Pediatric emergency medicine trisk 2984 2984
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and/or associated with systemic manifestations, markers of inflammation are typically
elevated, notably acute phase reactants like ESR and CRP. Likewise, the CBC may be
deranged. Mild to moderate anemia may be seen in all subtypes, particularly the
systemic type, reflecting the inflammatory state. The white blood count is often
elevated, again most typically in the systemic type, in which leukemoid reactions may
be seen. Platelet counts are often elevated, indicating systemic inflammation.
Complement levels may be normal or elevated, but immunoglobulins are typically
increased, leading to a reversal of the albumin to globulin ratio. In polyarticular JIA,
one subgroup shows RF in the serum, which is associated with a more severe, erosive
arthritis. While no other pediatric rheumatologic disease is associated with this marker,
it is important to note that the RF may be present nonspecifically in healthy children as
well. The absence of RF does not rule out JIA, and its presence does not necessarily
point to a diagnosis of JIA.
