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Systemic juvenile idiopathic arthritis — SCE Rheumatology MCQ

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HardPaediatric rheumatologySystemic juvenile idiopathic arthritisSCE Rheumatology

A child with Still disease receiving IL-1 inhibition develops persistent cough, clubbing and falling oxygen saturation. What disease complication should be actively investigated?

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Correct answer: E — Still-disease-associated interstitial lung disease

Still-disease-associated lung disease is uncommon but serious and can occur with characteristic clinical and treatment phenotypes. Persistent respiratory symptoms or clubbing require PFTs, HRCT, infection evaluation and a specialist paediatric ILD–rheumatology review.

Reference: Consensus screening algorithm for lung disease in systemic JIA and Still disease (Published 2023): https://pmc.ncbi.nlm.nih.gov/articles/PMC10570670/; EULAR/PReS recommendations for Still disease across children and adults (Published November 2024): https://ard.bmj.com/content/83/12/1614