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Shim, Kim, Lee, Lee, and Kim: Juvenile Rheumatoid Arthritis in Children with Ebstein-barr Virus Infection
Original Article
Journal of Rheumatic Diseases

Journal of Rheumatic Diseases 2012; 19(1): 19-24.

Published online: 28 February 2012

DOI: https://doi.org/10.4078/jrd.2012.19.1.19

Juvenile Rheumatoid Arthritis in Children with Ebstein-barr Virus Infection

Young-Seok Shim1, Joon-Sik Kim1, Kyung-Kyu Lee2, Kyu-Man Lee3, Kwang-Nam Kim1

1Department of Pediatrics, College of Medicine, Hallym University, Seoul, Korea.

2Department of Radiology, College of Medicine, Hallym University, Seoul, Korea.

3Department of Laboratory Medicine, College of Medicine, Hallym University, Seoul, Korea.

Corresponding author (rheumatol@korea.com)

Received 30 August 2011       Revised 21 September 2011       Accepted 4 October 2011

Copyright © 2012 Korean College of Rheumatology

Abstract

Objective

Juvenile rheumatoid arthritis (JRA) may occur in the wake of infection with several viruses including Ebstein-barr virus (EBV). EBV remains an interesting target. To determine the possible role of EBV infections in the clinical course of JRA, we attempt to demonstrate the radiologic changes and the frequency prescription of etanercept rather than classic therapy.

Methods

Total of 87 patients with JRA, who were hospitalized in Hangang Sacred Hospital and Kangnam Sacred Hospital in Seoul from 2002 to 2010, were assessed serologically for EBV infection (anti EBV VCA IgM and IgG) at admission. Patients with JRA were devided 2 groups, one is EBV VCA IgG (+) JRA patients who had been infected before and another is EBV VCA IgG (-) JRA patients who had not.

Results

EBV VCA IgG (+) were seen in 55 patients (63.2%). 31 boys (76%) and 24 girls (52%) were infected with EBV. The mean age of patients of EBV (+) JRA was 8.2±3.6 years and that of EBV (-) JRA was 5.3±3.4 years. 7 of EBV (+) JRA (13%) developed radiologic change within 2 years, compare with none of EBV (-) JRA. 22 of EBV (+) JRA (49%) with JRA did not respond to the classic therapy, compare with 7 of EBV (-) JRA (22%).

Conclusion

JRA patients with past EBV infection were older in ages, more in male, more radiologic changes, needed more biologic treatment than those without past EBV infection.

Keywords: Juvenile rheumatoid arthritis, Ebstein-Barr virus, Radiologic changes, Etanercept

Figures and Tables

Table 1
Characteristics of juvenile rheumatoid arthritis patients
jrd-19-19-i001

*in years.

Table 2
Comparision between EBV (+) and EBV (-) JRA patients
jrd-19-19-i002

RF: rheumatoid factor, ANA: anti-nuclear antibody. *in years.

Table 3
Comparision between EBV (+) and EBV (-) JRA patients by subtype
jrd-19-19-i003

RF: rheumatoid factor, ANA: anti-nuclear antibody. *in years.

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