The aim of this narrative review is to synthesize existing evidence-based knowledge on juvenile idiopathic arthritis-associated uveitis (JIA-U). We highlight epidemiology, pathophysiology, causes and genetics, risk factors, clinical features, diagnosis and screening, laboratory biomarkers, treatment options, trials with recent advances, and research challenges pertaining to JIA-U. The prevalence of JIA-U varies with different JIA subtypes, most frequently associated with the oligoarticular subtype. The risk factors involved in the development of JIA-U include younger age, antinuclear antibody (ANA) positivity, and the oligoarticular subtype of JIA, along with some specific major histocompatibility complex genes. Certain laboratory biomarkers, such as ANA, rheumatoid factor, interferon-λ, erythrocyte sedimentation rate, and transthyretin, have been used in JIA-U diagnosis, progress monitoring, and prognostication. Clinical features of JIA-U can range from asymptomatic to ophthalmic symptoms like redness, blurred vision, decreased visual acuity, hypopyon, and posterior uveitis, which can lead to retinal detachment and macular edema. The management protocol involves topical and systemic steroids, cycloplegics, disease-modifying antirheumatic drugs, biologic drugs, and surgical options. Early detection combined with prompt treatment is crucial to preventing irreversible vision loss in JIA-U.
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http://dx.doi.org/10.1080/08998280.2024.2305567 | DOI Listing |
Cureus
December 2024
Family Medicine, MJ Medical Group, Chicago, USA.
Chronic musculoskeletal pain in pediatric patients can be challenging to diagnose, particularly in the absence of overt signs of autoimmune disease, as these episodes can manifest episodically. We present a case of a 14-year-old female patient with a two-year history of episodic "bone pain," morning stiffness, and infrequent fever and fatigue. Laboratory testing revealed an antinuclear antibody (ANA) titer of 1:1280 with a nuclear homogeneous pattern and a mildly elevated erythrocyte sedimentation rate (ESR).
View Article and Find Full Text PDFPediatr Rheumatol Online J
December 2024
Infection, Immunity and Global Health Theme, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia.
Background: Juvenile idiopathic arthritis (JIA) is challenging to classify and effectively monitor due to the lack of disease- and subtype-specific biomarkers. A robust molecular signature that tracks with specific JIA features over time is urgently required, and targeted plasma metabolomics may reveal such a signature. The primary aim of this study was to characterise the differences in the plasma metabolome between JIA patients and non-JIA controls and identify specific markers of JIA subtype.
View Article and Find Full Text PDFPediatr Rheumatol Online J
December 2024
Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Objective: This systematic search and review aimed to evaluate the available literature on discontinuation of adalimumab and other tumor necrosis factor inhibitors (TNFi) for patients with well-controlled chronic inflammatory arthritides.
Methods: We conducted a publication search on adalimumab discontinuation from 2000-2023 using PubMed, CINAHL, EMBASE, and Cochrane Library. Included studies evaluated adalimumab discontinuation approaches, tapering schemes, and outcomes including successful discontinuation and recapture after flare, in patients with well-controlled disease.
Indian J Pediatr
December 2024
Department of Pediatrics, Dr. D.Y. Patil Medical College, Hospital and Research Center, Pune, Maharashtra, India.
Pediatr Rheumatol Online J
December 2024
Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, 686 Bay Street, Room 06.9715, Toronto, ON, M5G 0A4, Canada.
Background: Juvenile Idiopathic Arthritis (JIA) is a chronic pediatric illness, whereby youth experience physical, emotional and psychosocial challenges that result in reduced health related quality of life (HRQL). Peer mentoring has been shown to improve disease self-management in adults with chronic conditions, with mixed results in younger populations. Building on our pilot work - which supported the feasibility and initial effectiveness of the iPeer2Peer program - the objective of this study was to assess the clinical effectiveness of the program in youth with JIA through a waitlist randomized controlled trial.
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