Treatment guidelines, based upon presence or absence of active systemic features, clinician global assessment, active joint count, and presence or absence of features concerning for macrophage activation syndrome (MAS), are outlined by the American College of Rheumatology (ACR) [ 2 ]. These guidelines emphasize the earlier use of biologics in children with sJIA, although specific information on appropriate dose is lacking. Another set of standardized treatment plans was developed through a consensus process by the Childhood Arthritis and Rheumatology Research Alliance (CARRA) based upon the most commonly used treatment approaches for systemic JIA [ 3 ].
An infection of the eye or inflammation from trauma may cause iritis. Iritis may also be a complication of many diseases such as juvenile rheumatoid arthritis , ankylosing spondylitis , tuberculosis , sarcoidosis , and collagen vascular diseases such as lupus . Iritis may occur with herpes simplex of the eye and after eye surgery. Iritis related to juvenile rheumatoid arthritis is especially dangerous and may not respond well to treatment, leading to serious eye damage. In children with arthritis , pain from iritis is often absent. Because of this, "simple" red eyes in these children should not be ignored. Iritis is not contagious . Iritis may occur in one or both eyes. In a large proportion of cases, no cause can be found, particularly if it is a new and isolated symptom. Recurrent or bilateral episodes are much more likely to be significant.