Juvenile rheumatoid arthritis: A follow-up of 75 cases

Abstract

75 consecutive cases of juvenile rheumatoid arthritis have been followed up at an average interval of 10 6 years after the onset of the disease. The distribution of the patients corresponds to that of other similar series with regard to age and sex as well as to clinical findings in the initial stages of the disease. On follow-up, 36% of the patients were symptomfree, 350% had slightly reduced joint function, 22% were incapacitated, and 7% had died. As no previous studies have been made of the acid content of the gastric secretion in juvenile rheumatoid arthritis, this was examined by means of the Azure-Aresin test (Diagnex-Blue) during the follow-up. According to this test, 4 out of the 31 patients examined had achlorhydria. The prognosis was poorest in cases with pronounced general symptoms during the initial stage. A rise in the sedimentation rate above 100 mm. within one year after the onset of the disease, together with febrile periods, signified a statistically significant worsening in the prognosis. The effect of various modes of therapy is discussed. No clear change in prognosis could be observed for the period following on the introduction of pituitary and adrenal hormone therapy.