Juvenile Idiopathic Arthritis dengan Perawakan Pendek
Annisa Mulyandini, dr. Sumadiono, Sp.A(K); dr. Endy Paryanto Prawirohartono, MPH, Sp.A(K)
2024 | Tesis-Spesialis | S2 Ilmu Kesehatan anak
Background: Juvenile idiopathic arthritis (JIA) in male patient is less often rather than in female patient. Therapy of JIA is given for approximately eleven weeks pharmacology administration. For several unusual cases, JIA treatment is tended to be prolonged until several months.
Case Presentation: A 5-year-old male patient with chief complaint of leg pain for more than 6 weeks and shorter body height compared to other boys with the same age, went to allergy immunology outpatient clinic in tertiary level general hospital. There were no history of fever nor trauma. Treated as an oligoarticular JIA, the leg pain got better. However, new onset of pain existed on different areas such as finger hand joints.
Laboratory results of rheumatoid factor (RF) and antinuclear antibody test (ANA IF) were negative. Abnormal pGALS result (at gait and legs parameter), microcytic hypochromic anemia, stunting, moderate acute malnutrition, and leg-length discrepancy were found. The difference between both of femurs’ length range was less than 2 cm (in this case ±0.99 cm) radiologically, thus it didn’t meet any criteria for operation correction. JIA-related uveitis was not found. Its treatment was lengthened (while author’s observation period was 1 year) until approximately 19 months therapeutic session. Polyarticular JIA was established, and he received metabolite agent (methotrexate), and some episodes of intraarticular injections. Physiotherapy was also done supported by medical rehabilitation department.
During observation, better progress was noticed such as decreased intensity and quantity of pain every day, better pGALS parameters and better quality of night sleep.
Summary: This patient experienced prolonged JIA treatment rather than most cases. Low socioeconomic factor with the single-parent mother status were challenging in improving both child and family or caregivers’ quality of life. It may need many supporting factors that played role in such resemblant case. After total 19-month treatment, follow ups were still needed for possible complications.
Kata Kunci : Juvenile idiopathic arthritis, anak, oligoartikular, poliartikular