Juvenile idiopathic arthritis Flashcards
Definition
group of Sys Inflam Disorder
16 yrs below
important cause of disability and blindness
Amyloidosis
peritonitis, pleurisy, renal disease
auto immune disease
multifactorial and different from adultRA
Clinical subtypes
after 6 months 3 major subtypes
Pauciarticular (most common)
polyarticular
systemic onset
Pauciarticular type 1
4 or less joints limp rather than pain mainly LL joints Knee> ankle> hand or elbow \+ve ANA Chronic uveitis irregular iris due to posterior synechiae more girls
Type 2
more boys
limp due to LL affection
hip can be affected early
enthesitis
type 3
asymmetric UL and LL arthritis dactylitis very destructive family history of psoriasis chronic iridocyclitis
Polyarticular JIA
RF-ve constitutional manifestation 15% JIA hepatosplenomegaly mild anemia growth defects symmetric large and small joints affection RF +ve can be complicared by sjogren nodules anemia pulmonary fibrosis vasculitis
Systemic onset (STILL’s disease)
fever rash
types of JIA
Arthritis Abdominal Serositis Lymph nodes Pulmonary
diagnosis
ESR often elevated, very high in systemic
ANA
RF
1st line therapy
NSAIDS/ steroid injections
2nd line therapy
methorexate
anti TNF
IL1 R antagonist (Anakinra) refractory systemic arthritis
IL 6 anatagonist (Tocilizumab) refractory systemic disease
systemic steroids
limited indications due to serious side effects
used in
Systemic JIA
serious disease complications
periocrodial effusion, tamponade, vasculitis
risk of osteoporosis, infections, growth abnormalities
local steroids
intra articular mainly in oligo articular JIA
in eye disease
