Publication:

Atypical presentation of systemic onset juvenile idiopathic arthritis: a case report

Systemic Onset Juvenile Idiopathic Arthritis (SOJIA) is an autoinflammatory disorder that can present with a wide range of symptoms, often mimicking infectious etiologies like tuberculosis and other bacterial infections, so atypical presentations can pose a diagnostic challenge. Here, we report a case of a 4-year-old female who presented with high-grade fever for 2 weeks, unresponsive to initial antibiotic therapy. Despite extensive investigations, the focus of infection was not found. Imaging revealed bilateral shoulder joint abscesses, which were sterile, with significantly elevated serum inflammatory markers. Clinical and laboratory findings were consistent with diagnosis of Systemic Onset Juvenile Idiopathic Arthritis (SOJIA) and subsequently corticosteroid and methotrexate therapy were started, to which the child responded.