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[青少年关节炎]

[Juvenile arthritides].

作者信息

Horneff G

机构信息

Zentrum für Allgemeine Pädiatrie und Neonatologie und Kinderrheumazentrum, Asklepios Klinik Sankt Augustin, Deutschland.

出版信息

Z Rheumatol. 2010 Oct;69(8):719-35; quiz 736-7. doi: 10.1007/s00393-010-0664-7.

Abstract

Arthritis in children represents a diagnostic and therapeutic challenge. The diagnostic spectrum is broad and a very precise indication for diagnostic and therapeutic procedures, especially in small children, is important. In addition to acute arthritides - viral arthritis, reactive arthritis, Lyme arthritis and septic arthritis - secondary chronic arthritis related to an underlying disease as well as juvenile idiopathic arthritis (JIA), the most common chronic inflammatory systemic disease in children, need to be considered. This overview is a guide to the diagnosis of arthritis in childhood and to evidence-based therapy of JIA in particular. This consists of a combination of nonsteroidal anti-inflammatory drugs, systemic and intraarticular corticosteroids, traditional DMARDs such as sulfasalazine, methotrexate and leflunomide, the TNF inhibitors etanercept, adalimumab and, with restrictions, infliximab, other biopharmaceuticals such as anakinra, canakinumab and rilonacept, and tocilizumab and finally, abatacept.

摘要

儿童关节炎是一个诊断和治疗方面的挑战。诊断范围很广,对于诊断和治疗程序,尤其是对幼儿而言,非常精确的指征很重要。除了急性关节炎——病毒性关节炎、反应性关节炎、莱姆关节炎和化脓性关节炎——还需要考虑与潜在疾病相关的继发性慢性关节炎以及幼年特发性关节炎(JIA),这是儿童中最常见的慢性炎症性全身性疾病。本综述是儿童关节炎诊断的指南,尤其是JIA循证治疗的指南。这包括非甾体抗炎药、全身和关节内皮质类固醇、传统抗风湿药物如柳氮磺胺吡啶、甲氨蝶呤和来氟米特、肿瘤坏死因子抑制剂依那西普、阿达木单抗以及有一定限制的英夫利昔单抗、其他生物药物如阿那白滞素、卡那单抗和利罗那肽、托珠单抗,最后还有阿巴西普的联合应用。

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