Characteristic of Systemic Juvenile Idiopathic Arthritis -

Ans. is 'c' i.e., RA factor is negative * JRA is the most common type of Juvenile idiopathic arthritis, thus, most often JRA is used as a synonym for juvenile idiopathic arthritis.* JRA is a group of chronic inflammatory joint disorder characterized by :i) Arthritis of one or more jointsii) Onset before 16 yearsiii) Persisting for > 6 weaksiv) Exclusion of other causes of arthritis.* JRA can be classified into following typesA) Pauciarticular (oligoarticular) JRA# It is characterized by involvement of four or fewer joints. It is the most common type of JRA. Joint involvement is assymetrical.# There are two subtypesi) Type 1* It is characterized by eye involvment with iridocyclitis, glaucoma, cataract.* It is associated with HLA - DR5 and DRW8.* Antinuclear antibody (ANA) is positive but rheumatoid factor (RF) is negative.ii) Type II* It is characterized by self limiting iritis (not iridocyclitis) and is associated with HLA-B27.* Both ANA and RF are negative.B) Polyarticular JRA# It is characterized by involvement of 5 or more joints.# There are two subtypesi) Polyarticular RA positive* It is characterized by symmetrical joint involvement along with Uveitis, and rheumatoid nodules.* RA factor and ANA are positive.ii) Polyarticular RA negative* RA factor and rheumatoid nodules are not seen.C) Systemic JRA# It is characterized by systemic features like fever with rash, lymphadenopathy, and hepatosplenomegaly.# There is neutrophilic leukocytosis with raised ESR.# ANA may be positive, but RA factor is negative.# Uveitis (iridocyclitis) is characteristically asent.* Initial drug of choice for JRA is one of the NSAIDs. NSAIDs commonly used in children are Naproxen, Ibuprofen, Aspirin and Indomethacin.