Juvenile rheumatoid arthritis prognosis

Juvenile rheumatoid arthritis prognosis

A diagnosis of juvenile rheumatoid arthritis (also called juvenile idiopathic arthritis) can be confusing and concerning. It can be difficult to determine what this diagnosis means and find detailed information about the likely progression of the condition over time. If you are after some clear answers about the prognosis for children with juvenile rheumatoid arthritis, this article outlines what the latest research can tell us about juvenile rheumatoid arthritis prognosis amongst children with the condition.

This webpage is not a complete overview of the juvenile arthritis condition. If you are interested in a full explanation of the condition, symptoms, diagnosis methods and treatment here is an overview of juvenile arthritis. If you want to read about prognosis, then read on.

Juvenile arthritis is generally not a life threatening condition

To start this discussion it is worth highlighting that juvenile arthritis is not considered a life threatening condition. There are some preliminary data indicating that children with juvenile may have a higher risk of death as an adult.1 2 The research indicates that juvenile arthritis condition itself did not cause death amongst the adults in these studies. Instead, it is believed that children who are susceptible to juvenile arthritis are also susceptible to other autoimmune conditions as an adult.1 2

It is worth noting that these investigations are not necessarily conclusive across the population. It is also worth highlighting that the risk of death remains low amongst people who did have juvenile arthritis. Although the risk of death remained low, it was higher than one might expect for a general population of a similar age. Ongoing improvement in treatments for adult autoimmune conditions may reduce this risk of complications in the future.  

Prognosis for juvenile rheumatoid arthritis?

There is no certainty when it comes to the prognosis for children with juvenile rheumatoid arthritis. Some health conditions have well defined clinical pathways that make the progression of the disease easy to predict. This is not the case for juvenile arthritis. However, research and clinical reports have indicated some symptom patterns are associated with disease severity and prognosis. Here is a list of factors believed to be associated with a poorer prognosis:

1. Early hip or wrist symptoms.

2. Presence of rheumatoid factor (on lab tests).

3. Severe symptoms that do not respond well to treatment

4. Systemic involvement that does not respond well to treatment

Possible complications

1. Slower bone growth.

2. Uneven limb growth, particularly when disease symptoms are not symmetrical.

3. Wearing away of the joint structures in the most severely affected joints.

4. Chronic pain.

5. Decreased vision (when the eyes suffer from uveitis associated with juvenile arthritis).

6. Anemia

7. Pericarditis (swelling around the heart)

8. Loss of educational opportunity associated with poor school attendance

Avoiding complications

Modern treatments for juvenile rheumatoid arthritis have the potential to reduce symptoms and even reduce the severity of the disease. It is important to have a good ongoing relationship with appropriate health professionals to minimize the risk of developing unwanted complications. The increased use of disease-modifying anti rheumatic drugs may result in less severe complications amongst current sufferers than has been observed historically. Non-pharmaceutical treatments such as physical therapies are also progressing as researchers continue to refine treatment approaches.

Summary

With appropriate treatment, many juvenile rheumatoid arthritis suffers go on to lead full and productive lives. A substantial proportion of children are likely go into complete remission. A minority of patients do not experience remission and develop ongoing arthritic symptoms in multiple joints into adult hood. Ongoing improvements in treatment and the introduction of disease-modifying anti rheumatic drugs make it difficult to quantify the proportion of current suffers who will not experience remission. It is likely that severe symptoms, affecting multiple joints, or systemic disease that does not respond well to treatment indicates an increased likelihood of a poorer prognosis. 

Comments 2 comments

Jenna 5 years ago

At last some clear information that is useful to me. Thanks.


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Mickmc 5 years ago Author

Thanks for stopping by Jenna. Yes, I think its sometimes hard to find clear information because prognosis is often uncertain. I'm pleased this page was useful to you.

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    References

    1. French AR, Mason T, Nelson AM, O'Fallon WM, Gabriel SE. Increased mortality in adults with a history of juvenile rheumatoid arthritis: a population-based study. Arthritis Rheum 2001;44(3):523-7.

    2. Thomas E, Symmons DP, Brewster DH, Black RJ, Macfarlane GJ. National study of cause-specific mortality in rheumatoid arthritis, juvenile chronic arthritis, and other rheumatic conditions: a 20 year followup study. J Rheumatol 2003;30(5):958-65.

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