Juvenile Arthritis (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Arthritis in childhood? Isn't that only an old person's disease?
- How common is arthritis in children?
- What are the signs, symptoms, and treatment of the different forms of juvenile rheumatoid arthritis?
- Pauciarticular juvenile rheumatoid arthritis
- Polyarticular juvenile rheumatoid arthritis
- Systemic-onset juvenile rheumatoid arthritis
- What are some other forms of arthritis which can affect children?
- What is the outlook (prognosis) for children with arthritis?
- Juvenile Arthritis At A Glance
- Find a local Pediatric Rheumatologist in your town
Systemic-onset juvenile rheumatoid arthritis
Often the most difficult form of juvenile rheumatoid arthritis is systemic-onset JRA, also known as Still's disease. This form of juvenile rheumatoid arthritis begins with high fevers and a rash. It is very important in this setting to make sure the patient really has systemic-onset juvenile rheumatoid arthritis and not another condition, such as infection. One of the most important findings is that the fever goes away for at least part of every day in someone with systemic-onset juvenile rheumatoid arthritis. Usually the fever is high once or twice each day. At those times, the child looks very sick and doesn't want to be touched, but when the fever goes down to normal again, they look and feel better. Sometimes it goes completely away and never comes back again. Other times, the fevers and rash go away, but the arthritis progresses over time and can be very severe. This form of juvenile rheumatoid arthritis can involve the internal organs and rarely is a "life-threatening" disease.
Treatments for systemic-onset JRA include nonsteroidal antiinflammatory drugs (NSAIDs such as ibuprofen and naproxen), hydroxychloroquine (Plaquenil), cortisone medications (such as prednisone and prednisolone), methotrexate, and for resistant disease, anakinra (Kineret). Some research has suggested that thalidomide may be an effective treatment for children with systemic-onset JRA.
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