Antinuclear antibodies and juvenile chronic arthritis (JCA): search for a specific autoantibody associated with JCA

Article Abstract:

Many of the rheumatic diseases have an autoimmune basis, in which the body inappropriately makes antibodies against its own tissues. Some of these autoantibodies are antinuclear antibodies, directed against molecular structures that are normally, but not exclusively, found in the cell nucleus. These antinuclear antibodies are present in most children with juvenile chronic arthritis (JCA). Their presence correlates with the development of chronic anterior uveitis (inflammation of the iris and adjacent structures in the eye). Because JCA is probably due to more than one cause, a single type of antinuclear antibody is not likely to be present in all children with the disease. Studies about antinuclear antibodies in JCA and juvenile rheumatoid arthritis are reviewed in this article. Antibodies against histones (structural proteins in the nucleus) have been found in about half of JCA patients, but correlation of these with uveitis varies greatly among studies. Antihistone antibodies have also been found in children with another rheumatic disease, and so the relevance of the antibodies to the disease process of JCA, or in its diagnosis, is unclear. Current laboratory techniques used to analyze autoantibodies may need to be refined before the antibodies can be better understood. Although JCA infrequently occurs in more than one family member, families of JCA patients often have a higher frequency of autoimmune diseases and increased blood levels of autoantibodies. Thus, any genetic cause of JCA is likely to be indirect. Grouping of JCA patients by type of autoantibody rather than type of tissue involvement may provide information on the variability of disease course. Studies of autoantibodies may implicate specific infectious agents, allowing treatment focused toward antibiotic treatment, immunization, or removal of immune system molecules or cells involved in the disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Physiological aspects, editorial, Antinuclear antibodies

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Recent developments in the understanding of paediatric musculoskeletal pain syndromes

Article Abstract:

Some children may suffer from different types of chronic musculoskeletal pain syndromes. Musculoskeletal pain syndromes are characterized by pain that has no known cause. The incidence of these types of syndromes may be more common than previously thought by rheumatologists and pediatricians. There are two categories of musculoskeletal pain syndromes: localized idiopathic pain syndromes and diffuse idiopathic pain syndromes. Localized idiopathic pain syndromes are usually characterized by the inability to use a limb because of pain. These types of syndromes occur most often in young teenage girls. Children with diffuse idiopathic pain syndromes usually have generalized aches and pains. They also tire easily and are in poor physical condition. Some children may have episodes of both localized and diffuse idiopathic pain syndromes.

Causes of, Pediatric diseases, Children, Diseases, Fibromyalgia, Intractable pain

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Classifying childhood arthritis

Article Abstract:

The proposed new classification system for childhood arthritis has advantages and disadvantages. The ILAR/WHO task force has developed a new classification system for arthritic syndromes of unknown cause in childhood. Advantages include separating clinically distinguishable syndromes as discrete diseases, increased flexibility, adding the category oextended oligoarthritis, o which will cover patients who move from oligoarthritis to polyarthritis, and specifying a six-week period of persistent arthritis before diagnosis. Disadvantages include the subjective nature of the classifying criteria, using the sixteenth birthday as the dividing line, inconsistencies within criteria, and excluding arthritic syndromes of known cause.

Demographic aspects, Identification and classification, Arthritis

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