Significance of rubella virus infection in juvenile chronic polyarthritis

SUMMARY Fifty-three patients under the age of 5 years with definite juvenile chronic polyarthritis (JCP) were examined for serological evidence of rubella infection. The prevalence of rubella antibody was found to be low and did not differ significantly from that found in normal children of similar age. Patients with JCP and antibody to rubella virus had a clinical course indistinguishable from those with no detectable rubella antibody. The role of viruses in the aetiology and pathogenesis of connective tissue diseases has been widely dis-cussed (Phillips, 1971; Marmion, 1974; Denman, 1975) but definitive data to confirm such a relation-ship are lacking. Rubella virus has often been pro-posed to be of aetiological significance, particularly in juvenile chronic polyarthritis (JCP). Sero-epidemiological data (Ogra and Herd, 1972; Dein-hard et al., 1974; Ogra et al., 1975) and the finding of both a heightened and prolonged antibody res-ponse to rubella infection in patients with JCP (Ogra et al., 1975) has recently provided more direct evidence for a possible role of rubella virus in JCP. An outbreak of rubella which occurred among our hospitalized patients with JCP presented the oppor-tunity to examine the manner in which these patients responded to naturally acquired infection by this agent. The results of that investigation (Howard et al., 1975), while confirming the heightened serological response noted by some (Ogra and Herd, 1972; Ogra et al., 1975) but not all investigators in patients with JCP, stimulated the present study to determine the importance of rubella virus in the aetiology and pathogenesis of JCP. If rubella were an important aetiological agent in a substantial number of children with JCP, a higher incidence of rubella antibody among children with JCP might be expected to be found compared to the normal population. An