Juvenile Rheumatoid Arthritis in Children with Ebstein-barr Virus Infection

ABSTRACT

OBJECTIVE: Juvenile rheumatoid arthritis (JRA) may occur in the wake of infection with several viruses including Ebstein-barr virus (EBV). EBV remains an interesting target. To determine the possible role of EBV infections in the clinical course of JRA, we attempt to demonstrate the radiologic changes and the frequency prescription of etanercept rather than classic therapy. METHODS: Total of 87 patients with JRA, who were hospitalized in Hangang Sacred Hospital and Kangnam Sacred Hospital in Seoul from 2002 to 2010, were assessed serologically for EBV infection (anti EBV VCA IgM and IgG) at admission. Patients with JRA were devided 2 groups, one is EBV VCA IgG (+) JRA patients who had been infected before and another is EBV VCA IgG (-) JRA patients who had not. RESULTS: EBV VCA IgG (+) were seen in 55 patients (63.2%). 31 boys (76%) and 24 girls (52%) were infected with EBV. The mean age of patients of EBV (+) JRA was 8.2+/-3.6 years and that of EBV (-) JRA was 5.3+/-3.4 years. 7 of EBV (+) JRA (13%) developed radiologic change within 2 years, compare with none of EBV (-) JRA. 22 of EBV (+) JRA (49%) with JRA did not respond to the classic therapy, compare with 7 of EBV (-) JRA (22%). CONCLUSION: JRA patients with past EBV infection were older in ages, more in male, more radiologic changes, needed more biologic treatment than those without past EBV infection.