With a systemic version of juvenile rheumatoid arthritis in 40-50% of children is a favorable prognosis, there may come a remission lasting from several months to several years. However, the exacerbation of the disease can develop years after a persistent remission. In one-third of patients, the recurring course of the disease is continuously observed. The most unfavorable prognosis in children with persistent fever, thrombocytosis, prolonged therapy with corticosteroids. In 50% of patients, severe destructive arthritis develops, 20% have amyloidosis in adulthood, and 65% have severe functional insufficiency.
All children with an early debut of polyarticular seronegative juvenile arthritis have an unfavorable prognosis. In adolescents with seropositive polyarthritis, there is a high risk of developing severe destructive arthritis, disability according to the condition of the musculoskeletal system.
In 40% of patients with oligoarthritis with an early onset, destructive symmetrical polyarthritis is formed. In patients with late onset, the disease can be transformed into ankylosing spondylitis. 15% of patients with uveitis may develop blindness.
An increase in the level of C-reactive protein, IgA, IgM, IgG is a reliable sign of an unfavorable prognosis of the development of joint destruction and secondary amyloidosis.
Mortality in juvenile arthritis is low. Most of the deaths are associated with the development of amyloidosis or infectious complications in patients with a systemic version of juvenile rheumatoid arthritis, often resulting from prolonged glucocorticoid therapy. In secondary amyloidosis, the prognosis is determined by the possibility and success of the treatment of the underlying disease.