Systemic onset Arthritis

Definition

Definition of Systemic onset Arthritis
Juvenile rheumatoid arthritis (JRA) is a childhood disease that affects the joints. There are several different types of JRA, but systemic-onset juvenile rheumatoid arthritis is the rarest form, accounting for just 10%-20% of all JRA cases.

Symptoms

Symptoms of Systemic onset Arthritis
The hallmark signs of systemic-onset JRA are a very high fevers (102 degrees Fahrenheit or higher) and a pale pink or salmon-colored rash, usually on the child's chest and thighs. Because of these symptoms, systemic-onset JRA is sometimes confused with a bacterial infection, but systemic-onset JRA does not respond to antibiotic treatment.

The fever from systemic-onset JRA tends to spike several times during the day, usually peaking at night and then improving in the morning. Children also have joint pain and/or swelling, which can become more painful when the fever peaks.

Symptoms come and go over days, weeks, or months. When the fever is low, the child will seem to be fine, but when the fever returns the child will look and act sick. Children can have "good" days with few or no symptoms, and "bad" days with flare-ups of more severe symptoms.

Systemic-onset JRA also can cause inflammation of the lining of the lung (pleuritis) or lining of the heart (pericarditis), swollen lymph nodes, and an enlarged spleen and liver. Children with the condition may grow more slowly than normal.

Causes

Causes of Systemic onset Arthritis
Systemic-onset JRA causes high, spiking fevers, rash, and joint aches. The word "systemic" means that it affects the entire body. Systemic-onset JRA usually begins when a child is between 5 and 10 years old, and it affects boys and girls equally.

Diagnosis

Diagnosis of Systemic onset Arthritis
There is no single test for systemic-onset JRA. Doctors diagnose the disease by doing a physical examination and looking for its characteristic symptoms. Tests help rule out other diseases with similar symptoms (including bacterial or viral infections, and other forms of arthritis).

Treatment

Treatment of Systemic onset Arthritis
Doctors typically treat the condition with medications such as:

1. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as celecoxib (Celebrex),  diclofenac (Voltaren), ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn); these drugs help relieve fever, pain, and joint inflammation.
2. Corticosteroid medications such as prednisone; these drugs suppress the immune response and relieve inflammation.
3. Disease-modifying antirheumatic drugs (DMARDs) such as hydroxychloroquine (Plaquenil), methotrexate (Rheumatrex), and sulfasalazine (Azulfidine); these drugs slow the progression of the disease.
4. Biologic drugs (which are also in the category of DMARDs) such as abatacept (Orencia), adalimumab (Humira), anakinra (Kineret), etanercept (Enbrel), and tocilizumab (Actemra).

It is important for children with systemic-onset JRA to get plenty of rest, especially when they are experiencing symptoms. When children are feeling up to it, exercise can help keep their joints strong and mobile. Physical therapy also may be helpful.

Prognosis

Prognosis of Systemic onset Arthritis
Consult with your doctor.

Prevention

Prevention of Systemic onset Arthritis
Children who have JIA need a careful balance of activity and rest. Encourage your child not to overdo activity when he or she is feeling well. Too much activity will generally make soreness worse. Limit your child's participation in activities that are stressful to joints (such as running or contact sports) during flares of arthritis. But try not to discourage activity so that the child begins to feel very different from his or her playmates or friends.