SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS MIMICKING INFECTION: A CASE REPORT

Background:Juvenile Idiopathic Arthritis (JIA) is the most common chronic rheumatic disease in children,with systemic JIA (sJIA) comprising 10–20% of cases. Its varied presentation, including fever, lymphadenopathy, and hepatosplenomegaly,often mimics infections and malignancies,leading to delayed diagnosis. Case Presentation:We report the case of a 13-year-old male who presented with intermittent fever for two years, joint pains, and cervical lymphadenopathy.Extensive infectious and autoimmune work-up was inconclusive.Laboratory investigations revealed elevated ESR, CRP, ferritin, and leukocytosis. Imaging demonstrated lymphadenopathy and hepatosplenomegaly. Despite broad-spectrum antibiotics,his fever persisted.A clinical diagnosis of systemic JIA was established,and he was initiated on corticosteroids and disease-modifying anti-rheumatic drugs (DMARDs), including methotrexate and hydroxychloroquine. The patient showed marked clinical improvement and remains in remission on follow-up. Discussion: Systemic JIA poses significant diagnostic challenges due to its overlapping features with infectious and malignant disorders.Elevated ferritin and persistent systemic inflammation are helpful diagnostic clues.Early initiation of corticosteroids and DMARDs is crucial to control disease activity and prevent complications such as macrophage activation syndrome. Conclusion: This case highlights the importance of considering systemic JIA as a differential diagnosis in pediatric patients with prolonged fever and elevated inflammatory markers.Prompt recognition and timely treatment can significantly improve long-term outcomes.