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Features and Clinical Course of Infantile Juvenile Idiopathic Arthritis
Julie A Campbell1, Susan Shenoi
1From the Pediatric Rheumatology Division, Seattle Children's Hospital and Research Center, University of Washington, Seattle, WA.
Insights
Infantile-onset juvenile idiopathic arthritis (JIA) shares similarities with older JIA patients but may experience diagnostic delays and contractures. Early identification is crucial for managing this chronic childhood arthritis.
Area of Science:
- Pediatric Rheumatology
- Immunology
- Clinical Pediatrics
Background:
- Juvenile idiopathic arthritis (JIA) is a complex group of chronic childhood arthritides.
- This study focuses on JIA diagnosed in infants under 12 months old.
Purpose of the Study:
- To characterize patients diagnosed with JIA before 12 months of age.
- To understand the clinical presentation and treatment course of infantile-onset JIA.
Main Methods:
- Retrospective chart review of patients with JIA onset before 1 year.
- Data collected included demographics, clinical features, lab results, imaging, and treatment.
Main Results:
- Twelve patients met inclusion criteria: 8 oligoarticular, 3 polyarticular, 1 systemic JIA.
- Over half (58%) presented with joint contractures.
- Oligoarticular JIA patients required DMARDs and some biologic therapy for remission.
Conclusions:
- Infantile JIA patients are similar to older JIA cohorts.
- Delayed diagnosis and contractures are significant concerns in this group.
- Disease severity may not differ, but early intervention is key.
Background:
Juvenile idiopathic arthritis (JIA) is a heterogeneous group of 7 chronic arthritides categories that affects children younger than 16 years. This case series elucidates the characteristics of patients from a single center diagnosed with JIA at younger than 12 months.
Methods:
We included patients who presented to the rheumatology clinic for JIA with symptom onset at younger than 1 year. Chart review was conducted to complete case report forms that included demographics, historical features, examination features, laboratory results, imaging results, and treatment courses.
Results:
We identified 12 patients who met our inclusion criteria. Eight of our patients were diagnosed with oligoarticular JIA, 3 had polyarticular JIA, and 1 was diagnosed with systemic JIA. Overall, 58% (7/12) of patients had joint contractures at their initial visit. Of the patients with oligoarticular JIA, 50% (4/8) required a disease-modifying antirheumatic drug to achieve disease remission; 12.5% (1/8) required biologic therapy. All of the polyarticular JIA patients had highly positive antinuclear antibodies, as well as elevated inflammatory markers.
Conclusions:
Children with infantile JIA are overall similar to the larger population of patients with JIA. Disease severity may not be different compared with that of older children with JIA; however, there is likely a larger delay in diagnosis and the presence of contractures, which occurred in more than half of our patients.
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