PReS-FINAL-1005: Hypertransaminasemia in systemic juvenile idiopathic arthritis during anti-interleukin 1 treatment

Systemic juvenile idiopathic arthritis (sJIA) accounts for 10-15% of JIA patients and is characterized by arthritis with fever, plus rash, generalized lymphadenopathy, hepatosplenomegaly and serositis. It is associated with significant morbidity and may be complicated with macrophagic activation syndrome (MAS). The use of anti-interleukin 1 (IL1) therapy results in dramatic improvement in both the systemic and articular disease. Elevation of liver enzymes can be seen in sJIA patients because of disease activity, MAS, an infection, hepatotoxicity from pharmacologic treatment or as manifestation of another disease (such as autoimmune hepatitis). Achieving the diagnosis of the hypertransaminasemia in these patients may be difficult for the clinician.