Polyarticular Juvenile Rheumatoid Arthritis

Polyarticular juvenile rheumatoid arthritis is a type of juvenile RA in which more than four joints are affected. About 30% of JRA patients suffer from this type. The most commonly affected joints are the smaller ones, like that in hands and feet, as well as neck and jaw. However, it is not a rule and sometimes larger and weight-bearing joints may also be affected, like ankles, knees and hips. Joint inflammation starts within initial six months of illness. This is a rather dangerous type of JRA regarding number of joints affected and damage caused. An aggressive treatment is therefore necessary to control it as soon as possible.


Polyarticular JRA is generally symmetrical, i.e. same joints on both the sides of body are affected. Presence of rheumatoid factor is seen in some children having this type of JRA. Often the occurrence of this disease is more severe and according to doctors, it is same as adult rheumatoid arthritis. Children having this type of JRA are at greater risk of getting affected by chronic iridocyclitis or uveitis (eye inflammation). Therefore regular visits to an ophthalmologist are necessary. A doctor always sees to it that he or she can control the disease as soon as possible, because of its seriousness. This involves medicines that control inflammation. While administering stronger medicines it should be taken care of recognizing that they are essential for reducing symptoms and preventing further damage.


The treatment may involve non-steroidal anti-inflammatory drugs (NSAIDs) at least or stronger medicines in addition. Steroids like prednisone gives instant relief to the patient. However it causes severe problems in the long run, like short stature and feeble bones and so, should be discontinued on time. Some children may require second-line medicines, like methotrexate, gold shots or sulfasalazine, which and even steroids, are to be administered strictly under the supervision of a physician. Polyarticular Juvenile Rheumatoid Arthritis TNF-blockers is a new generation of medicines available now. TNF or tumor necrosis factor alpha which is produced by cells causes inflammation. TNF-blockers stop its production and thus reduce the symptoms of the disease like inflammation. One such TNF-blocker is Etanercept which is self-injectable which is to be injected in skin twice in a week and helps in reducing signs and symptoms of moderate to severe polyarticular JRA in patients who have shown adequate response to disease-modifying medications. One more self-injectable TNF-blocker is Adalimumab which reduces the activity of moderate to severe form of disease in children of 4 years or older. Another TNF-blocker is Infliximab which is to be administered intravenously. This is an antibody which stops the effects of TNF-alpha. It is administered every two months and is effective in reducing the activity of the disease and enhances quality of life. Polyarticular juvenile rheumatoid arthritis being more dangerous should be identified and treated on time, that too on emergency basis. Parents therefore need to observe their child carefully if the child shows any abnormality while walking or any other problem and ensure that he or she is not suffering from the disease. Unfortunately if the child suffers from the disease, they can start the treatment at once.