Abstract

Systemic Juvenile Idiopathic Arthritis (sJIA, Still’s disease) in children was first described by George Frederick Still in 1896 in Great Britain. In 1971 E.G. Bywaters identified and described in detail the adult form-the so-called adult-onset Still’s disease. This was an important step in distinguishing between children’s and adults’ manifestations of the disease, and since then the world literature has clearly differentiated juvenile and adult forms, although modern recommendations (EULAR/PReS 2024) treat them as a single spectrum- Still’s disease.
sJIA is a rare systemic inflammatory disease, diagnosed based on clinical signs and supported by laboratory and instrumental findings; it remains a diagnosis of exclusion. In the treatment strategy for sJIA, nonsteroidal anti‑inflammatory drugs and glucocorticosteroids are widely used for anti‑inflammatory, antipyretic and analgesic purposes. Recent clinical trials have shown positive results in the use of new pharmacotherapeutic agents, such as monoclonal antibodies and anti-interleukin drugs. The optimal therapeutic strategy is the early use of interleukins (IL-1 or IL-6 inhibitors) in combination with glucocorticoids and immunosuppressants (e.g., cyclosporine A, methotrexate) in severe cases or in Macrophage Activation Syndrome (MAS).
The prognosis of sJIA varies among different children: some patients recover completely after a certain time, some have a relapsing course with alternating periods of exacerbation and remission, and about half of the patients have a long‑term course of the disease. This article presents a clinical case of sJIA in an eleven‑month‑old child.

Keywords:Still’s syndrome; Systemic juvenile idiopathic arthritis; Rash; Fever; Systemic inflammatory response syndrome

Abbreviations: JIA: Juvenile Idiopathic Arthritis; sJIA: Systemic Juvenile Idiopathic Arthritis; SIRS: Systemic Inflammatory Response Syndrome; MAS: Macrophage Activation Syndrome; CRP: C-Reactive Protein; BMP: Bone Marrow Punctate; ANA: Antinuclear Antibodies; CMV: Cytomegalovirus; EBV: Epstein-Barr Virus