From the Guidelines
Yes, Juvenile Rheumatoid Arthritis (JRA) can cause leukocytosis, as evidenced by a recent study published in 2024 in the Annals of the Rheumatic Diseases 1.
Leukocytosis in JRA
The study found that leukocytosis (>10,000/mm³) was present in 79% of patients with systemic juvenile idiopathic arthritis (sJIA), a subtype of JRA, with a prevalence of 79% (95% CI: 65-90) 1.
- The prevalence of leukocytosis (>15,000/mm³) was 52% (95% CI: 34-71) in sJIA patients 1.
- These findings suggest that leukocytosis is a common feature of JRA, particularly during active disease flares.
Disease Activity and Leukocytosis
- The study also found that disease activity is correlated with the presence of leukocytosis, with higher white blood cell counts often seen during more severe flares 1.
- The elevation in white blood cell count is often characterized by an increase in neutrophils specifically.
Clinical Implications
- Regular complete blood count monitoring is typically part of the standard care for children with JRA to track these hematologic changes.
- Persistent significant leukocytosis should prompt investigation for other causes such as infection or medication effects, as it may not be explained by JRA alone.
- Appropriate medications such as NSAIDs, corticosteroids, disease-modifying antirheumatic drugs (DMARDs), or biologics may help control disease activity and reduce leukocytosis.
From the Research
Juvenile Rheumatoid Arthritis and Leukocytosis
- Juvenile Rheumatoid Arthritis (JRA) is a chronic autoimmune disease that can cause inflammation and damage to the joints, as well as other parts of the body 2, 3, 4.
- Leukocytosis, which is an increase in the number of white blood cells, can be associated with JRA, particularly in cases where there is active inflammation or infection 5.
- Studies have shown that patients with JRA may experience leukocytosis, as well as other laboratory abnormalities such as thrombocytosis and anemia 5.
- The relationship between JRA and leukocytosis is not fully understood, but it is thought to be related to the inflammatory activity of the disease 5.
- Treatment of JRA with medications such as azathioprine and corticosteroids can help to reduce inflammation and improve symptoms, but may also have adverse effects such as pancytopenia and disseminated infection 6.
Key Findings
- Thrombocytosis was found in 88% of patients with active JRA, and was positively correlated with anemia, sedimentation rate, and leukocytosis 5.
- Leukocytosis was found to be significantly related to the presence of articular inflammation in patients with JRA 5.
- Azathioprine therapy was found to be effective in reducing corticosteroid doses and improving clinical symptoms in patients with JRA, but required careful monitoring for adverse effects 6.