Nomenclature of Juvenile Arthritis: Past, Present and Future (Literature Review)
The purpose of the work is on the base of scientific data in a historical perspective to trace the ways of formation of the nomenclature of juvenile arthritis; to find out the reasons for its continuous improvement; to analyze the advantages and disadvantages of the current classification and diagnostic criteria; to show their strengths and weaknesses; to find out the key principles in creating the future nomenclature of chronic arthritis in children. Since the middle of the last century, discussions on the distribution and diagnosis of juvenile arthritis have continued. In the past, there were, and continue to be, three names for this large and heterogeneous group of diseases - juvenile rheumatoid arthritis, juvenile chronic arthritis, juvenile arthritis. The current nomenclature combines seven categories of arthritis included in one term - juvenile idiopathic arthritis. The main purpose of its creation was the integration of international efforts to study the most common joint diseases of childhood, and the main principle - the construction of their mutually exclusive categories. Of course, this has led to significant progress in the comprehensive study of this issue, but over time it became clear: there were significant regional differences in the interpretation of the term; categories of juvenile idiopathic arthritis were heterogeneous in genetic, biological and phenotypic characteristics and became difficult to differentiate; the absence in the classification of some, completely child-specific nosological units (juvenile rheumatoid arthritis, juvenile ankylosing spondylitis), led to inconsistencies with national protocols for medical and social care; therapeutic approaches to them were different; inconsistency in the classification of chronic arthritis in children and adults has complicated the process of heredity in the transition period. The need to create a new nomenclature of chronic arthritis in children is obvious. The question remains: on what basis will it be created - will there be a new attempt to unite all types of arthritis in one term? The long and painstaking path of precision medicine will be chosen on the basis of genetic and immunobiological features of each category of arthritis separately; there will be a synchronization of the distribution of juvenile arthritis by analogy with the classification of joint diseases in adults. Will the world scientific community invent a new version of the classification?