Systemic Juvenile Idiopathic Arthritis is the most common type of arthritis in children and adolescents (sJIA). The diagnosis of the disease is rather a diagnosis of exclusion. The disease includes different clinical pictures rather than being a single disease. The incidence of the disease ranges from 16 to 50 per 100,000 children. Types of JIA are Systemic JIA, Oligoarticular JIA, Continuous oligoarthritis, Prolonged oligoarthritis, Seronegative polyarticular JIA, Seropositive polyarticular JIA, Juvenile psoriatic arthritis, Enthesitis-related arthritis, and Unclassified arthritis.
It manifests itself with recurrent fever and rash. Fever usually rises in the morning and evening. It is mostly accompanied by a maculopapular rash on the body. Less frequently, the disease is accompanied by hepatosplenomegaly and lymphadenopathy. Rarely, pericardial effusion may accompany the disease. Increased interleukin 1 and interleukin 6 levels are the main causes of the clinical picture.
JIA therapy should include multidisciplinary treatment. The main purpose of treatment is to restore the child's social relationships and activity. Controlling extra-articular findings is another aim of treatment. For the treatment of mild sJIA cases, Non-Steroid Anti-inflammatory Treatment provided during the whole 24 hours is generally sufficient. Indomethacin is useful for fever and pericarditis. Glucocorticoids are required in the acute phase of sJIA. In more severe cases, intravenous high-dose methylprednisolone is used, followed by oral prednisolone. Combination therapy with DMARDs is often recommended to reduce steroid-related morbidity.
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