Fledelius Hans Callø, Nielsen Susan M, Nissen Kamilla Rothe, Pedersen Freddy Karup, Zak Marek Stanislaw
Rigshospitalet, Øjenafdelingen, København Ø.
Ugeskr Laeger. 2007 Apr 2;169(14):1309-12.
To present our experience with anti-TNFalpha treatment of juvenile idiopatic arthritis (JIA) associated uveitis.
All 11 children with severe uveitis were monitored between 2001 and 2005. Nine of the children had JIA and a set of twins had a rare hereditary granulomatous disease, Blau's syndrome. The patients were selected and the reason for starting anti-TNFalpha treatment was an insufficient response in the arthritis or uveitis to previous therapy.
In all patients the anti-TNFalpha treatment reduced the activity of uveitis. The response to treatment was related to 1) visual acuity and 2) the reduction of systemic immune-suppressing agents. All 11 children are still on anti-TNFalpha treatment.
Anti-TNFalpha was effective in treating uveitis in all 11 patients. In patients with active uveitis associated JIA not responding to corticosteroids and methotrexate and with declined vision the trend is to start anti-TNFalpha treatment early in the inflammatory disease to prevent long term complications to the eyes. The results indicate a superiority of infliximab over Eternacept in the treatment of uveitis.
介绍我们使用抗TNFα治疗幼年特发性关节炎（JIA）相关葡萄膜炎的经验。
2001年至2005年间对11例重度葡萄膜炎患儿进行了监测。其中9例患儿患有JIA，一对双胞胎患有罕见的遗传性肉芽肿病——布劳综合征。对患者进行了筛选，开始抗TNFα治疗的原因是关节炎或葡萄膜炎对先前治疗反应不足。
在所有患者中，抗TNFα治疗均降低了葡萄膜炎的活动度。治疗反应与1）视力和2）全身免疫抑制剂的减少有关。所有11名儿童仍在接受抗TNFα治疗。
抗TNFα对所有11例患者的葡萄膜炎治疗均有效。对于活动性葡萄膜炎合并JIA、对皮质类固醇和甲氨蝶呤无反应且视力下降的患者，倾向于在炎症性疾病早期开始抗TNFα治疗，以预防眼部长期并发症。结果表明英夫利昔单抗在葡萄膜炎治疗方面优于依那西普。
