New classification criteria for juvenile idiopathic arthritis

Chen, Kexin; Zeng, Haisheng; Togizbayev, Galymzhan; Martini, Alberto; Zeng, Huasong

doi:10.1111/1756-185x.14813

Cited by 3 publications

(1 citation statement)

References 25 publications

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“…The diagnosis of systemic JIA, which represents 15-20% of all forms of JIA, remains by exclusion. The newly proposed JIA classification states that sJIA is equivalent to adultonset Still disease, and, therefore, the presence of arthritis is no longer mandatory [40]. In addition to fever, the presence of a classic rash plus the presence of at least two secondary criteria are sufficient for diagnosis.…”

Section: Autoimmune Inflammatory Diseasesmentioning

confidence: 99%

Update on Fever of Unknown Origin in Children: Focus on Etiologies and Clinical Approach

Trapani,

Fiordelisi,

Stinco

et al. 2023

Children

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Fever of unknown origin (FUO) can be caused by four etiological categories of diseases. The most common cause of FUO in children is represented by infections, followed by inflammatory conditions and neoplastic causes; a decreasing quote remains still without diagnosis. Despite the fact that several diagnostic and therapeutic approaches have been proposed since the first definition of FUO, none of them has been fully validated in pediatric populations. A focused review of the patient’s history and a thorough physical examination may offer helpful hints in suggesting a likely diagnosis. The diagnostic algorithm should proceed sequentially, and invasive testing should be performed only in select cases, possibly targeted by a diagnostic suspect. Pioneering serum biomarkers have been developed and validated; however, they are still far from becoming part of routine clinical practice. Novel noninvasive imaging techniques have shown promising diagnostic accuracy; however, their positioning in the diagnostic algorithm of pediatric FUO is still not clear. This narrative review aims to provide a synopsis of the existent literature on FUO in children, with its major causes and possible diagnostic workup, to help the clinician tackle the complex spectrum of pediatric FUO in everyday clinical practice.

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Section: Autoimmune Inflammatory Diseasesmentioning

confidence: 99%

Update on Fever of Unknown Origin in Children: Focus on Etiologies and Clinical Approach

Trapani,

Fiordelisi,

Stinco

et al. 2023

Children

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Polyarteritis nodosa mimics Kawasaki disease

Alibrahim,

Mirza,

Khojah

2024

BMJ Case Rep

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Polyarteritis nodosa (PAN) is a rarely seen vasculitis that often affects small-sized and medium-sized arteries. PAN can present with diverse clinical features depending on the organs involved, including potential cardiac involvement. Typical cardiac manifestations of PAN in the paediatric age group include pericarditis, valvular heart disease and coronary artery aneurysms. In contrast to PAN, Kawasaki disease (KD) is often associated with coronary artery abnormalities. Herein, we report a case of a young boy presented with KD-like features, including a coronary artery aneurysm confirmed by an echocardiogram (ECHO) and eventually diagnosed as PAN. The patient was treated with steroids, methotrexate and tocilizumab with improvement of the symptoms. Repeated ECHO revealed the resolution of the coronary artery aneurysms. Our paper highlights a rare presentation of PAN mimicking KD presentation. Physicians should consider PAN in chronic or severe courses of KD or coronary artery aneurysms.

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Conservative, Non-pharmacological Interventions for Pain Management in Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Musso-Daury,

Pascual Fernández,

López-Ortiz

et al. 2024

Cureus

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We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the effectiveness of conservative, non-pharmacological interventions for chronic pain management in children and adolescents with juvenile idiopathic arthritis (JIA). A comprehensive search strategy was implemented across PubMed, PEDro, and Web of Science databases, utilizing predefined terms and strict inclusion and exclusion criteria. The initial search yielded 1,308 studies, which were subsequently narrowed to 65 relevant articles. Following a rigorous evaluation, 14 studies met the inclusion criteria for final review, with an average PEDro scale score of 6.1/10, indicating fair to good methodological quality. The included RCTs focused on various interventions, including physical exercise (five studies), hydrotherapy (three studies), orthoses (two studies), online cognitive behavior therapy for pain management (two studies), low-level laser therapy (one study), and video games (one study). A random-effects model meta-analysis was performed for interventions and outcome measures that were comparable across at least three RCTs. Physical exercise interventions met this criterion and were thus subjected to meta-analytic evaluation. The pooled analysis demonstrated a statistically significant beneficial effect of exercise interventions on chronic pain (mean difference (MD) = -1.37, 95% CI = -2.19 to -0.55, p < 0.01). Subgroup analyses further supported the efficacy of exercise compared to both other active interventions (MD = -1.37, 95% CI = -2.25 to -0.5, p < 0.01) and control conditions (MD = -1.69, 95% CI = -3.09 to -0.29, p = 0.02). These findings suggest that conservative, non-pharmacological interventions, particularly physical exercise, show promise as a component of a multidisciplinary pain management strategy for patients with JIA. While further high-quality research is needed to bolster the evidence base, our findings highlight the potential efficacy of integrating physical exercise interventions into comprehensive pain management strategies for this pediatric population.

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New classification criteria for juvenile idiopathic arthritis

Cited by 3 publications

References 25 publications

Update on Fever of Unknown Origin in Children: Focus on Etiologies and Clinical Approach

Update on Fever of Unknown Origin in Children: Focus on Etiologies and Clinical Approach

Polyarteritis nodosa mimics Kawasaki disease

Conservative, Non-pharmacological Interventions for Pain Management in Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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