Quarta Laura, Corrado Addolorata, Melillo Nadia, Cantatore Francesco Paolo
Clinica Reumatologica M. Carrozzo, Universiti degli Studi di Foggia.
Ann Ital Med Int. 2005 Oct-Dec;20(4):211-7.
Juvenile idiopathic arthritis represents a heterogeneous group of autoimmune diseases. It arises before 16 years of age and lasts more than 6 months. We can distinguish many arthritis sub-types. A serious problem in juvenile idiopathic arthritis is skeletal growth retardation, osteopenia and greater risk of developing fractures. Juvenile idiopathic arthritis diagnosis is an exclusion diagnosis. Many conditions can simulate it. First-choice drugs in juvenile idiopathic arthritis treatment are nonsteroidal anti-inflammatory drugs, analgesic and antipyretic drugs. The second-choice drugs are "slow-acting" antirheumatic drugs, like methotrexate. The use of glucocorticoids is strongly influenced by their side effects, in particular the inhibition of statural growth and the premature appearance of osteoporosis. Recent findings on the central role of tumor necrosis factor-alpha, in particular damage pathogenesis in the course of juvenile idiopathic arthritis, have permitted the development of new therapeutic strategies (infliximab, etanercept), aimed at blocking this cytokine.
青少年特发性关节炎是一组异质性自身免疫性疾病。它在16岁之前发病，病程持续超过6个月。我们可以区分出许多关节炎亚型。青少年特发性关节炎中的一个严重问题是骨骼生长发育迟缓、骨质减少以及发生骨折的风险增加。青少年特发性关节炎的诊断是排除性诊断。许多病症可能会与之相似。青少年特发性关节炎治疗的首选药物是非甾体抗炎药、止痛和解热药物。次选药物是“慢作用”抗风湿药物，如甲氨蝶呤。糖皮质激素的使用因其副作用而受到很大影响，尤其是对身高增长的抑制和骨质疏松症的过早出现。最近关于肿瘤坏死因子-α的核心作用的研究发现，特别是在青少年特发性关节炎病程中的损伤发病机制，使得旨在阻断这种细胞因子的新治疗策略（英夫利昔单抗、依那西普）得以发展。
