Hilário M O, Goldenberg J, Naspitz C K
Departamento de Pediatria, Escola Paulista de Medicina.
Rev Paul Med. 1991 Jan-Feb;109(1):35-40.
Major current clinical, laboratory, and etiopathogenic aspects of juvenile rheumatoid arthritis (JRA) are focused by this article. The authors make a comparison of data of their patients to those described in the literature. A retrospective clinicolaboratory study was performed of 130 patients with JRA followed in the Pediatric Rheumatology Department of the Division of Allergy, Rheumatology, and Clinical Immunology of the Service of Pediatrics of Escola Paulista de Medicina from 1982 to 1989. These patients (73 female and 57 male) were analyzed for the type and age of onset, clinical manifestations (articular and extraarticular), laboratory data, and prognosis. The findings of the authors are similar to those reported, with the exception of eye involvement (chronic iridocyclitis) and of the presence of the IgM rheumatoid factor (RF) and the antinuclear antibody (ANA), which were lower than those described by other authors. With respect to prognosis, the authors verified the greatest number of remissions (40%) with the pauciarticular type, whereas the polyarticular type presented the lowest number of remissions (27%). The two deaths occurred in the series were of children with the systemic type of the disease. Although etiology and the mechanism responsible for its release are not yet known, therefore, not allowing a definite type of treatment, experience gathered throughout the years has made it possible for physicians who attend to these patients not only to make an early diagnosis but also to resort to more efficient means of control.
本文重点介绍了青少年类风湿性关节炎(JRA)当前主要的临床、实验室及病因学方面的情况。作者将其患者的数据与文献中描述的数据进行了比较。对1982年至1989年在圣保罗医科大学儿科学系过敏、风湿病和临床免疫学教研室小儿风湿病科就诊的130例JRA患者进行了回顾性临床实验室研究。对这些患者(73名女性和57名男性)的发病类型和年龄、临床表现(关节和关节外)、实验室数据及预后进行了分析。作者的研究结果与已报道的相似,但眼部受累(慢性虹膜睫状体炎)以及IgM类风湿因子(RF)和抗核抗体(ANA)的存在情况除外,作者研究中的这些指标低于其他作者所描述的。关于预后,作者发现少关节型缓解率最高(40%),而多关节型缓解率最低(27%)。该系列中有两例死亡发生在患有全身型疾病的儿童中。尽管病因及其发病机制尚不清楚,因此无法进行明确的治疗,但多年积累的经验使诊治这些患者的医生不仅能够早期诊断,还能采用更有效的控制手段。