title: Juvenile idiopathic arthritis.
abstract: One of the most enigmatic problems in rheumatology has been juvenile idiopathic arthritis (JIA). Firstly, the classification has often depended on clinical features that have variations between patients. Secondly, there are different classification schemes in usage and there are few objective serologic tests that help to resolve the differences between the criteria sets. Thirdly, only recently have significant advances been made in understanding the immunology and immunopathology of JIA and, in particular, new treatment options. In this review, we will define the historical basis of JIA and emphasize not only the clinical features, but also the immunological characteristics, the pathogenesis, and treatment options. We will also discuss, in particular, quality of life, psychosocial functioning, socioeconomic outcomes and the difficult area of mortality. Finally, this review will attempt to bridge genetic observations with clinical presentation. JIA represents a relatively common syndrome of pediatric onset rheumatologic disease and a better understanding of the clinical definition, the relationship to autoimmunity, and novel treatments with biologic agents are critical for improved patient care.
authors.affiliation: Department of Nutrition, USA.
authors.forename: Andrea T
authors.initials: AT
authors.lastname: Borchers
authors.forename: Carlo
authors.initials: C
authors.lastname: Selmi
authors.forename: Gurtej
authors.initials: G
authors.lastname: Cheema
authors.forename: Carl L
authors.initials: CL
authors.lastname: Keen
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Shoenfeld
authors.forename: M Eric
authors.initials: ME
authors.lastname: Gershwin
mesh_terms: D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000974:Antibodies, Antinuclear / Q000276:immunology*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000276:immunology* / Q000473:pathology / Q000628:therapy*; D002648:Child; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D011788:Quality of Life
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000974:Antibodies, Antinuclear; D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D008727:Methotrexate