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Juvenile Idiopathic Arthritis

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Abstract

Juvenile idiopathic arthritis (JIA) is the most common cause of chronic inflammatory arthritis in children and many patients have active disease that persists into adulthood. There are differences in the classification and management of JIA in comparison to adult-onset arthritis. Many patients will be taking immunosuppressive medications when they transition to adult care. In addition, they are at risk for comorbid conditions related to bone health, cardiovascular disease, reproductive health, medication toxicity, and complications from their arthritis. Primary care providers have an important role in the care of young adults with JIA. Being knowledgeable about this condition will assist them in anticipating, preventing, and treating late effects of this pediatric-onset condition. This chapter discusses the areas adult providers should consider when caring for young adults with juvenile idiopathic arthritis.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Rheumatology, Children’s National Health System, 111 Michigan Ave NW, Washington, DC, 20010, USA

    Tova Ronis

  2. Got Transition: the Center for Health Care Transition Improvement, Department of Medicine and Pediatrics, George Washington University School of Medicine and Health Sciences, 1615 M Street, NW, Suite 290, Washington, DC, 20036, USA

    Patience H. White

Authors
  1. Tova Ronis
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  2. Patience H. White
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Corresponding author

Correspondence to Tova Ronis .

Editor information

Editors and Affiliations

  1. School of Medicine, Hofstra North Shore-LIJ School of Medicine, LAKE SUCCESS, New York, USA

    Mariecel Pilapil

  2. Mount Sinai School of Medicine , NEW YORK, New York, USA

    David E. DeLaet

  3. University of California Los Angeles , SANTA MONICA, California, USA

    Alice A. Kuo

  4. Baylor Clinic , HOUSTON, Texas, USA

    Cynthia Peacock

  5. Brigham and Women's Hospital , BOSTON, Massachusetts, USA

    Niraj Sharma

Appendix

Appendix

Juvenile Idiopathic Arthritis (JIA) condition fact Sheet

Definition

JIA is an autoimmune disease defined by arthritis occurring for greater than 6 weeks in a child younger than 16

 • Subtypes of JIA include: systemic, oligoarticular, polyarticular (rheumatoid factor positive or negative), enthesitis-related arthritis, psoriatic arthritis, and undifferentiated

 • Each subtype of JIA has a different presentation

Epidemiology

 • Prevalence of JIA ranges from 10 to 400 per 100,000 around the world

 • There is overall a 2:1 female-to-male ratio

 • Oligoarthritis is the most common subtype of childhood arthritis affecting 50–80 % of all children with chronic arthritis

 • A substantial number of JIA patients continue to have active arthritis into adulthood

Special considerations

Individuals with JIA are at risk for comorbid physical and mental health conditions, including

 • Persistent arthritis

 • Growth abnormalities

 • Ocular complications

 • Medication toxicity including infection, teratogenic risk

 • Anxiety and depression

 • Macrophage activation syndrome

 • Chronic pain

Individuals are at heightened risk for chronic conditions, including

 • Uveitis

 • Atherosclerosis and coronary heart disease

 • Osteoporosis and fractures

 • Osteoarthritis

 • Malignancy

 • Need for joint replacement surgery

 • Sjögren’s syndrome

Recommended screening

Patients may require lab screening for medication side effects

Suggested Reading List

  • Petty RE, Laxer RM, Lindsley CB, Wedderburn L, Cassidy JT (eds). Textbook of pediatric rheumatology, Seventh edition. Philadelphia, PA: Elsevier. 2016

  • Espinosa M, Gottlieb BS. Juvenile Idiopathic Arthritis. Pediatr. Rev. 2012;33, 303–313.

  • Coulson EJ, Hanson HJM, Foster HE. What does an adult rheumatologist need to know about juvenile idiopathic arthritis? Rheumatol Oxf Engl. 2014 Dec;53(12):2155–66.

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Ronis, T., White, P.H. (2016). Juvenile Idiopathic Arthritis. In: Pilapil, M., DeLaet, D., Kuo, A., Peacock, C., Sharma, N. (eds) Care of Adults with Chronic Childhood Conditions. Springer, Cham. https://doi.org/10.1007/978-3-319-43827-6_14

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  • DOI: https://doi.org/10.1007/978-3-319-43827-6_14

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  • Online ISBN: 978-3-319-43827-6

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