N. Iagăru, A.V. Cochino
University of Medicine and Pharmacy “Carol Davila”, Pediatric Clinic/Mother and Child Healthcare Institute “Alfred Rusescu” Bucharest
Abstract
Background. Systemic arthritis belongs to a heterogeneous group of pediatric rheumatic diseases known as juvenile idiopathic arthritis (JIA). This subtype is defi ned by extraarticular signs which, even today, lead to diagnosis without specific lab tests. Patients with systemic arthritis (sJIA) also have a range of other prominent features, including elevation of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), leukocytosis with high neutrophil counts and thrombocytosis. Ferritin concentrations are high and correlate with systemic disease activity. Systemic arthritis is often extraordinarily resistant to treatment with steroids, methotrexate, etanercept, etc. We will present one such case, with persistent evolution refractory to multiple conventional and biological remissive drugs.