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Juvenile arthritis is a chronic inflammatory disease that affects the joints, causing swelling, inflammation, pain, and tenderness
Juvenile arthritis (JA) has a high mortality rate and life expectancy for people with the condition may be reduced by as much as 10 years.
JA is a chronic inflammatory disease that affects about 300,000 children in the United States under the age of 16 and is usually diagnosed at age 11. JA affects the joints, causing swelling, inflammation, pain, and tenderness. In some cases, symptoms can progress with age and become debilitating.
What causes high mortality rates in juvenile arthritis?
Although juvenile arthritis (JA) does not directly lead to death, individuals with JA are often more prone to substance abuse and drug overdose due to chronic pain.
JA is often self-limiting, and about 60% of individuals reach adulthood with no active synovitis (inflammation of the joint cavity) or functional restriction. However, many patients experience side effects such as joint deformity and destruction, growth anomalies, retardation, osteoporosis, poor psychological health and problems with daily functioning.
Disease progression is variable. Exacerbations are distinguished by the reappearance of synovitis in previously affected joints and an increase in the number of joints implicated. Continued active arthritis into adulthood increases the degree of functional restriction and joint deterioration.
Generalized growth failure is observed in JA as a result of persistent severe illness exacerbated by corticosteroid therapy. Active illness can induce early epiphyseal closure and low height, as well as micrognathia (small jaw) and shortening of the fingers, hands, forearms, toes, or feet. Localized overgrowth can develop at the knee, causing a leg length mismatch.
What co-occurring diseases increase mortality in systemic juvenile arthritis?
Systemic juvenile arthritis is a type of juvenile rheumatoid arthritis (JRA) that affects the internal organs. The most common co-occurring illnesses in patients with JRA include:
- Heart diseases: According to studies, children with JRA are at a higher risk of cardiovascular mortality, ischemic heart disease, and heart failure than healthy individuals. This is attributed to inflammation in cardiac tissue and an increase in plaque in blood arteries, which can block blood flow.
- Lung diseases: Lung issues (involvement of the connective tissue in the lung) are linked to high morbidity and death in children with JRA. Approximately 33% of children with JRA have impaired lung function.
- Skin: Scaly red rash (psoriatic), light speckled pink rash (systemic), butterfly-shaped rash over the bridge of the nose and cheekbones (lupus), or thick, firm patches of skin are all possible skin symptoms (scleroderma).
- Eyes: JRA leads to uveitis, which is chronic eye inflammation that causes dryness, discomfort, redness, sensitivity to light, and vision problems.
- Cancer: Studies have shown that patients with JRA are more likely to develop specific cancers, such as lung cancer and lymphoma. The evidence implies that the link between cancer and JRA is due to inflammation and common risk factors.
How to improve life expectancy with juvenile arthritis
There is no definitive cure for juvenile arthritis (JA), but medications can help patients go into remission. Remission occurs when JA symptoms subside, and the child begins to feel better.
Treatment with disease-modifying antirheumatic medications, immunosuppressants, disease-modifying antirheumatic drugs, and biologics can improve quality of life and life expectancy.
The objective of JA treatment is to alleviate pain while also improving symptoms. An effective treatment plan, monitored by a rheumatologist, can help prevent or manage issues as they arise.
