Juvenile Idiopathic Arthritis (JIA)/Adult-onset Still's Disease

Overview

JIA

In JIA, autoantibodies target healthy joint cells and tissues. Formerly known as juvenile rheumatoid arthritis, JIA is a diagnosis that covers all forms of arthritis in individuals under 16 that last more than 6 weeks and whose origin is unknown. 

JIA can arise in 6 different subtypes: 

  • Oligoarthritis
  • Polyarthritis
  • Systemic-onset (Still’s Disease)
  • Psoriatic arthritis (PsA)
  • Enthesitis-related
  • Undifferentiated

 

Adult-onset Still’s Disease

When diagnosed in adults, JIA is more commonly called adult-onset Still’s disease. Some people only experience one episode of Still’s disease, but for others, it can cause chronic progressive illness.

The cause of Still’s disease is unknown, though several different treatments are available to help manage symptoms. As symptoms, progression, and severity differ widely amongst individuals with Still’s, the disease can be challenging to diagnose and treat.

Common Symptoms

JIA

Joint pain, swelling, stiffness, fevers, swollen lymph nodes, and rashes (particularly on the torso of the body).

 

Adult-onset Still’s Disease

Joint pain, recurrent high fevers, skin rash, muscle pain, and sore throat.

Coexisting Diseases and Conditions

JIA

Eye inflammation (uveitis) can arise if left untreated, such as cataracts, glaucoma, and blindness, growth and bone development can be affected both by the condition itself and certain medications (mainly corticosteroids) used to treat the condition, psoriasis, Hashimoto’s thyroiditis, Crohn’s disease, ulcerative colitis, diabetes mellitus.

 

Adult-onset Still’s Disease

Chronic organ and joint inflammation leads to most complications including joint destruction, heart inflammation, excess fluid around the lungs, and macrophage activation syndrome.

Risk Factors and Prevalence

JIA

Girls tend to be more than twice as likely as boys to develop JIA. Further studies have shown that children aged 2-4 and 6-12 are at the highest risk of developing JIA. Studies have found that exposure to cigarette smoke puts children at further risk of developing JIA.

 

Adult-onset Still’s Disease

There are two peaks of age ranges when developing adult Still’s disease is most common, 15-25 years and 36-46 years.

Sources

  1. Article Sources and Footnotes

    1. Ellis, J. A., Munro, J. E., & Ponsonby, A.-L. (2010). Possible environmental determinants of juvenile idiopathic arthritis. Rheumatology, 49(3), 411–425. https://doi.org/10.1093/rheumatology/kep383.

    2. França, C. M. P., Sallum, A. M. E., Braga, A. L. F., Strufaldi, F. L., Silva, C. A. A., & Farhat, S. C. L. (2018). Risk Factors Associated with Juvenile Idiopathic Arthritis: Exposure to Cigarette Smoke and Air Pollution from Pregnancy to Disease Diagnosis. The Journal of Rheumatology, 45(2), 248–256. https://doi.org/10.3899/jrheum.161500.

    3. Juvenile Arthritis | Boston Children’s Hospital. (n.d.). Https://Www.Childrenshospital.Org/Conditions-and-Treatments/Conditions/j/Juvenile-Arthritis. Retrieved July 9, 2021, from https://www.childrenshospital.org/conditions-and-treatments/conditions/j/juvenile-arthritis. 

    4. Juvenile idiopathic arthritis. (n.d.). Ada. Retrieved July 9, 2021, from https://ada.com/conditions/juvenile-idiopathic-arthritis/.

    5. Juvenile Idiopathic Arthritis (JIA) | Arthritis Foundation. (n.d.). Retrieved July 9, 2021, from https://www.arthritis.org/diseases/juvenile-idiopathic-arthritis.

    6. Juvenile idiopathic arthritis—Symptoms and causes. (n.d.). Mayo Clinic. Retrieved July 9, 2021, from https://www.mayoclinic.org/diseases-conditions/juvenile-idiopathic-arthritis/symptoms-causes/syc-20374082.

    7. Simon, T. A., Harikrishnan, G. P., Kawabata, H., Singhal, S., Brunner, H. I., & Lovell, D. J. (2020). Prevalence of co-existing autoimmune disease in juvenile idiopathic arthritis: A cross-sectional study. Pediatric Rheumatology, 18(1), 43. https://doi.org/10.1186/s12969-020-00426-9.

    8. Rose, N. R., & Mackay, I. R. (2020). The Autoimmune Diseases (6th ed., pp. 676-687). Academic Press.

    9. Liu Z, et al. Clinical features and prognosis of adult-onset Still’s disease: 75 cases from China. International Journal of Clinical and Experimental Medicine. 2015;8:16634