In this critical nosological study of chronic juvenile rheumatoid arthritis, the author opposes his own pluralist concept based on a longitudinal analysis of the overall development to the conventional unicist concept in which the three forms of the disease are regarded as initial presentations of one single entity. The relationship between the systemic form and the abarticular hyperimmune syndromes previously described by Wissler and Fanconi is stressed. Similarities between juvenile rheumatoid arthritis and reactional inflammatory joint diseases of well defined aetiology are discussed; both are considered articular immune reactions to more or less demonstrable antigens. In the absence of specific laboratory tests, the disease can only be defined on clinical grounds. Without being exceedingly wide, this definition should be less restrictive than that based on currently accepted criteria.
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