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To the Editor.—Hearey and his colleagues in their case report entitled "Prolonged Fever From Unusual Cause (Retinoblastoma)" (Amer J Dis Child 123:51-52, 1972) state, "Our patient, if presented to the average pediatrician without mention of the ocular findings, would certainly have been suspected of having juvenile rheumatoid arthritis, in which fever, lymphadenopathy, rash, etc, can persist for many months before arthritic changes occur."
While some patients with juvenile rheumatoid arthritis present without arthritis, definitive diagnosis is impossible in the absence of joint involvement. Even so, diagnosis of juvenile rheumatoid arthritis requires careful exclusion of many other conditions, including leukemia and neoplasms. However, the case report provides an opportunity to reiterate that up to 20% of children with juvenile rheumatoid arthritis have uveitis at some time in the course of their disease, and therefore, slit-lamp examination of the eyes is mandatory not only for diagnosis of the uveitis but because
JACOBS JC. FEVER FROM RETINOBLASTOMA. Am J Dis Child. 1972;123(6):612. doi:10.1001/archpedi.1972.02110120136026