Juvenile Idiopathic Arthritis Flashcards
What is JIA
Autoimmune infection occuring in joints of children and adolescents. 5 main types
Key features of JIA
Diagnosed where there is arthritis without any cause, lasting more than 6 weeks.Patient under 16, joint pain, swelling and stiffness
Types of JIA
Systemic, polyarticular, oligoarticular, enthesitis related arthritis and juvenile psoriatic arthritis
Symptoms of systemic JIA (Stills disease)
Systemic illness that can occur throughout childhood.
Salmon pink rash, high swinging fevers, weight loss, enlarged lymph nodes, joint inflammation and pain, splenomegaly, muscle pain, pleuritis, pericarditis
Investigation results in systemic JIA
Antinuclear factors and RF negative.
Raised inflammatory markers with raised CRP, ESR, platelets and serum ferritin
Key complications of systemic JIA
Macrophage activation syndrome where there is activation of the immune system with massive infalammatory response
What is macrophage activation syndrome
Acutely unwell child with DIC, anaemia, thrombocytopenia, bleeding and non-blanching rash. Low ESR
Symptoms of polyarticular JIA
Idiopathic inflammatory arthritis in 5 joints of more, tends to be symmetrical, can affect small hands and feet as well as hip and knees. Mild compared to systemic JIA. Minimal systemic symptoms
Investigations into poltarticular JIA
Most negative for RF and are described as seronegative, but if positive then seropositive class.
Symptoms of oligoarticular JIA
Involves 4 joints or less, usually affects single joint which is described as monoarthritis, tending to affect larger joints such as knee or ankle. Associated with anterior uveitis
Who is oligoarticular arthritis more commonly seen in
Girls under age 6
Investigation results for oligoarticular JIA
Tend not to have any systemic symptoms or inflammatory markers, antinuclear antibodies are often positive but RF negative
Management of JIA
NSAIDs, steroids, DMARDs, biologic therapy
DMARDs used in JIA
Methotrexate, sulfasalazine, leflunomide
Biologics used in JIA
TNF inhibitors such as etanercept, infliximab and adalimumab
