Juvenile Idiopathic Arthitris(JIA)

As per the new classification criteria, JIA again subdivided into many categories.

• Systemic onset JIA - affects about ten percent of children with arthritis. It begins with repeating fevers that can be 103°F or higher, often accompanied by a salmon-colored rash that comes and goes. Systemic onset JIA may cause inflammation of the internal organs as well as the joints, though joint swelling may not appear until months or even years after the fevers began.
• Oligoarticular JIA – which involves fewer than five joints in its first stages, affects about half of all children with arthritis. Girls are more at risk than boys. Some older children with oligoarticular JIA may develop “extended” arthritis that involves many joints and lasts into adulthood. 
• Polyarticular JIA – affects five or more joints and can begin at any age. Children diagnosed with polyarticular JIA in their teens may actually have the adult form of rheumatoid arthritis at an earlier-than-usual age
• Juvenile psoriatic arthritis – children have both arthritis and a skin disease called psoriasis or a family history of psoriasis in a parent or sibling. Typical signs of psoriatic arthritis include nail changes and widespread swelling of a toe or finger called dactylitis.
• Enthesitis-Related Arthritis – It is a form of JIA that often involves attachments of ligaments as well as the spine. This form is sometimes called a spondyloarthritis. These children may have joint pain without obvious swelling and may complain of back pain and stiffness. There is sometimes a family history of arthritis of the spine
• Undifferentiated JIA – If the child having joint swelling and pain but not fall into above categories

It’s not known exactly what causes JIA in kids and atart arthritis at such an early age.Research indicates that it is an autoimmune disease which means white blood cells can’t tell the difference between the body’s own healthy cells and outside germs .The immune system, which is supposed to protect the body from these harmful invaders, instead releases chemicals that can damage healthy tissues and cause inflammation and pain.To effectively manage and minimize the effects of arthritis, an early and accurate diagnosis is essential. By understanding the symptoms and characteristics of each type of JIA, you can help your child maintain an active, productive lifestyle.

Diagnosis of juvenile idiopathic arthritis can be difficult because joint pain can be caused by many different types of problems. No single test can confirm a diagnosis, but tests can help rule out some other conditions that produce similar signs and symptoms. Blood tests Some of the most common blood tests for suspected cases include:

• Erythrocyte sedimentation rate (ESR).An elevated ESR can indicate inflammation but it can be sometime nonspecific. Measuring the ESR is primarily used to determine the degree of inflammation.
• C-reactive protein. This blood test also measures levels of general inflammation in the body and more specific in doing so than ESR
• Anti-nuclear antibody.Anti-nuclear antibodies if present in a child with JIA, often act as marker for an increased chance of eye inflammation.
• Rheumatoid factor.This antibody is mainly found in the blood of children who have polyarticular variety of juvenile idiopathic arthritis.
• Cyclic citrullinated peptide (CCP)Like Rheumatoid factor, the anti CCP antibody is another antibody that may be found in the blood of children with juvenile idiopathic arthritis. This is a more specific marker than Rheumatoid factor

In many children with juvenile idiopathic arthritis, no significant abnormality will be found in these blood tests. Imaging scans X-rays or magnetic resonance imaging (MRI) may be taken to exclude other conditions, such as fractures, tumors, infection or congenital defects.Imaging may also be used from time to time after the diagnosis to monitor bone development and to detect joint damage.

Treating a child with JIA involves many psychological and physical apects. With proper counseling and available drugs a child with JIA may lead a normal life and can fulfill the career goals.

• The drugs that are useful in treating JIA are known as DMARDs(Disease modifying antirheumatic drugs). They Include Methotrexate, sulfasalazine, Hydroxycholoroquine, leflunamide etc. They are particularly useful for knee or ankle joint swelling but not for upper or lower back problems.
• These drugs should be prescribed and taken under supervision of a rheumatologist as they are trained to periodically monitor your blood test to look for any side effects of these drugs.
• If taken properly under supervision, these drugs helps to control joint inflammation and give patient a normal life
• Biological drugs are new drugs that target specific molecules like TNF and other cytokines like IL 17 which incite inflammation in JIA. They are very effective drugs but because of high costs, usually given after failure of other drugs.
• Biologic drugs that are effective in JIA include – Eternacept, Adalimumab, Infliximab, tocilizumab.

At OARC, we offer holistic care to patients suffering from all kind of adult and childhood arthritis by our renowned rheumatologist.Because of chronic illness of the disease and attached concerns, we spend some time with the patient as well as the parents helping them to know about their disease, and demystify the myths regarding the disease and treatment.We have collaboration with NABL accredited laboratory where all kind of blood tests can be done at reasonable costs.We also have patient support system where patient can approach in case of any emergency.We believe in a friendly relation with patients and relatives so that they can share all their sufferings and get the best possible treatment.