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What are the three types of juvenile rheumatoid arthritis (JRA)?

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  • Pauciarticular juvenle rheumatoid artritis (JRA)
  • Polyarticular JRA
  • Systemic JRA

Pauciarticular (paw-see-are-tick-you-lar) means that four or fewer joints are involved. This is the most common form of JRA; about half of all children with JRA have this type. It typically affects large joints, such as the knees. Girls under age 8 are most likely to develop this type of JRA. Some children with pauciarticular JRA have abnormal proteins in the blood called antinuclear antibodies (ANAs).

Eye disease affects from 20% to 30% of children with pauciarticular JRA and is more common in children with abnormal ANAs. Regular preventive exams by an ophthalmologist (a doctor specializing in eye diseases) are necessary to treat serious eye problems such as iritis (inflammation of the iris or colored part of the eye) or uveitis (inflammation of the inner eye, or uvea). Many children with pauciarticular disease outgrow arthritis by adulthood, although eye problems can continue and joint symptoms may recur in some people.

About 30% of all children with JRA have polyarticular disease, in which five or more joints are affected. The small joints, such as those in the hands and feet, are most commonly involved, but the disease may also affect large joints. Polyarticular JRA often is symmetrical - it affects the same joints on both sides of the body. Some children with polyarticular disease have a special kind of antibody in their blood called rheumatoid factor. These children often have a more severe form of the disease, which doctors consider to be similar to adult rheumatoid arthritis.

Along with joint swelling, the systemic form of JRA is characterized by fever and a light pink rash, and may also affect internal organs such as the heart, liver, spleen, and lymph nodes. The systemic form, sometimes called Still's disease, affects 20% of children with JRA. Almost all children with this type of JRA test negative for both rheumatoid factor and ANA. A small percentage of these children develop arthritis in many joints and can have severe arthritis that continues into adulthood.

SOURCE: 

National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Reviewed by David Zelman on January 30, 2019

SOURCE: 

National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Reviewed by David Zelman on January 30, 2019

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What are some differences between juvenile rheumatoid arthritis (JRA) and adult arthritis?

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