What is the role of inflammatory markers in the diagnosis of juvenile idiopathic arthritis (JIA)?

Updated: Jul 25, 2019
  • Author: David D Sherry, MD; Chief Editor: Lawrence K Jung, MD  more...
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Answer

The erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) level is usually elevated in children with systemic-onset JIA (with a disproportionate increase in the CRP) and may be elevated in those with polyarticular disease; however, it is often within the reference range in those with oligoarticular disease. When elevated, inflammatory markers can be used to monitor disease activity.

Other markers of inflammation include thrombocytosis, leukocytosis, complement, and, in a reverse fashion, albumin and hemoglobin.

In a study that examined whether the risk of JIA relapse can be identified by biomarkers in the absence of clinical signs of disease activity, Gerss et al found that 35 of 188 patients with JIA experienced a flare within 6 months. [22] Myeloid-related proteins 8/14 (MRP8/14) and S100A12 levels were significantly higher in subjects who developed flares than in those with stable remission. The best single biomarker for predicting flare was S100A12. Predictive performance of this biomarker may be improved by combining it with high-sensitivity C-reactive protein (CRP).


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