Foeldvari Ivan, Wierk Angela
Pediatric Rheumatologic Clinic, Allgemeines Krankenhaus Eilbek, Hamburg, Germany.
J Rheumatol. 2005 Feb;32(2):362-5.
To assess the effectiveness of methotrexate (MTX) in the treatment of juvenile idiopathic arthritis (JIA) associated uveitis, which is still one of the most common causes of visual impairment.
A retrospective chart review of patients with the diagnosis of uveitis associated with JIA between July 1, 2002, and December 31, 2002.
Four hundred sixty-seven patients with JIA were followed. Thirty-eight had uveitis: 31 associated with oligoarticular JIA and 7 with psoriatic JIA. Twenty-five of the 38 patients received MTX; in 23 patients uveitis was the indication for MTX therapy. In the MTX treated group 46/50 eyes had uveitis, the mean (range) age at onset of uveitis was 7.82 years (1.8-15.8), and the mean age at onset of arthritis was 7.25 years (1.25-15.7). MTX treatment was started an average of 11.4 months (0-72) after the onset of uveitis. The mean MTX dose was 15.6 mg/m2. Remission occurred after 4.25 months (1-12). Mean duration of remission was 10.3 months (3-27). The total duration of MTX therapy was 661 months and patients were in remission for 417/661 months. In 6 patients MTX was discontinued after 12 months of remission. Four patients were still in remission after 7.5 months (1-14).
MTX seems to be an effective therapy for JIA associated uveitis.
评估甲氨蝶呤（MTX）治疗幼年特发性关节炎（JIA）相关葡萄膜炎的有效性，该病症仍是视力损害的最常见原因之一。
对2002年7月1日至2002年12月31日期间诊断为与JIA相关葡萄膜炎的患者进行回顾性病历审查。
对467例JIA患者进行了随访。38例患有葡萄膜炎：31例与少关节型JIA相关，7例与银屑病性JIA相关。38例患者中有25例接受了MTX治疗；23例患者葡萄膜炎是MTX治疗的指征。在MTX治疗组中，50只眼中有46只患有葡萄膜炎，葡萄膜炎发病的平均（范围）年龄为7.82岁（1.8 - 15.8岁），关节炎发病的平均年龄为7.25岁（1.25 - 15.7岁）。MTX治疗平均在葡萄膜炎发病后11.4个月（0 - 72个月）开始。MTX的平均剂量为15.6mg/m²。4.25个月（1 - 12个月）后出现缓解。缓解的平均持续时间为10.3个月（3 - 27个月）。MTX治疗的总时长为661个月，患者缓解时长为417/661个月。6例患者在缓解12个月后停用MTX。4例患者在7.5个月（1 - 14个月）后仍处于缓解状态。
MTX似乎是治疗JIA相关葡萄膜炎的有效疗法。
