Juvenile Idiopathic Arthritis - Research Paper Example

Epidemiology The incidence of this condition in the United States is 4-14 per 100,000 children of less than 16 years of age, per year (Rabinovich, 2010). The prevalence rates are estimated to be 9-113 cases, per 100,000 population in general (Rabinovich, 2010). Internationally, it has been found that this condition is more prevalent among certain populations like Native Americans (Rabinovich, 2010). Etiology More often than not, the cause of this condition is idiopathic and most researchers are of the opinion that the disease occurs due to interaction of multiple factors, the environmental, genetic and infectious factors (Ringold et al, 2005).

The gene which has been implicated for this condition is IL2RA/CD25 gene. Another gene which has been implicated is VTCN1 gene (Rabinovich, 2010). Pathophysiology The pathogenesis is not well understood. Most of the experts opine that an external trigger, in the form of trauma or infection triggers autoimmune reaction and this leads to synovial hypertrophy and inflammation of the synovium. The inflammation extends further and affects other organs too (Rabinovich, 2010). . The onset is either abrupt or insidious.

other symptoms include limping, gastrointestinal symptoms, redness of eye, fever, photophobia, orthopnea, weight loss, systemic illness and shortness of breath (Ringold et al, 2005). Children with this condition usually have history of school absences. They are unlikely to participate in physical education classes. In many children, a triggering factor, either in the form of infection or in the form of trauma may be noted. History of travel to regions endemic for ticks can point to a diagnosis of Lyme's disease.

In some children anemia may be present. Illness in home pets is significant and can point to the diagnosis of reactive arthritis (Rabinovich, 2010). Physical examination may reveal arthritis, macular rash, hepatosplenomegaly, lymphadenopathy, muscle tenderness, serositis and pericardial rub (Rabinovich, 2010). Types There are mainly 5 types of juvenile idiopathic arthritis which have been described. These are based on the number of joints involved within 6 months of presentation and associated involvement of other organs in the body (Ringold et al, 2005).

They are: 1. Oligoarthritis: This is the most common type of juvenile idiopathic arthritis and accounts for more than 50 percent of the cases. It involves less than 5 joints. Uveitis is commonly associated with this type (Ringold et al, 2005). 2. Polyarthritis: More than 5 joints are involved in this type (Ringold et al, 2005). 3. Systemic arthritis: Systemic involvement is predominant in this type and presents as fever, generalised rash and inflammation of various other organs along with arthritis.

10- 20 percent cases of juvenile idiopathic arthritis present with systemic involvement (Ringold et al, 2005). 4. Enthesitis-related