To investigate the clinical features of juvenile rheumatoid arthritis (JIA) complicated with varicella.

From January 1st, 2015 to December 31st, 2019, a total of 9 cases of JIA with varicella (JIA with varicella group) and 18 cases with pure varicella (varicella group) with age and sex matching treated in Beijing Ditan Hospital, Capital Medical University were collected, and the fever time, hyperthermia ratio, skin scab time, skin infection, blood routine and liver function and myocardial enzyme of the two groups were analyzed by retrospective case-control study.

The mean age of 9 children in JIA with varicella group was (6.1 ± 4.0) years old, among whom, 4 cases were male and 5 cases were female; 8 cases with varicella contact history, 8 cases with high fever, the highest body temperature was 41 ℃. All the children in varicella group had definite contact history of varicella, among whom, 4 cases with high fever, the highest body temperature was 39 ℃. The fever duration of cases in JIA with varicella group was significantly longer than that of varicella group [(7.89 ± 2.15) d vs. (4.50 ± 1.20) d) ], with significant difference (t = 2.89, P < 0.001). A typical papules, herpes and scab were found in JIA with varicella group, and the skin rash was densely distributed throughout the body, the number of herpes was more than 50, mostly on the face, and occipital, forechest, back and buttocks obviously visible; most of the papules fused into pieces, part of the fusion rash were full transparent, herpes and erosion may occur on mucous membrane. But the fusion herpes, skin erosion and infection were rare in children of varicella group. Cases in JIA with varicella group had longer scab time than children with varicella [(10.78 ± 2.17) d vs. (5.72 ± 1.02) d], with significant difference (t =-4.24, P < 0.001). In JIA with varicella group, 4 cases (44.44%) with cellulitis, 3 cases (33.33%) with granulocyte deficiency, 2 cases (22.22%) with thrombocytopenia, 4 cases (44.44%) with abnormal liver function and 4 cases (44.44%) with abnormal myocardial enzymes. In varicella group, 1 case (5.56%) with skin infections, 1 case (5.56%) with granulocyte deficiency and 1 case (5.56%) with abnormal myocardial enzymes, no case with thrombocytopenia or abnormal liver function. There was 1 case with severe hemorrhagic varicella in children with JIA and varicella group. Cases with JIA and varicella were treated with acyclovir and high-dose intravenous immunoglobulin for 3-5 days, varicella rash was treated with recombinant human interferon α-1b gel. Children with common aricella were treated with recombinant human interferon α-1b gel.

children of JIA with varicella usually had high fever, longer fever duration, severe skin mucosal damage, bullae, fusion and even cellulitis. Cases could be treated with acyclovir and high-dose intravenous human blood gamma globulin. During the treatment, the primary disease showed no activity.