Researchers Provide a Better Understanding of sJIA and Still’s Disease

According to Healio, medical professionals from Boston Children’s Hospital have conducted research that provides a better look at systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease. They looked specifically at diagnostic criteria, therapeutic options, and the connection to macrophage activation syndrome (MAS).

Juvenile Idiopathic Arthritis

JIA is inflammation of the joints that is due to an unknown cause, and it impacts children. There are a number of forms of this condition, and the researchers focused on systemic JIA. The majority of types are autoimmune disorders, meaning that the body mistakenly attacks its own tissue. Common symptoms between forms include joint pain, inflammation, swelling, and limited movement. Children may also experience skin rashes, swollen lymph nodes, and fever. However, symptoms are not typically present at all times. They occur in episodes. Eye inflammation is a possible complication as well. As there is no cure for JIA, treatment is symptomatic. Doctors often prescribe NSAIDs, corticosteroids, DMARDs, and biologic agents.

Adult-Onset Still’s Disease

Adult-onset Still’s disease is characterized by episodes of rash, fever, and joint pain. Episodes vary greatly between individuals, with some experiencing flare-ups for several months and others just a single episode. While episodes can vary, the symptoms are typically the same. They include sore throat, swollen lymph nodes, pain when breathing, muscle and abdominal pain, and weight loss. Doctors suspect that a connection to antigens may be part of the cause of this disease, but they are unsure. As little is known about the cause, there are also no cures. Treatment consists of prednisone, anakinra, methotrexate, tocilizumab, and etanercept. Lifestyle changes, such as exercise and healthy diet, can also be helpful.

More About the Conditions

Dr. Peter Nigrovic and his colleagues have conducted research that revealed more about sJIA and adult-onset Still’s disease. Specifically, they looked at diagnostic criteria and characteristic symptoms. In terms of sJIA, they found that three major symptoms are arthritis, fever, and rash. Research also unveiled more biomarkers that can be used for better diagnosis, with examples such as ferritin and low platelet counts. They also noted that sJIA can be intermittent, persistent, or monophasic. Diving further into this, they spoke of how it is impossible to tell which child will present in which way at the time of diagnosis.

In terms of Still’s disease, researchers stress that it is nearly identical to sJIA. However, IL-1, IL-6, and IL-8 are the biomarkers that they discovered to be associated with Still’s disease. They also associated the various biomarkers with rates of MAS. In fact, ferritin is the best biomarker to monitor to predict MAS.

Discovering these biomarkers not only enhanced the understanding of Still’s disease and sJIA, it improved the comprehension of MAS. With this knowledge, medical professionals can better manage and treat MAS. The researchers noted that this newfound information is transformative within the field.

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