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Juvenile idiopathic arthritis.

Authors
  • Borchers, Andrea T
  • Selmi, Carlo
  • Cheema, Gurtej
  • Keen, Carl L
  • Shoenfeld, Yehuda
  • Gershwin, M Eric
Type
Published Article
Journal
Autoimmunity Reviews
Publisher
Elsevier
Publication Date
Apr 01, 2006
Volume
5
Issue
4
Pages
279–298
Identifiers
PMID: 16697970
Source
Medline
License
Unknown

Abstract

One of the most enigmatic problems in rheumatology has been juvenile idiopathic arthritis (JIA). Firstly, the classification has often depended on clinical features that have variations between patients. Secondly, there are different classification schemes in usage and there are few objective serologic tests that help to resolve the differences between the criteria sets. Thirdly, only recently have significant advances been made in understanding the immunology and immunopathology of JIA and, in particular, new treatment options. In this review, we will define the historical basis of JIA and emphasize not only the clinical features, but also the immunological characteristics, the pathogenesis, and treatment options. We will also discuss, in particular, quality of life, psychosocial functioning, socioeconomic outcomes and the difficult area of mortality. Finally, this review will attempt to bridge genetic observations with clinical presentation. JIA represents a relatively common syndrome of pediatric onset rheumatologic disease and a better understanding of the clinical definition, the relationship to autoimmunity, and novel treatments with biologic agents are critical for improved patient care.

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