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Arthritis Rheumatol. 2018 Jan;70(1):7-17. doi: 10.1002/art.40350. Epub 2017 Dec 1.

Review: Genetics and the Classification of Arthritis in Adults and Children.

Author information

1
Brigham and Women's Hospital and Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
2
Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, and Broad Institute of MIT and Harvard, Cambridge, Massachusetts.
3
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Abstract

Current classification of primary inflammatory arthritis begins from the assumption that adults and children are different. No form of juvenile idiopathic arthritis bears the same name as an adult arthritis, a nomenclature gap with implications for both clinical care and research. Recent genetic data have raised questions regarding this adult/pediatric divide, revealing instead broad patterns that span the age spectrum. Combining these genetic patterns with demographic and clinical data, we propose that inflammatory arthritis can be segregated into 4 main clusters, largely irrespective of pediatric or adult onset: seropositive, seronegative (likely including a distinct group that usually begins in early childhood), spondyloarthritis, and systemic. Each of these broad clusters is internally heterogeneous, highlighting the need for further study to resolve etiologically discrete entities. Eliminating divisions based on arbitrary age cutoffs will enhance opportunities for collaboration between adult and pediatric rheumatologists, thereby helping to promote the understanding and treatment of arthritis.

PMID:
29024575
PMCID:
PMC5805142
DOI:
10.1002/art.40350
[Indexed for MEDLINE]
Free PMC Article

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