Table 1

Similarities and differences between RA and JRA/JIA

Feature
RA
JRA/JIA

Classification criteria
Single disease with different manifestations
Phenotypically and genetically distinct subtypes
Gender
Females > males
Females > males except in systemic arthritis
Age of onset
Puberty plus; peak 4th to 5th decade
Polyarticular: throughout childhood; peak 1-3 years of age


Pauciarticular: early childhood; peak 1-2 years of age


Systemic: throughout childhood; no peak
Extended multiplex families
Present
Very rare
Family history of other autoimmune disorders
Present
Present
Typical ocular involvement
Keratoconjunctivitis sicca
Chronic anterior uveitis
Prevalence
10/1000
0.86/1000
Ethnic distribution
Reported in all populations
EOPA is rare in non-Caucasians
HLA association
HLA DRB1*0401, 0404, 0101 in Caucasians
EOPA: HLA-A2, -DR5, -DR8, -DPB1*0201. (HLA-DR4 is protective)


Late pauciarticular: HLA-B27


Polyarticular: HLA-DR1, -DR4
Shared epitope
Defined; amino acid positions 67-74 of third hypervariable region
Not described
Growth/developmental issues
Rare
Common
Pathophysiology
Th1-mediated disease
Th1-mediated disease (Pauciarticular: Also Th2-mediated)
Autoantibodies
IgM RF common
IgM RF rare
Natural history
Majority have long-term disability
Fewer than half have long-term disability

EOPA, early-onset pauciarticular arthritis; HLA, human leukocyte antigen; JIA, juvenile idiopathic arthritis; JRA, juvenile rheumatoid arthritis; RA, rheumatoid arthritis; RF, rheumatoid factor; Th, T helper.

Prahalad and Glass Arthritis Res 2002 4(Suppl 3):303   doi:10.1186/ar594