RENAL INVOLVEMENT IN A CHIL WITH JUVENILLE IDIOPATHIC ARTHRITIS (JIA)
Zulkarman Masud,Budi Setiabudiawan,Reni Ghrahani,Gartika Sapartini
Background : Juvenille Idiopathic Arthritis (JIA) is a chronic inflammation of the joint for more than 6 weeks. It might involve other organs such as lung or renal. Renal involvement maybe part of the disease progression or side effects due to therapy. It is important for a doctor to screen whether there is extra-articular involvement in JIA. Urinalysis and renal function test should be done for monitoring and early diagnosed that can reduce morbidity and mortality. Eventhough the case were rare, every doctor have to improve their awareness.
Case Presentation Summary : A girl, 13 years old, came to Allergy Immunology Clinic of Hasan Sadikin Hospital with chief complaint swollen joints since 2016. Physical examination showed swollen of inter-phalang and knee joint, pain and hyperaemia. Laboratory examination showed Rheumatoid Factor positive, ANA test and anti-dsDNA were non reactive. She diagnosed with polyarthritis JIA and was given methotrexate (MTX) subcutaneously for the therapy. After 2 years diagnosed and treated with MTX, the patient showed elevated of renal function (Ureum 121 mg/dL, Creatinin 6,35 mg/dL, and protein urine +3). From physical examination we found hypertension. The renal function became normal after observation 1 month without any spesific treatment. She was then recommended to undergo renal biopsy.
Learning Points/Discussion : Renal involvement in child with JIA is a rare case. Urinalysis and renal function test should be done routinely in patient with JIA to monitor the progression of the disease
Keywords: Juvenille Idhiopathic Arthritis renal involvement children
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