthritis, Rheumatoid ; Humans ; Tumor Necrosis Factor-alpha

Juvenile rheumatoid arthritis (JRA) is basically the same disease as rheumatoid arhritis in the adult. However juvenile rheumatoid arthritis has many features that differ from rheumatoid arthritis in the adult, and since the onset of the disease occurs before the age of puberty, variable alterations in growth may occur. In this study, fifty cases of juvenile rheumatoid arthritis treated at Severance Hospital from January 1970 to December 1977 were analysed clinically and the following results were obtained. 1. By classification, the polyarticular type (46%) was most frequent, followed by the pauciarticular type (34%) and systemic type (20%) in order. 2. The most frequent joint affected was the knee (82%) followed by the ankle (60%), hand (22%), wrist (20%), etc. 3. The extra-articular manifestations on admission were high fever (40%), rash (16%), carditis (14%), lymphadenopathy (14%), etc. 4. Laboratory findings on admission showed increased ESR (88%), positive rheumatoid factor (15.5%), positive ANA (16.6%), etc. 5. Clinical symptoms were managed medically and surgically with aspirin, salicylates and steroids, physical therapy, and synovectomy.
Adolescent ; Arthritis, Juvenile Rheumatoid/classification ; Arthritis, Juvenile Rheumatoid/epidemiology* ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Human ; Korea ; Male

Introduction. Studies have shown that tocilizumab (TCZ) is effective in the treatment of rheumatoid arthritis. This study examined the efficacy and safety of TCZ in Filipino patients with moderate to severe rheumatoid arthritis (RA). Methods. This was an open-label, one-arm clinical trial approved by the Philippine Council Health Research Development-National Ethics Committee (PCHRD-NEC), among moderate-severe active RA Filipino patients in 4 RA clinics. The study consisted of a 28-day screening-baseline period; a 24-week treatment period, with once every-4-weeks TCZ 8mg/kg intravenous infusion (IV) and an efficacy-safety evaluation. Patients already receiving methotrexate (MTX) at study entry went on with MTX plus TCZ per medical discretion. Descriptive statistics computed for physician's and patient's global assessment of disease activity, patient's global assessment of pain, ACR20, ACR50 and ACR70. Analysis of variance (ANOVA) determined significant changes over time for DAS-28 ESR, FACIT and HAQ-DI fatigue scores. Twenty-nine of thirty patients were included in efficacy and safety analysis. Results. After 24 weeks of TCZ: 86%, 66%, and 48% of 29 Filipino RA patients achieved ACR20, ACR50, ACR70, respectively, with 34% achieving remission according to DAS28-ESR. Median times to first achieving ACR20, ACR50 and ACR70 were 4, 12, and 24 weeks, respectively. There were also significant rapid reductions in physician's and patient's global assessment of disease activity, patient's global assessment of pain, HAQ-DI and FACIT scores noted over time. Tolerability profile was similar to published literature on TCZ. Conclusions. TCZ has been shown to be effective in the treatment of Filipino patients with moderate to severe rheumatoid arthritis. TCZ can be given in an out-patient RA clinic setting.
Human ; Male ; Female ; TOCILIZUMAB ; ARTHRITIS, RHEUMATOID ; MUSCULOSKELETAL DISEASES ; JOINT DISEASES ; ARTHRITIS ; THERAPEUTICS ; THERAPY ; TREATMENT OUTCOME ;

Chronic arthritis, the most common chronic rheumatic disease of childhood, is one of the most frequent chronic illness of children and an important cause of short and long term disability. It is not a single disease, but a group of related, genetically heterogeneous, phenotypically diverse immunoinflammatory disorders that affect the joints and other structures, possibly activated by contact with external antigens. Since its introduction in 1994, the term Juvenile Idiopathic Arthritis (JIA) has largely supplanted the terms Juvenile Chronic Arthritis and Juvenile Rheumatoid Arthritis. However, it is necessary to understand the older classifications in order to interpret the literature on the subject. Each subtype of JIA is to provide a general introduction.
Arthritis ; Arthritis, Juvenile Rheumatoid ; Child ; Chronic Disease ; Humans ; Joints ; Rheumatic Diseases