Goldman J A, Beard M R, Casey H L
South Med J. 1980 May;73(5):555-63. doi: 10.1097/00007611-198005000-00005.
Acute febrile juvenile rheumatoid arthritis (JRA) of adult onset is often diagnosed by ruling out other problems. The classification of JRA is primarily based on the distinct type of onset, of which there are usually three: (1) acute febrile or Still's type, (2) polyarticular, and (3) monoarticular pauciarticular arthritis. Fever of unknown cause is frequently the initial symptom. This type of arthritis may be characterized by any or all of the following: unexplained high fever, rash, weight loss, lymphadenopathy, splenomegaly, pericarditis, pleurisy, pneumonitis, abdominal pain, myalgias, arthralgias, arthritis, sore throat, leukocytosis, anemia, circulating immune complexes, liver test abnormalities, and carpal-metacarpal and tarsal-metatarsal fusion. Patients often respond dramatically to anti-inflammatory agents. Corticosteroids, gold salts, penicillamine, and cytotoxic drugs have been effective for certain patients. The prognosis of the disease has been generally favorable. Although symptoms may recur, remission can be prolonged.
成人起病的急性发热性幼年类风湿性关节炎（JRA）通常通过排除其他问题来诊断。JRA的分类主要基于不同的起病类型，通常有三种：（1）急性发热型或斯提尔病型，（2）多关节型，以及（3）单关节少关节型关节炎。不明原因发热常为初始症状。这种类型的关节炎可能具有以下任何一种或全部特征：无法解释的高热、皮疹、体重减轻、淋巴结病、脾肿大、心包炎、胸膜炎、肺炎、腹痛、肌痛、关节痛、关节炎、喉咙痛、白细胞增多、贫血、循环免疫复合物、肝功能检查异常以及腕掌关节和跗跖关节融合。患者通常对抗炎药反应显著。皮质类固醇、金盐、青霉胺和细胞毒性药物对某些患者有效。该疾病的预后总体良好。尽管症状可能复发，但缓解期可延长。
