SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS: ETIOLOGY, PATHOGENESIS, CLASSIFICATION, CLINICS, DIAGNOSIS, TREATMENT. MODERN ASPECTS. LITERATURE REVIEW

Abstract

The article is devoted to the current state of the problem of Systemic Juvenile Idiopathic Arthritis. A historical insight into the concept of the disease and its definitions is made. The literature review of the modern concept of epidemiology, etiology, pathogenesis, classification, course, clinic of Systemic Juvenile Idiopathic Arthritis is presented. It is emphasized that the diagnosis of Systemic Juvenile Idiopathic Arthritis is the most difficult, especially when the joint syndrome is absent or delayed, or mild, or may have arthralgia, and the clinical picture is dominated by hectic fever, rash and internal organ damage. The modern criteria for the diagnosis of Systemic Juvenile Idiopathic Arthritis are presented. A comparative characterization of the ILAR and Yamaguchi criteria was performed. Yamaguchi’s criteria do not make arthritis mandatory for the diagnosis and treatment of systemic juvenile idiopathic arthritis, which makes these criteria more sensitive, facilitates early and timely diagnosis and timely treatment.The latest data on the possibility of treating the disease are highlighted in detail: glucocorticosteroids, nonsteroidal anti-inflammatory drugs, immunosuppressants, genetically engineered biological drugs. Particular attention is paid to international experience in the use of genetically engineered biological drugs in the treatment of Systemic Juvenile Idiopathic Arthritis: IL-6 inhibitor – tocilizumab, IL-1 inhibitors – anakinra, canakimumab, and in case of ineffectiveness of IL-6, IL-1, – rituximab – chimeric monoclonal antibodies to CD20 + (B lymphocytes). The prospects for the use of Jak inhibitors in patients with refractory Systemic Juvenile Idiopathic Arthritis are discussed. The appropriate appointment of aggressive therapy in the early stages of Systemic Juvenile Idiopathic Arthritis can prevent complications, prevent the progression of the pathological process and the formation of deforming arthritis with early disability of the child. It is concluded that Systemic Juvenile Idiopathic Arthritis is a severe serious pathology in children and requires further in-depth study of this problem, optimization of the diagnostic algorithm and individual approach to treatment.

Keywords

• systemic juvenile idiopathic arthritis
• children
• clinic
• diagnosis
• treatment.