Nutritional Status in Children with Juvenile Rheumatoid Arthritis!!!

Juvenile rheumatoid arthritis (JRA) also known as juvenile idiopathic arthritis is a type of arthritis that happens in children age 16 or younger. The most common symptoms are persistent joint swelling, pain, and stiffness that is typically worse in the morning or after a nap. The pain may limit movement of the affected joint, although many children, especially younger ones, will not complain of pain. JRA commonly affects the knees and the joints in the hands and feet. One of the earliest signs of JRA may be limping in the morning because of an affected knee. Typically, there are periods when the symptoms of JRA are better or disappear (remissions) and times when symptoms “flare,” or get worse. JRA is different in each child; some may have just one or two flares and never have symptoms again, while others experience many flares or even have symptoms that never go away.

The main goals of treatment are to preserve a high level of physical and social functioning and maintain a good quality of life. To achieve these goals, doctors recommend treatments to reduce swelling, maintain full movement in the affected joints, relieve pain, and prevent, identify, and treat complications. Most children with JRA need a combination of medication and physical therapy to reach these goals.

The purpose of a recent study was to evaluate clinical characteristics and nutritional status of children with juvenile rheumatoid arthritis. The study included 53 children with JRA and 75 healthy, age-matched children to serve as the control group. Researchers recorded disease subtype, body mass index (BMI), white blood cell count, platelet count, C-reactive protein and erythrocyte sedimentation rate in all of the participants. It was found that the BMI level of the JRA group was significantly lower than the control group, especially in males and when the patient was over 4 years of age. It was also discovered that the children with oligoarticular onset JRA (arthritis affecting 4 or fewer joints in the first 6 months of illness) had significantly lower BMI when compared with the control group. The researchers also found that markers for inflammation, which included white blood cell count, platelet count, C-reactive protein and erythrocyte sedimentation rate, were elevated in the group with JRA. These results suggest that nutritional status appears to be impaired in children with JRA.1

1 Shin ST, Yu HH, Wang LC, et al. Nutritional Status and Clinical Characteristics in Children With Juvenile Rheumatoid Arthritis. J Microbiol Immunol Infect. 2010;43(2):93-98.