Acta reumatologica portuguesa · 2019
Tocilizumab in refractory juvenile idiopathic arthritis with associated uveitis: a case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Sousa-Neves Filipe, Braga Joana, Teixeira Sara, Barge Sidnei, Fonseca Sofia, Meira Dália, Rodrigues Lúcia, Varandas Rosário
Аннотация
INTRODUCTION: We report a 9-year follow-up of a child with refractory juvenile idiopathic arthritis (JIA) with associated uveitis in which tocilizumab proved to be effective in achieving disease control.
CASE REPORT: A 16-month child was diagnosed with JIA and at the age of 3 developed bilateral non-granulomatous anterior uveitis. Throughout the follow-up, the patient presented frequent joint and ocular flares. Refractory anterior uveitis and topical corticosteroid therapy resulted in the development of bilateral cataract and high intraocular pressure (IOP). The patient underwent multiple ocular surgeries along with corticosteroids, immunosuppressive therapy with Methotrexate and Adalimumab failing to reach disease control. Only after the introduction of Tocilizumab a lower disease activity was achieved.
DISCUSSION: Management of JIA-associated uveitis is challenging and requires a close collaboration between paediatric rheumatologists and ophthalmologists. Clinical remission can be difficult to achieve. However, one should always pursuit JIA inactivity with IOP and inflammation control. This report supports Tocilizumab as a useful therapeutic option for JIA-associated uveitis.
CASE REPORT: A 16-month child was diagnosed with JIA and at the age of 3 developed bilateral non-granulomatous anterior uveitis. Throughout the follow-up, the patient presented frequent joint and ocular flares. Refractory anterior uveitis and topical corticosteroid therapy resulted in the development of bilateral cataract and high intraocular pressure (IOP). The patient underwent multiple ocular surgeries along with corticosteroids, immunosuppressive therapy with Methotrexate and Adalimumab failing to reach disease control. Only after the introduction of Tocilizumab a lower disease activity was achieved.
DISCUSSION: Management of JIA-associated uveitis is challenging and requires a close collaboration between paediatric rheumatologists and ophthalmologists. Clinical remission can be difficult to achieve. However, one should always pursuit JIA inactivity with IOP and inflammation control. This report supports Tocilizumab as a useful therapeutic option for JIA-associated uveitis.