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[JUVENILE SPONDYLOARTHRITIS].

Lovro Lamot, Miroslav Harjaček

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    Juvenile spondyloarthritis (jSpA) involves immune system and environmental factors, causing inflammation and joint damage. Diagnosis relies on clinical signs and history, with varied treatment responses.

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    Area of Science:

    • Pediatric Rheumatology
    • Immunology
    • Genetics

    Background:

    • Juvenile spondyloarthritis (jSpA) is a multifactorial disease.
    • It involves immune system dysregulation, environmental factors, and genetic predisposition.
    • jSpA leads to inflammation and structural damage, often presenting as peripheral arthritis rather than spinal involvement.

    Purpose of the Study:

    • To summarize the current understanding of juvenile spondyloarthritis (jSpA).
    • To outline diagnostic criteria and methods.
    • To review treatment strategies and challenges in predicting outcomes.

    Main Methods:

    • Review of International League Against Rheumatism (ILAR) criteria for classification.
    • Clinical examination and medical history for diagnosis.
    • Laboratory tests including ANA, RF, HLA-B27, and fecal calprotectin.
    • Imaging techniques such as musculoskeletal ultrasound (PDUS), radiography, and MRI.
    • Pharmacological treatments including NSAIDs, synthetic DMARDs, and biologic DMARDs.

    Main Results:

    • Most jSpA patients are classified under the enthesitis-related arthritis group of juvenile idiopathic arthritis.
    • Diagnosis often relies on clinical presentation and family history, with HLA-B27 being a significant genetic marker.
    • Treatment varies from NSAIDs and physical therapy to synthetic and biologic DMARDs based on disease presentation (peripheral vs. axial).

    Conclusions:

    • Early diagnosis and appropriate treatment are crucial for managing jSpA.
    • Predicting treatment response and prognosis remains challenging.
    • Further research into jSpA pathogenesis may improve patient outcomes.