> 17% of new docs leave SA

> People live longer than ever

> Exercise for weight-loss?

> Your doctor never told you...

> A glass or two a day...

> Breast cancer overtreated?

> Swine flu cases rise to 47

> Sperm from stem cells?

> Are you going hard enough?

> New flu virus found

Today, 24 November 2009

› 'They tried to kill me'

› Exam leak source found?

› Henry left devastated

› Batting for Hersch

› McBride still eyes return

Yesterday, 23 November 2009

› 'Malema must apologise'

› 'They tried to kill me'

› Boks are thugs - Ireland

› Malema attack 'racist'

› YCLSA: Malema a racist

Question

My three-year-old son has had rheumatoid arthritis for the past 16 months. He recently developed iridocyclitis in association with this. Will the iridocyclitis resolve as the disease burns itself out? What are the long-term effects of juvenile rheumatoid arthritis?

Answer

Iridocyclitis is an inflammation of the anterior part of the eye and can be very serious, resulting in raised pressure in the eye with subsequent blindness if it is not treated appropriately. Since your son is being treated, there should be no long term problems. The eye problems associated with rheumatoid arthritis are as a result of the general inflammation associated with the illness, and so usually also settle as the inflammatory response settles.

Juvenile rheumatoid arthritis is similar to the adult form. It can be divided into three types, each with a different clinical onset. The systemic form, called Still's Disease, accounts for about 20 percent of those with the illness and starts with a high fever, rash, enlarged spleen, enlarged glands and characteristic blood changes. Rheumatoid factor is usually absent.

The pauciarticular form, affecting about 40 percent of patients, have antinuclear antibodies in their blood and a high incidence of chronic iridocyclitis. This is generally not symptomatic and is detected using slit-lamp examination. There is a subgroup of boys with this form of the illness who have the HLA-B27 antigen which is associated with the so-called seronegative arthropathies, which they may develop later in life.

The remaining 40 percent have a polyarticular onset often similar to adult rheumatoid arthritis.

In general the outlook for juvenile rheumatoid arthritis is better than that of the adult form and complete remission can occur in 75 percent of patients.

The long term effects in your son's case will depend on the particular type of juvenile rheumatoid arthritis which he has. If you are not happy with the specialist who is dealing with your son, try and find someone who is more communicative, or ask your GP to contact him or her so that you can get more information that way.