10 - Arthritis of Childhood Onset

Abstract

SUMMARY In conclusion, immunogenetic studies in childhood onset arthritis have proven valuable in defining subtypes of ‘juvenile rheumatoid arthritis’ or ‘juvenile chronic polyarthritis’; HLA-B27 is associated with pauciarticular arthritis in older onset boys who have many hallmarks of early ankylosing spondylitis. This association of HLA-B27 with a particular subgroup of children with chronic arthritis points out the value of considering patients and their types of diseases with care so that findings of basic medical science can be accurately applied to clinical medicine. This assocation would have been lost had all children with chronic arthritis been lumped together as having the same disease. There is preliminary evidence that some HLA-D antigens and B lymphocyte specificities may be associated with certain JRA subgroups; further studies are warranted in this regard. Childhood onset ankylosing spondylitis, Reiter's disease, spondylitis of bowel disease, and reactive arthritis are associated with HLA-B27 in children as they are in adults.