To determine in a case-control study if new onset JDMS patients had increased 1) symptoms, 2)environmental conditions, 3) familial autoimmune diseases, or 4) antibody titers, compared with two control groups. The families of 80 JDMS and 62 JRA or healthy children had a structured interview. All childrens' sera were tested for antibody to Toxoplasma gondii, Herpes simplex virus (HSV), or Coxsackievirus B (CVB). Children with JDMS had symptoms 3 months before disease index date, p=0.013. JRA families had more rheumatoid arthritis (p=.0001) and pernicious anemia (p=.003) than those of JDMS or healthy children. Enteroviral titers were higher in JDMS children ≤ 7 years of age (84%) and controls (89%) than JRA (53%), suggesting an environmental exposure. Titers to T. gondii, HSV or CVB 1-6 were normal. Conclusion: Familial autoimmune disease, environmental factors, or antibody titers to T. gondii, HSV or CVB are not increased in JDMS. JDMS children have symptoms three months before disease index date; young patients have elevated enteroviral titers as do regional controls.

Supported by a Clinical Science Grant from The Arthritis Foundation.