Juvenile Idiopathic Arthritis (JIA)

What Is Juvenile Idiopathic Arthritis (JIA)?

Juvenile rheumatoid arthritis, also known as juvenile idiopathic arthritis, is the most common type of arthritis in children under the age of 17. Juvenile rheumatoid arthritis causes persistent joint pain, swelling and stiffness. Some children may experience symptoms for only a few months, while others have symptoms for the rest of their lives. It occurs more often in girls.

What Causes Juvenile Idiopathic Arthritis (JIA)?

• Cause of JIA is not known exactly. Juvenile idiopathic arthritis is believed to be a disease of the immune system. Several factors may be involved, alone or in combination, in triggering the inflammatory reaction seen in JIA, however it’s not a hereditary disease. Combination factors are-
• Genetics
• Environment
• Immune system

Symptoms Of JIA?

• Either insidious or abrupt disease onset, often with morning stiffness when moving joints
• Complaints of joint pain, swelling , abnormal joint use, warmth or tenderness
• History of school absences or limited ability to participate in physical education classes
• Spiking fevers occurring once or twice each day at about the same time of day
• Quickly fading or disappearing rash on the trunk and extremities.

How is it diagnosed?

• The most important step in treating is getting an accurate diagnosis. The diagnostic process can be long but you need to be patient. Your child may be recommended to visit a pediatric rheumatologist who will then take a complete health history to determine the length of time and type of symptoms present.
• There is no single blood test that confirms JIA. In fact, blood testing will reveal relatively little in diagnosis (can rule out the possibility of an underlying infection). The key to diagnosis is a careful physical examination, along with taking a medical history.
• Along with the physical examination itself, your child’s doctor will take a number of other diagnostic steps – such as laboratory work and x-rays and other imaging tests – in part to rule out other potential conditions.
• Tests such as to determine the degree of inflammation, antinuclear antibody (ANA), and rheumatoid factor.

Can JIA be prevented?

At this time, there is no known way to prevent JIA. Unfortunately, there is no cure for juvenile arthritis.

Complications?

Psoriatic arthritis can be treated with a number of different medicines.

If it is untreated, JIA can lead to:

• Loss of vision or decreased vision due to iridocyclitis/uveitis
• Permanent damage to joints
• Chronic arthritis and disability (loss of function)
• Interference with a child’s bone growth
• Inflammation of the membranes surrounding the heart (pericarditis) or lungs (pleuritis)

Treatment

The goal should be aimed to relieve inflammation, control pain and improve your child’s quality of life. Most treatment plans include a combination of medication, physical activity, eye care and healthy eating. In JIA, there is excessive production of certain proteins such as TNF which causes joint pain, stiffness and damage of joints.

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
• Corticosteroids
• Disease-modifying antirheumatic drugs (DMARDs) like methotrexate
• Biologic DMARDs

Exemptia (contains adalimumab) is one such biological DMARD which blocks TNF-α , which causes inflammation and tissue damage.