Types of juvenile idiopathic arthritis
International League of Associations for Rheumatology (ILAR) has proposed the following criteria which classifies JIA into 7 heterogeneous subgroups
- oligoarticular
- no more than four affected joints in the first six months of disease
- 27–56% of JIA cases
- F>M
- often antinuclear antibody (ANA) positive. Strong association with anterior uveitis
- polyarticular – RF negative
- more than four affected joints in the first six months of disease; RF negative
- 11–28% of JIA cases
- F>M
- often symmetric involvement of small, medium and large joints
- polyarticular – RF positive
- more than four affected joints in the first six months of disease; RF positive on two separate occasions
- 2–7% of JIA cases
- F>M
- closely related to rheumatoid arthritis with similar phenotypic and prognostic features; classically affects adolescent girls
- enthesitis-related arthritis
- arthritis, enthesitis – tends to involve axial and weight-bearing joints including SIJ
- 3–11% of JIA cases
- M>F
- the juvenile spondyloparthropathy, often HLA-B27 positive males
- psoriatic arthritis
- arthritis, psoriasis
- 2–11% of JIA cases
- F>M
- also associated with dactylitis and nail changes such as pitting, ridging, onycholysis
- systemic onset
- fever, rash, arthritis (‘Still’s disease’); may have hepatosplenomegaly, lymphadenopathy
- 4–17% of JIA cases
- F>M
- can develop life-threatening immune dysregulation known as macrophage activation syndrome
- undifferentiated
- arthritis that does not meet criteria for other JIA subtypes
- 11–21% of JIA cases
Reference:
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