A total of 433 children, hospitalized in the Rheumatic Children's Hospital Garmisch-Partenkirchen, were followed on average for 15 years (range 10-22 years) after the onset of definite juvenile chronic arthritis. This paper reveals clearly that the different * Presented at the Plenary Session on juvenile chronic arthritis, IX European Congress of Rheumatology in Wiesbaden FRG, September 1979 ** The nomenclature used in this paper follows the recommendations of the symposium 'The care of rheumatic children ', held in Oslo in 1977 [2]. These have been generally accepted in the international field of paediatric rheumatology. The general term 'juvenile chronic arthritis' corresponds to 'juvenile rheumatoid arthritis' and includes several subgroups such as: juvenile chronic poly-, mono-, pauci-oligoarthritis (less than five joints involved), with or without IgM rheumatoid factor and with non-systemic or systemic onset (Still's syndrome) subgroups of chronic rheumatic disease in childhood with their different complications have a definite relationship to prognosis.
Severe limitation with inability to attend normal school or employment occurred in 13.4% of children with systemic polyarticular arthritis (Still's syndrome) and 11.4% of the non-systemic cases, but not in the pauci-articular group. In the latter group 82.5% of the children remained without disability or with only slight impairment: this is significantly better than in the systemic or non-systemic polyarticular groups. Although the high incidence of chronic rheumatic iridocyclitis is common in children with pauci-articular arthritis, none of this group had been handicapped by severe eye complications or blindness, in contrast to several early cases with systemic or non-systemic polyarthritis. This might be due to regular eye checks in the pauci-articular group.
Of the children in the systemic polyarticular group 10% were dwarfed. Mortality in the systemic group was 13.8%, in contrast to 1% in the non-systemic polyarticular and 0% in the pauci-articular arthritis group. Secondary amyloidosis was the most important cause of death, mainly in systemic cases. Of the children whose amyloidosis had been verified, 44% died in their second or third decades, mostly with uraemia.