Juvenile rheumatoid arthritis
Alternate Names : Juvenile chronic polyarthritis, JRA, Still's disease, Juvenile idiopathic arthritis
Treatment
When only a small number of joints are involved, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be enough to control symptoms. Corticosteroids may be used for more severe flare-ups to help control symptoms. Children who have arthritis in many joints, or who have fever, rash, and swollen glands may need other medicines. These medicines are called disease-modifying antirheumatic drugs (DMARDs). They can decrease or prevent swelling or inflammation in the body. DMARDs include:
- Methotrexate is often the first drug used.
- Biologic drugs, such as such as etanercept, infliximab, and related drugs block high levels of proteins that cause inflammation.
It is important for children with JRA to stay active and keep their muscles strong. Walking, bicycling, and swimming may be good activities. Children should learn to warm up before exercising. Support and help for children who experience sadness or anger about their arthritis is also very important. Some children with JRA may need surgery, including joint replacement.
Prognosis (Expectations)
JRA is seldom life threatening. Children who have many joints involved, or who have a positive rheumatoid factor are more likely to have chronic pain and poor school attendance, and to be disabled. Long periods with no symptoms are more common in those who have only a small number of joints involved. Many patients with JRA eventually go into remission with very little loss of function and deformity. For additional information and resources, see arthritis support group.
Complications
- Wearing away or destruction of joints (can occur in patients with more severe JRA)
- Slow rate of growth
- Uneven growth of an arm or leg
- Loss of vision or decreased vision from chronic uveitis (this problem may be severe, even when the arthritis is not very severe)
- Anemia
- Swelling around the heart (pericarditis)
- Chronic pain, poor school attendance
Calling Your Health Care Provider
Call for an appointment with your health care provider if: - You notice symptoms of juvenile rheumatoid arthritis
- Symptoms get worse or do not improve with treatment
- New symptoms develop
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