Clinical Observations On Juvenile Rheumatoid Arthritis: I. Systemic Type / 대한류마티스학회지

ABSTRACT

OBJECTIVE: To investigate the cl'mical manifestations and laboratory findings observed from the patients with systemic juvenile rheumatoid arthritis. METHODS: Twenty three patients with systemic JRA who were diagnosed and treated at the Department of Pediatrics, Seoul National University Children's Hospital from 1988 to 1993 were investigated for their clinical manifestations and laboratory findings. RESULTS: 1) Boys were affected more prevalently than girls, as a ratio of 21. 2) Sixty seven percent of patients were 3 to 6 years old at onset. 3) The clinical manifestations observed were high fever(100%), rash(78%), arthritis(96%), lymphadenopathy(45%), hepatomegaly(41%), splenomegaly(30%), pericarditis(22%), pleuritis(22%), peritonitis(13%) and myalgia(100%). Arthritis occurred with the onset of systemic manifestations in 82% of patients and occurred 8 month later 3 cases in but in one case arthritis proceeded the systemic manifestations for 5 months. The arthritis mainly involved the large joints, knees(68%), ankles(59%), wrists(50%), elbows(32%) and shoulders(23%) and also involved small joints, fingers, (27%) and toes(5%). The number of joints involved was four or fewer in 50% of patients and 5 or more in 50% of patients. The patterns of joint involvement were symmetric(77%) or asymmetric(23%). 4) The main laboratory findings observed were anemia(61%), leukocytosis(91%), thrombocytosis(65%), increased ESR(100%), positive CRP(100%), positive RF(13%) and positive ANA(9%), homogenous or speckled type. One patients gave the transient proteinuria. The histology of lymph nodes showed the follicular hyperplasia of interfollicular plasmocytosis, indicating the nonspecific reactive hyperplasia. The bone marrow showed granulocytosis, monocytosis or toxic granules. CONCLUSION: These data showed the clinical manifestations and laboratory findings of systemic juvenile rheumatoid arthritis in the Korean patients.