Juvenile idiopathic arthritis

• Published in: The Lancet (British edition) 2007-03, Vol.369 (9563), p.767-778
• Main Authors: Ravelli, Angelo, Dr, Martini, Alberto, Prof
• Format: Article
• Language: English
• Subjects: Adolescent; Adults; Age; Anemia; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Antirheumatic agents; Arthritis; Arthritis, Juvenile - classification; Arthritis, Juvenile - diagnosis; Arthritis, Juvenile - genetics; Arthritis, Juvenile - immunology; Arthritis, Juvenile - therapy; Biological and medical sciences; Bone density; Child; Child development; Child, Preschool; Children & youth; Chronic Disease; Chronic illnesses; Classification; Diagnosis, Differential; Disease control; Disease Progression; Diseases of the osteoarticular system; Drug development; Drugs; Environmental factors; Female; Fever; General aspects; Heterogeneity; HLA Antigens - genetics; Humans; Immune response; Immune system; Immunosuppressive agents; Infant; Inflammation; Inflammation - immunology; Inflammatory joint diseases; Injections, Intra-Articular; Internal Medicine; Joint surgery; Laboratories; Male; Medical sciences; Molecular chains; Pathogenesis; Patients; Physical Therapy Modalities; Prognosis; Psoriasis; Rheumatic diseases; Rheumatoid arthritis; Rheumatology; Risk factors; Steroids - administration & dosage; Treatment Outcome
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(07)60363-8

Summary Juvenile idiopathic arthritis is a broad term that describes a clinically heterogeneous group of arthritides of unknown cause, which begin before 16 years of age. This term encompasses several disease categories, each of which has distinct methods of presentation, clinical signs, and symptoms, and, in some cases, genetic background. The cause of disease is still poorly understood but seems to be related to both genetic and environmental factors, which result in the heterogeneity of the illness. Although none of the available drugs has a curative potential, prognosis has greatly improved as a result of substantial progresses in disease management. The most important new development has been the introduction of drugs such as anticytokine agents, which constitute a valuable treatment option for patients who are resistant to conventional antirheumatic agents. Further insights into the disease pathogenesis and treatment will be provided by the continuous advances in understanding of the mechanisms connected to the immune response and inflammatory process, and by the development of new drugs that are able to inhibit selectively single molecules or pathways.