Juvenile Idiopathic Arthritis

The most common type of arthritis in children and adolescents is Systemic Juvenile Idiopathic Arthritis (sJIA). The diagnosis of the disease is more of a diagnosis of exclusion. The disease is not a single disease but includes different clinical pictures. The incidence rate varies between 16-50 per 100,000 children. Types of Juvenile Idiopathic Arthritis (JIA) are Systemic JIA, Oligoarticular JIA, Persistent Oligoarthritis, Prolonged Oligoarthritis, Seronegative Polyarticular JIA, Seropositive Polyarticular JIA, Juvenile Psoriatic Arthritis, Arthritis associated with Enthesitis and Unclassified Arthritis.

It presents with recurrent fever and rash. Fever usually rises in the morning and evening. It is often accompanied by a maculopapular rash localized on the trunk. Less commonly, hepatosplenomegaly and lymphadenopathy accompany the disease. Pericardial effusion may rarely accompany the disease. Increased levels of interleukin 1 and interleukin 6 are mainly responsible for the clinical picture.

Treatment of JIA should include a multidisciplinary approach. The main goal of treatment is to restore the child's social relationships and activity. Controlling extra-articular findings are other points aimed at in the treatment. For the treatment of mild cases of sJIA, non-steroidal anti-inflammatories given for 24 hours are often sufficient. In the acute phase of sJIA, glucocorticoids are required. In more severe cases, intravenous high dose steroids are given, followed by oral steroids. Combination therapy with DMARDs is often recommended to reduce steroid-related morbidity.

References

1. Giancane, G., Consolaro, A., Lanni, S., Davi, S., Schiappapietra, B., & Ravelli, A. (2016). Juvenile idiopathic arthritis: diagnosis and treatment. Rheumatology and therapy, 3, 187-207. [Accessed: July 2023]

2. Juvenile Idiopathic Arthritis, https://www.arthritis.org/diseases/juvenile-idiopathic-arthritis. [Accessed: July 2023]

3. Juvenile Idıopathic Arthritis, https://www.mayoclinic.org/diseases-conditions/juvenile-idiopathic-arthritis/symptoms-causes/syc-20374082. [Accessed: July 2023]

4. Juvenile Idiopathic Arthritis (JIA), https://www.versusarthritis.org/about-arthritis/conditions/juvenile-idiopathic-arthritis/. [Accessed: July 2023]