title: Juvenile rheumatoid arthritis.
abstract: OBJECTIVE
  To determine the spectrum of clinical presentation, laboratory parameters and drug therapy in patients with Juvenile Rheumatoid Arthritis (JRA).
  
  
  METHODS
  Case series.
  
  
  METHODS
  The Children's Hospital and The Institute of Child Health, Lahore, from October 2008 to October 2011.
  
  
  METHODS
  All patients who fulfilled the American College of Rheumatology criteria for JRA were enrolled. Their clinical features, investigations done and treatment received for JRA were noted. Statistical analysis of data was done on SPSS version 16.0 for obtaining descriptive statistics.
  
  
  RESULTS
  Out of 185 patients, 50.3% (n = 93) were females; 54% (n = 100) were between 10 - 15 years of age. Polyarthritis was found in 71.9% (n = 133) followed by oligoarthritis (22.7%, n = 42) and systemic onset disease (5.4%, n = 10). Morning stiffness (78%) and fever (68%) were the most common clinical presentations. All patients with systemic onset disease had fever (n = 10) followed by skin rash, hepatosplenomegaly and lymphadenopathy. Uveitis was found in 2 patients, and both belonged to the oligoarticular group. Rheumatoid factor was found in 10.27% (n = 19) of all patients. All patients were given non-steroidal anti-inflammatory drugs (NSAIDs). Disease modifying agents (methotrexate) were given to 43.8% (n = 81). Steroids were used in 61% (n = 113) of patients either with NSAIDs alone or NSAIDs plus methotrexate.
  
  
  CONCLUSIONS
  Disease profile of JRA at the study centre showed that polyarthritis is the commonest type. Recognition of subtypes will help in planning the management of these patients.
authors.affiliation: Department of Paediatric Medicine , The Children's Hospital and The Institute of Child Health, Lahore. naz_arfi@hotmail.com
authors.forename: Samia
authors.initials: S
authors.lastname: Naz
authors.forename: Asma
authors.initials: A
authors.lastname: Mushtaq
authors.forename: Saira
authors.initials: S
authors.lastname: Rehman
authors.forename: Attia
authors.initials: A
authors.lastname: Bari
authors.forename: Amnah
authors.initials: A
authors.lastname: Maqsud
authors.forename: Muhammad Zeeshan
authors.initials: MZ
authors.lastname: Khan
authors.forename: Tahir Masood
authors.initials: TM
authors.lastname: Ahmad
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D017668:Age of Onset; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000175:diagnosis / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D012217:Rheumatoid Factor; D017678:Sex Distribution; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007166:Immunosuppressive Agents; D012217:Rheumatoid Factor; D008727:Methotrexate