Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Potential long-term complications of juvenile idiopathic arthritis (JIA) to monitor include:
- Joint damage and deformities: Chronic inflammation can lead to joint erosion, growth disturbances, and permanent deformities, impacting function and mobility NICE NG100 Boros & Whitehead 2010.
- Ocular complications: Chronic anterior uveitis is a significant risk, potentially causing vision loss if not detected and treated early NICE NG100 Quartier et al. 2025.
- Growth abnormalities: Both localised limb length discrepancies and overall growth retardation may occur due to disease activity or corticosteroid use NICE NG100 Boros & Whitehead 2010.
- Systemic complications: In systemic JIA, there is risk of macrophage activation syndrome, a life-threatening hyperinflammatory state, and potential organ involvement including liver and heart NICE NG100 Quartier et al. 2025.
- Increased risk of comorbid autoimmune conditions: There is emerging evidence of associations with other autoimmune diseases such as type 1 diabetes, which may complicate management Szabłowski et al. 2022.
- Psychosocial impact: Chronic disease burden can affect mental health and quality of life, necessitating holistic monitoring NICE NG100.
Regular multidisciplinary follow-up is essential to detect and manage these complications early, including ophthalmologic screening, growth monitoring, and assessment for systemic features NICE NG100 Quartier et al. 2025.
Key References
- NG100 - Rheumatoid arthritis in adults: management
- CKS - DMARDs
- CKS - Spondyloarthritis and psoriatic arthropathy
- NG65 - Spondyloarthritis in over 16s: diagnosis and management
- CKS - Ulcerative colitis
- NG130 - Ulcerative colitis: management
- (Boros and Whitehead, 2010): Juvenile idiopathic arthritis.
- (Szabłowski et al., 2022): Coincidence of juvenile idiopathic arthritis and type 1 diabetes: a case-based review.
- (Quartier et al., 2025): French protocol for the diagnosis and management of juvenile idiopathic arthritis including pediatric-onset Still's disease.