The etiology and pathogenesis of juvenile rheumatoid arthritis remains unknown; however, research using new techniques is revealing information on the roles of immunogenetics, cellular immunity, and humoral immunity in these disorders. Interest continues in infection as a potential trigger of juvenile rheumatoid arthritis, as reactivity to infectious agents in synovial lymphocytes is sought. Reactivity to heat-shock proteins suggests a pathogenetic role for this class of proteins as well. Careful analysis of outcome in children with systemic-onset juvenile rheumatoid arthritis has identified clinical features that may predict later clinical course; in related work, investigators have not been able to identify such features to predict the outcome of children with pauciarticular juvenile rheumatoid arthritis. Juvenile rheumatoid arthritis has a broad impact on the lives of patients and their families, and appropriate assessment and management of such problems as chronic pain, vocational readiness, and family financing have been addressed over the past year.





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