paed rheumatology Flashcards
most common rheumatological disease in children
JIA
JIA immune response
pro-inflammatory markers TNF, IL-1, IL-2
presence of antibodies
JIA features
arthritis 6+ weeks morning stifness irratibility, refusal to walk rash, fever delayed puberty fatigue poor appetite, weight loss
polyarticular JIA
5+ joints
few or no systemic manifestations
RF+
RF-
psoriatic JIA
HLA-B27 positive
FH psoriasis
onchylosis
finger/toe inflammation
chronic arthritis and definitive psoriasis present
systemic JIA
unwell arthritis fever erythematous rash lymphadenopathy serositis hepato/spleno megaly high inflam markers
JIA Ix
labs
plain X-ray
USS
MRI with contrast
pharmalogical Mx
NSAIDs
DMARDs
biologics
IA/oral steroids
IA steroids
highly efficacious
remission>6mo
safe and effective
good for oligoarticular JIA
DMARDs
methotrexate top choice
if poor response to steroid oligo JIA
biological agents
failure to response to DMARD
anti-tnf
uveitis
assoc with JIA
all pts undergo screening
features uveitis
red eyes headache reduced vision cataracts glaucoma blindness
Rx uveitis
topical steroids
poor response - systemic steroids
poor steroid response: DMARD, biologic
JIA complications
poor growth localised growth disturbances micrognathia contractures ocular complications
