Abstract

Background: Juvenile Idiopathic Arthritis (JIA) is a prevalent pediatric rheumatological disorder characterized by inflammatory joint disease lasting over six weeks in children under sixteen years of age. Early intervention with disease-modifying anti-rheumatic medications and biologic response modifiers can alter the disease’s natural course and reduce the risk of joint and ocular damage.
Methods: A comprehensive review of the literature from 2005 to 2023 was conducted using PubMed/MEDLINE and Google Scholar. The search focused on recent articles, including retrospective cohort studies, observational studies, systematic reviews, comparative studies, case reports, randomized controlled trials, and clinical trials related to JIA.
Results: JIA comprises various subtypes, each with distinct clinical features and diagnostic criteria. These include oligoarticular JIA, polyarticular JIA, systemic JIA, enthesitis-related JIA, psoriatic JIA, and undifferentiated JIA. The etiology of JIA is multifactorial, involving genetic, environmental, and immunological factors. Genetic predisposition, such as specific HLA alleles, may increase the risk. Environmental factors, including infections and exposure to toxins, can trigger or exacerbate JIA. Immunological dysregulation, with elevated proinflammatory cytokines like TNF-α, IL-6, and IL-1, plays a central role. Pharmacological treatment options for JIA encompass nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and biologic agents. NSAIDs are used primarily for symptomatic relief, while DMARDs, notably methotrexate, are mainstays of treatment. Biologic agents like TNF inhibitors, IL-1, and IL-6 inhibitors have revolutionized JIA management. Physical activity and exercise can help alleviate inflammation, and some surgical interventions, including joint replacements, may be necessary in advanced cases. Dietary interventions, such as omega-3 supplements and diets rich in fruits and vegetables, may offer additional benefits. Psychological therapy can contribute to pain management and overall well-being in children with JIA.
Conclusion: JIA is a multifaceted disease with varying subtypes and complex etiology. Early diagnosis and tailored treatment plans, including NSAIDs, DMARDs, and biologic agents, can effectively manage the condition. Complementary approaches, such as exercise, surgery, dietary modifications, and psychological interventions, may further enhance the quality of life for JIA patients. Continued research is essential to deepen our understanding of JIA’s pathophysiology and refine treatment strategies.