Juvenile arthritis often goes undiagnosed
Many children with juvenile arthritis suffer from joint pain and stiffness, loss of motion in joints, rash, fever and weight loss. "But some affected children seem healthy and don't complain of pain," Bohnsack says. "Laboratory tests to make the diagnosis do not exist, and the condition often goes unrecognized." Parents and providers who aren't familiar with juvenile arthritis may mistake symptoms for normal growing pains or other disorders.
It has a genetic component
Studies at the University of Utah indicate that siblings and first cousins of children with juvenile arthritis have an increased risk of developing it. Environmental factors may also be a factor, but no specific influences have been identified.
Juvenile arthritis can affect organs
About 10% to 20% of children with the most common form of arthritis develop uveitis, an inflammation of the eyes that can lead to visual impairment if not detected and treated early, explains Bohnsack. Another rare form of arthritis, systemic onset juvenile arthritis, can cause inflammation in the lining of the heart and lungs. The liver and blood cells can also be affected. It's vital to recognize and treat these issues promptly.
Treatment includes exercise
"We encourage our patients with juvenile arthritis to be active," Bohnsack says. The goal of therapy is to restore the child to a healthy state— exercise helps strengthen muscles and improves joint range. Treatment has advanced considerably in the last 30 years, and many affected children can live symptom-free, although this may require medical treatment.
The prognosis is improving
"The improvement in care over the years is striking due to the advances in recognition and treatment of the disease," notes Bohnsack, who has been treating patients with juvenile arthritis for 30 years.
The Intermountain Registry of Childhood Rheumatic Diseases at University of Utah Health was established 15 years ago to study the genetic and environmental influences that lead to juvenile arthritis, to examine treatment outcomes and to determine the long-term effects of this condition.
"We participate in treatment trials and international networks that study the safety and efficacy of medications that treat juvenile arthritis. We are currently studying two new forms of treatment, and there are many more on the horizon," Bohnsack adds. The future looks bright.