Juvenile Idiopathic Arthritis

Question 1

What is Juvenile idiopathic Arthritis?

Answer 1

1. Autoimmune mono or polyarthritis in children < 16 yoa
   *can resolve by puberty

Question 2

What are the clinical manifestations of Juvenile Idiopathic Arthritis?

Answer 2

1. Oligoarticular (few joints)
   * <5 jt involved, usually large joints +/- small joints
2. Polyarticular
   * >5 jt w/in the first 6 months

Question 3

What are the two types of oligoarticular Juvenile Idiopathic Arthritis?

Answer 3

I-iridocuclitis (anterior uveitis) (will be severe inflammation of the iris)
2. Increased incidence of AS (inflammation of the spine)

Question 4

What are the clinical manifestations of polyarticular Juvenile Idiopathic Arthritis?

Answer 4

1. Arthritis >5 small joints with in 1st 6 months
   *Hip involvement is common
2. Most similar to adult RA
3. Rf negative disease associated with better prognosis than Rf positive (we want Rf to be negative)

Question 5

What can be used to diagnosis Juvenile Idiopathic Arthritis?

Answer 5

1. Increased ESR, CRP
2. Positive ANA in oligoarticular
3. (+) Rf in 15% of patients

Question 6

What are some treatment options of Juvenile Idiopathic Arthritis?

Answer 6

1. NSAIDs and or corticosteroids
2. Methotrexate
3. Leflunomide
4. Frequent eye exams to detect iridocyclitis (inflammation of the iris and ciliary body)