Importancia de la evaluación oftalmológica en pacientes con artritis idiopática juvenil

Rodríguez-García, Alejandro

doi:10.1016/j.reuma.2014.08.003

Cited by 2 publications

(1 citation statement)

References 34 publications

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“…Surprisingly, a large group of children presented with inflammatory changes within the anterior segment of the eye prior to arthritis – it concerned almost half of our patients with JIA. In some patients, it was the first routine ophthalmologic examination after the diagnosis of arthritis that showed old changes within the eye resulting from the prior, silent uveitis, which is also described in the literature [ 11 ]. However, most of the children remained under the care of the ophthalmologist earlier and, according to our observations, this is the group of increased risk of inflammatory disease of the joints.…”

Section: Discussionmentioning

confidence: 99%

Comparison of uveitis in the course of juvenile idiopathic arthritis with isolated uveitis in children – own experiences

et al. 2018

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ObjectivesUveitis and juvenile idiopathic arthritis (JIA) relatively often coexist. Inflammatory changes in the anterior segment of the eye are the most common extra-articular symptom in children with JIA, and JIA is, in turn, the main systemic cause of anterior uveitis in children. The aim of our study was to compare the course of anterior uveitis accompanying JIA and isolated uveitis.Material and methodsWe analyzed 25 children with JIA and uveitis (group I) and 28 children with isolated uveitis (group II). The study population was retrospectively selected from the patients treated in our center in the years 1998–2016 through a search of the hospital database. All data were presented as descriptive statistics.ResultsIn group I there was a higher percentage of girls than in group II (64% vs. 50%) and uveitis occurred at a significantly younger age (8.7 years vs. 11.6). Patients from group I more often presented with immunological abnormalities (positive antinuclear antibodies or HLA-B27 antigen). The majority of children from group I developed uveitis prior to (44%) or simultaneously with (20%) arthritis. In patients who first presented with uveitis, arthritis appeared on average after 28 months (median 12 months). In children in whom arthritis developed first, uveitis appeared on average after 51 months (median 36 months). In some patients the time interval between the involvement of these two organs was as long as 9–10 years. Four children from group I and three from group II were qualified for biological treatment.ConclusionsThe results of our analysis indicate the need for constant cooperation between the pediatric rheumatologist and the ophthalmologist. Although the risk of uveitis in JIA decreases with the disease duration, in some cases this complication can develop after many years. Children with present antinuclear antibodies, at younger age and of female gender should be subject to particularly close observation.

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Section: Discussionmentioning

confidence: 99%

Comparison of uveitis in the course of juvenile idiopathic arthritis with isolated uveitis in children – own experiences

et al. 2018

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Outcome of Juvenile Idiopathic Arthritis Associated Uveitis in Two Disease Subtypes

Lazarević

2017

Arch Rheumatol

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Objectives: This study aims to evaluate the efficacy of adalimumab as a first line biologic agent in specific subtypes of juvenile idiopathic arthritis (JIA) patients with associated uveitis. Patients and methods:We retrospectively analyzed the data of 11 JIA patients (8 males, 3 females; mean age 14.5 years; range 9 to 18 years) with associated uveitis treated with biologic therapy. All patients were diagnosed as oligoarticular/extended oligoarticular or enthesitis-related JIA subtypes, treated with methotrexate, and had active or previous history of uveitis for which adalimumab was prescribed. We tested all patients for anti-nuclear antibody presence and human leukocyte antigen genotype. We assessed disease activity and therapy efficacy by American College of Rheumatology 50%, 70%, and 100% improvement criteria. We evaluated uveitis activity by slit-lamp biomicroscopy and recorded adverse events. Results: Of the JIA patients, three (27.27%) had oligoarticular/extended oligoarticular JIA and eight (72.73%) had enthesitis-related arthritis. Anti-nuclear antibody positivity was present in 27.27% (all females) while human leukocyte antigen-B51 was determined in 62.5% and human leukocyte antigen-B27 in 12.5% of patients. Mean uveitis duration before adalimumab introduction was 12.3 months. After two years of follow-up, there were no relapses of uveitis and visual acuity was stable while on adalimumab and methotrexate treatment. All patient were gradually tapered and discontinued treatment with topical steroids. Disease activity improved and seven patients (63.64%) achieved American College of Rheumatology 100% response rate (attained remission), while four patients (36.36%) achieved American College of Rheumatology 70% response rate. Conclusion: Anti-nuclear antibody positivity with oligoarticular/extended oligoarticular and enthesitis-related arthritis JIA subtypes, which are known for their high risk to develop uveitis, may benefit from adalimumab as a first line anti-tumor necrosis factor agent.

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Importancia de la evaluación oftalmológica en pacientes con artritis idiopática juvenil

Cited by 2 publications

References 34 publications

Comparison of uveitis in the course of juvenile idiopathic arthritis with isolated uveitis in children – own experiences

Comparison of uveitis in the course of juvenile idiopathic arthritis with isolated uveitis in children – own experiences

Outcome of Juvenile Idiopathic Arthritis Associated Uveitis in Two Disease Subtypes

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