A 4-year-old child presents with daily high spiking fevers (39-40°C) for 3 weeks, evanescent salmon-colored rash during fever spikes, and arthritis. Laboratory tests show leukocytosis, thrombocytosis, and elevated ferritin. Which subtype of juvenile idiopathic arthritis does this represent?
- A Polyarticular JIA, RF positive
- B Systemic-onset JIA ✓
- C Oligoarticular JIA
- D Polyarticular JIA, RF negative
Correct answer: B. Systemic-onset JIA
Explanation
Systemic-onset JIA (Still disease) is characterized by quotidian fever, evanescent salmon-colored rash, arthritis, and systemic inflammation with very high ferritin. It represents 10-20% of JIA cases. Polyarticular JIA involves 5 or more joints. Oligoarticular involves 4 or fewer joints.
Reference: Nelson Textbook of Pediatrics, 21st ed.
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