Introduction to rheumatoid factor-positive polyarticular JIA

Onel, 2022Petty, 2004Ringold, 2019

Rheumatoid factor (RF)–positive polyarticular juvenile idiopathic arthritis (JIA) may affect both large and small joints, often in a symmetrical pattern. It most commonly occurs in older children and adolescents. It is phenotypically equivalent to RF-positive rheumatoid arthritis in adults, including in its potential for early progression to erosive disease, nodules and significant functional disability. Early and aggressive treatment with immunomodulatory drugs (eg biological disease-modifying antirheumatic drugs [bDMARDs]) is required to slow disease progression.

Rheumatoid factor–positive polyarticular JIA is less common than RF-negative polyarticular JIA; it generally is a more aggressive disease with a poorer prognosis, and drug-free remission is far less likely.

Note: Rheumatoid factor–positive polyarticular JIA is an aggressive disease that usually requires early intervention with immunomodulatory drugs.

Although children with RF-positive polyarticular JIA are at low risk of developing uveitis, regular slit-lamp screening examinations are still required (see JIA-associated uveitis for advice on screening interval and duration).