Juvenile rheumatoid arthritis

Juvenile rheumatoid arthritis also called as juvenile idiopathic arthritis (JIA), is a type of arthritis that causes stiffness and inflammation in the joints of a child aged 15 or less. JIA is the most common type of arthritis in children.

JIA is an autoimmune disorder and causes inflammation, soreness, and redness in the joint thereby limiting the movement of the joint. Our immune system is the defense system of our body fighting against the foreign particles. However our immune system sometimes mistakenly identifies some of its own body cells as foreign. Although there is no clear reason for what actually triggers this disorder, however there are two suspects for the disorder:

(a) Child’s genetic makeup

(b) Environmental factors like Virus 

There are different types of this kind of Arthritis:

  1. Systemic arthritis – It is found in both boys and girls. This occurs when the body’s immune system attacks the joints. It also causes a fever and rash. Children age 1 to 16 years can get systemic arthritis.
  2. Polyarthritis –This type of problem is more common in girls than in boys. It is also called “polyarticular arthritis.” It affects more than five joints after the child has it for 6 months.
  3. Psoriatic arthritis – This type affects more commonly to girls than boys and very rare below the age of 12 months. Patients can have sausage-like swelling of fingers. It also causes a rashes and nail changes.
  4. Enthesitis-related arthritis – This type of arthritis is more common in boys than in girls. Mostly this type of arthritis affects the leg and back joints. It is also called “spondyloarthropathy” or “spondyloarthritis.”

What are the symptoms of arthritis rheumatoid Juvenile?

Symptoms can include:

1.Fever :- Children who have systemic arthritis sometimes get a fever at the same time every day for 2 weeks or more.

2.Rash :- Children who have systemic arthritis sometimes get a rash and fever. The rash go away as the fever goes down and comes back as the fever returns.

3. Children with psoriatic arthritis get a different type of rash. This rash looks like red, raised patches of skin that are sometimes covered by silver or white scales.

4. Pain, stiffness, and swelling in the joints

–The joint symptoms happen in all types of juvenile idiopathic arthritis.

–The joints affected depend on which type of arthritis the child has. Many types affect the hands, wrists, elbows, knees, jaws, and ankles. The back and hips are affected in Enthesitis-related arthritis.

— Some children have a stiff or swollen joint that does not hurt. For example, a child might “walk funny” in the morning, but get better after a little while

5. Eye redness – This is usually painless, but the cause of the redness is a condition called “uveitis,” which can be serious. This can lead to vision loss, so make sure to mention this symptom to your child’s doctor.

Systemic Juvenile Arthritis

Although systematic juvenile arthritis (SJIA) can occur at any age in the child hood however, most commonly it starts at about 2 years of age .Both sexes (boys and girls) are affected . about 10-20% of children with JIA are suffering from systematic JIA. Systematic means it not only affects the joints but other parts of the body also like liver, heart and lings. Systematic juvenile arthritis is very challenging to diagnose and treat compared to other types of juvenile arthritis

Cause of the systematic juvenile arthritis

The exact reason of  systematic juvenile arthritis is not known. However researchers believe that systematic juvenile arthritis is an auto-inflammatory disease.In the auto-inflammatory condition the innate immune system of the body is activated even when there is no infection in the body.Higher blood levels of two inflammatory proteins are found in the kids with  systematic juvenile arthritis.also kids with  systematic juvenile arthritis generally don’t have auto-antibodies in their blood.

Treatment for systematic Juvenile Arthritis

There is no cure for the systematic juvenile arthritis. However the remission of the disease with little or almost zero symptoms is possible.The main goal of the treatment plan by the doctors is to relieve the pain, fever and inflammation by giving some nonsteroidal anti-inflammatory drugs (NSAIDs) like diclofenac, celecoxib,

The standard approach for the treatment is to start first with NSAIDs and if NSAIDs don’t work we can go for the corticosteroids. However we can not continue with the corticosteroids for a longer period. Because  high-doses of corticosteroids  for  longer duration can cause serious side effects in children.

medlinesplus.com medical refrence | Reviewed by Dr Zubair Ahmad khaja (MD ) on 4/4/2020