Pattern of Juvenile Rheumatoid Arthritis seen in 91 patients, presenting to an urban rheumatology clinic in Pakistan

ABSTRACT

To determine various types of Juvenile rheumatoid arthritis [JRA] seen in patients visiting our rheumatology clinic. A retrospective review of case records of 91 patients ages who satisfied American College of Rheumatology [ACR] criteria for Juvenile rheumatoid arthritis was done. These patients visited rheumatology clinic from April 2002 to Jun 2004. Total patients were 91. Females were 49[54%] and males were 42[46%]. There was an overall female predominance except for pauciarticular type where males were more than females 24[60%] vs. 16[40%] p value<0.05. Mean age of onset was 10.7 yrs +/- 04. Polyarticular sub-type was the commonest pattern seen in 51.6% of cases while 44% of the patients had pauciarticular disease. Systemic JRA was seen in 4.4%. Rheumatoid factor was positive in 48.4% cases with Polyarticular disease and in this sub-group of seropositive polyarticular patients 88% were females. Pattern of JRA in this case series was quite diff erent in comparison to data generated from western countries. Mean age of onset was much higher than quoted in literature. Polyarticular sub-type was the commonest pattern seen in our patients, where as pauciarticular is more prevalent in the west. Rheumatoid factor was positive in 48% of the patients with polyarticular disease in contrast to 5-10% seen in western data. As sero positive polyarticular JRA is associated with more aggressive disease and disability so these patients have to be identified earlier and need aggressive treatment with disease modifying agents