MANAGEMENT DILEMMA IN REFRACTORY JIA: OUR EXPERIENCES
Sanat Biswas*, Rakesh Mondal**, Madhumita Nandi***, Dipankar Gupta****, Tapas Sabui*****
Pediatric Rheumatology Clinic, Department of Pediatrics IPGME&R and SSKM Hospital, Kolkata *, Pediatric Rheumatology Clinic, Department of Pediatrics IPGME&R and SSKM Hospital, Kolkata.**, Pediatric Rheumatology Clinic, Department of Pediatrics IPGME&R and SSKM Hospital, Kolkata.***, Pediatric Rheumatology Clinic, Department of Pediatrics IPGME&R and SSKM Hospital, Kolkata. ****, Pediatric Rheumatology Clinic, Department of Pediatrics IPGME&R and SSKM Hospital, Kolkata. *****
Abstract
Objective
To study the profile of Juvenile Idiopathic Arthritis patients who were resistant to the standard treatment protocols.

Methods and Results
5 cases out of a total of 200 cases of JIA attending a tertiary care center in eastern India were resistant to first and second lines of treatment. They were retrospectively analysed. Their complete patient profile presented and the factors responsible for refractoriness tried to be found out. Only one child was male and the rest were female. One 12 year old female child had SOJIA and the rest had POJIA. The SOJIA child had to be given Leflunomide in addition to the traditional first and second line drugs to which she responded partially. All the POJIA children were RF negative.

Conclusion
2-3% of all cases of JIA is found to be having refractory JIA. They also had different associated complications like AIHA, MAS, etc, making them more difficult to manage in absence of any definite protocol. In "country in transition" like us, we're required to have some less costly options of newer biologicals therapy for managing these difficult patients.
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Biswas S, Mondal R, Nandi M, Gupta D, Sabui T.. Available From : http://www.pediatriconcall.com/fordoctor/ Conference_abstracts/report.aspx?reportid=54
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