National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Rheumatoid factor-negative juvenile idiopathic arthritis



Other Names:
Rheumatoid factor negative erosive chronic polyarthritis; Rheumatoid factor-negative polyarthritis; RF-ve CP; Rheumatoid factor negative erosive chronic polyarthritis; Rheumatoid factor-negative polyarthritis; RF-ve CP; Juvenile rheumatoid factor-negative polyarthritis; Rheumatoid factor-negative JIA; Polyarthritis without rheumatoid factor See More
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The following summary is from Orphanet, a European reference portal for information on rare diseases and orphan drugs.
orphanet

Orpha Number: 85408

Definition
Rheumatoid factor-negative polyarthritis is a term used to describe a group of poorly defined heterogenous conditions that incorporates forms of rheumatoid factor-negative polyarthritis and forms of oligoarticular arthritis that become extensive in less than 6 months after onset.

Epidemiology
Rheumatoid factor-negative polyarthritis represents around 15-20% of cases of juvenile idiopathic arthritis (JIA). Prevalence has been estimated at between 1 and 13 in 22,200 children, with an annual incidence of 1-26 in 700,000 children. Females are affected more often than males.

Clinical description
The joint manifestations are bilateral, nearly symmetrical and affect both the large and small joints. Biological signs of inflammatory disease are frequent. Rheumatoid factor tests are always negative but antinuclear antibodies may be present.

Etiology
The aetiology is difficult to determine as a result of the heterogeneity.

Diagnostic methods
The diagnostic criteria for the disease were established in 2001 at the last international meeting in Edmonton. Rheumatoid factor-negative polyarthritis is defined as the presence of arthritis affecting five or more joints at disease onset. Exclusion criteria are the presence of systemic arthritis or psoriasis in the patient, or a family history of psoriasis in one of the parents or a first-degree relative, HLA B27-positivity in males with onset of arthritis after 6 years of age, and detection of rheumatoid factor IgM in two test samples taken three months apart. Other exclusion criteria include: the presence of ankylosing spondylarthritis, enthesitis and arthritis, sacroiliitis with an inflammatory enteropathy or acute anterior uveitis in the patient, or a family history of one of these conditions in a parent or first-degree relative.

Differential diagnosis
The differential diagnosis should include other forms of polyarthritis (associated with inflammatory or haemato-oncologic diseases).

Management and treatment
Patients should be managed in a multidisciplinary manner, incorporating expertise in paediatric rheumatology, physiotherapy, psychologyand infantile orthopaedic care. Treatment is based on the association nonsteroidal anti-inflammatory agents (NSAIDS), disease-modifying antirheumatic drugs (methotrexate as a first-line treatment and tumour necrosis factor (TNF)-alpha as a second-line treatment) and rehabilitation. Corticotherapy is used at low doses and as rarely as possible. Intraarticular injection of delayed-action corticoids (triamcinolone hexacetonide) may be recommended in case of persistent arthritis.

Prognosis
The prognosis is difficult to determine due to the heterogeneity of the condition but it appears the percentage of remission is low.

Visit the Orphanet disease page for more resources.
Last updated: 1/1/2007

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms Other Names
Learn More:
HPO ID
80%-99% of people have these symptoms
Antinuclear antibody positivity 0003493
Apraxia 0002186
Arthralgia
Joint pain
0002829
Dental malocclusion
Bad bite
Malalignment of upper and lower dental arches
Misalignment of upper and lower dental arches
[ more ]
0000689
Elevated C-reactive protein level 0011227
Elevated erythrocyte sedimentation rate
High ESR
0003565
Joint dislocation
Joint dislocations
Recurrent joint dislocations
[ more ]
0001373
Joint swelling 0001386
Juvenile rheumatoid arthritis 0005681
Limitation of joint mobility
Decreased joint mobility
Decreased mobility of joints
Limited joint mobility
Limited joint motion
[ more ]
0001376
Polyarticular arthritis 0005764
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Last updated: 7/1/2020

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources


Living with a genetic or rare disease can impact the daily lives of patients and families. These resources can help families navigate various aspects of living with a rare disease.

Financial Resources

  • Patient Access Network Foundation (PAN Foundation) has Assistance Programs for those with health insurance who reside in the United States. The disease fund status can change over time, so you may need to check back if funds are not currently available. 

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

In-Depth Information

  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Rheumatoid factor-negative juvenile idiopathic arthritis. Click on the link to view a sample search on this topic.

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