Treatment of Juvenile Idiopathic Arthritis: Transitioning to Adult Care

Juvenile rheumatoid arthritis, referred to as juvenile idiopathic arthritis, is the most prevalent form of arthritis among children under 16 years old. It is an autoimmune condition with symptoms that often persist into adulthood. Patients diagnosed with juvenile idiopathic arthritis often require a transition of care from a pediatric rheumatologist to an adult rheumatologist when they turn 18. 

Transitioning from pediatric to adult care presents a unique set of challenges. Significant life changes like going away to college, starting a new job, or moving to a new location all while trying to find a new provider can add to the stress of the transition. However, it’s very important to ensure the continuity of treatment and support to best manage the treatment of juvenile idiopathic arthritis. 

What is Juvenile Idiopathic Arthritis? 

Juvenile idiopathic arthritis (JIA) is an autoimmune disease. In individuals with autoimmune diseases, the immune system, which is designed to fight invaders such as germs and viruses, becomes confused and begins to attack its own cells and tissues. This immune dysregulation triggers an inflammatory response. In patients with rheumatoid arthritis or juvenile idiopathic arthritis, the lining of the joints (joint capsule) becomes inflamed.   

JIA causes the swelling of joints that is characterized by heat and pain. JIA can be short-term, lasting a few weeks or months before symptoms improve. It can also be chronic and last for years or even a lifetime. The first signs of JIA can easily be mistaken for common illnesses and injuries of childhood.  Other children with JIA may experience more obvious symptoms of arthritis. 

Symptoms of Juvenile Idiopathic Arthritis 

The most common symptoms of JIA include: 

  • Pain: Children may not express that they are experiencing joint pain. However, that pain may present as limping, especially in the morning or after periods of being sedentary. 
  • Swelling: Joint swelling is common in JIA and most often noticed in larger joints such as the knee. 
  • Stiffness: Clumsiness, particularly in the morning or after periods of rest, may indicate stiffness. 
  • Fever, swollen lymph nodes and rash: In some cases, additional symptoms can occur and may worsen in the evenings. 

Types of Juvenile Idiopathic Arthritis 

JIA can affect a single joint or multiple joints. There are several subtypes of JIA including systemic polyarthritis and oligoarthritis. The main differentiators between the various types of JIA are the symptoms and the number of joints affected.  

The term “idiopathic” means that the cause is unknown, and researchers are not sure why children develop JIA. Most believe that specific genes in children with JIA may be triggered by viruses, bacteria, or other external factors. There is no definitive evidence that suggests dietary factors, toxins, vitamin deficiencies or allergies play a role in the development of JIA. 

What is the Difference between Juvenile Idiopathic Arthritis and Rheumatoid Arthritis? 

Like JIA, RA is a disease where your immune system attacks the tissue lining the joints. While both are types of inflammatory arthritis, JIA is not the same as RA. To be diagnosed with JIA, a child must be under 16 years old and have inflammation in at least one joint that lasts for more than 6 weeks.  RA usually starts to develop between the ages of 30 and 60.   

JIA encompasses various types of arthritis occurring in children, whereas RA specifically refers to the chronic autoimmune condition affecting adults. Unlike adult RA, an ongoing and life-long condition, children may outgrow JIA. However, in some cases, JIA may turn into RA in adulthood. Understanding the differences between JIA and RA is crucial for accurate diagnosis and appropriate treatment planning.   

When to Start Searching for an Adult Rheumatoid Arthritis Provider? 

Transitioning to adult care should begin well in advance to ensure a smooth transfer of care. Typically, discussions about transitioning should start during adolescence, around the ages of 14 to 18, depending on individual circumstances. Signs indicating the need for transition include changes in disease severity, the onset of adulthood, or graduating from pediatric care due to age restrictions. 

How to Transition to Adult Arthritis Care? 

Transitioning to adult rheumatoid arthritis care is a process that involves several steps: 

  • Communication: Maintain communication with current healthcare providers to discuss the transition process, gather necessary information, determine transition “readiness” and create a plan. 
  • Research: Research adult rheumatoid arthritis providers in your area and consider factors such as their experience, expertise, convenience, and compatibility with your needs. It may also help to seek advice from your pediatric rheumatologist. 
  • Medical Records: Ensure all medical records, including treatment history and diagnostic tests, are well maintained, organized, and readily available for a new provider. 
  • Insurance and Logistics: Understand any changes in insurance coverage or healthcare plans that may occur during the transitional period. Plan accordingly. 
  • Self-advocacy: Develop self-advocacy skills so that you may participate in treatment decisions and communicate your needs effectively. 
  • Support System: Seek support from family, friends, and patient advocacy groups to help you navigate the transition process and adjust to the changes that will come along with adult care. 

Transitioning juvenile idiopathic arthritis treatment to adult care requires planning and proactive involvement from patients, caregivers, and healthcare providers. Our team at Summit Rheumatology accepts patients transitioning their juvenile idiopathic arthritis treatment to adult care.  

Give us a call at (480) 660-0780 or send us a message to learn more or schedule an appointment with a rheumatologist.