Our 30 year-old daughter was diagnosed with systemic JRA at the age of 12. Since then, she has undergone 2 hip replacements, 2 knee replacements, and 1 shoulder replacement. She has been on almost every type of medication, and each appears to only help for a short time. The latest, Rituxin, showed some promise when her blood level indicators almost returned to normal. But then 2 weeks before her scheduled infusion (6 months lapse), she experienced a horrible “flare.” She is again extrememly inflamed, depressed, and in sigficant pain (ALL joints). Her “physician” says he has run out of options, except for experimental drugs. I am less than satisfied with the quality of this care. Can anyone offer us any new insight, advice, or referral to a good, caring specialist in the LA area? She was at Mayo at the age of 13, and at that time they concurred with the treatment paradigm of the physicians at (Chicago) Children’s Memorial. I look forward to any suggestions.