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葡萄膜炎与青少年银屑病关节炎或银屑病

Uveitis and Juvenile Psoriatic Arthritis or Psoriasis.

作者信息

Salek Sherveen S, Pradeep Archana, Guly Catherine, Ramanan Athimalaipet V, Rosenbaum James T

机构信息

Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon.

University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom.

出版信息

Am J Ophthalmol. 2018 Jan;185:68-74. doi: 10.1016/j.ajo.2017.10.018. Epub 2017 Oct 31.

Abstract

PURPOSE

To describe the phenotype of the uveitis that accompanies juvenile psoriatic arthritis or psoriasis.

DESIGN

Observational case series.

METHODS

Setting: Two university-based referral clinics: 1 in England, 1 in the United States.

STUDY POPULATION

Five children with uveitis and psoriatic arthritis and 1 with uveitis and psoriasis Observational Procedure: Retrospective chart review.

MAIN OUTCOME MEASURES

Demographics of subjects such as age and sex; description of ocular and joint disease; surgical and other complications; medical treatment.

RESULTS

Five of the 6 children in this series had the onset of disease at or before age 6 (P = .0008 compared to expected age of onset for psoriatic arthritis in childhood). All children in this series had an inadequate response to topical corticosteroids. Most of the children were treated with systemic corticosteroids for many months, yet all of them went on to require methotrexate. Therapy with systemic methotrexate did not suffice, as all the patients also required some form of biologic therapy. Five of 6 had surgeries such as vitrectomy, cataract extraction, or a procedure for glaucoma control.

CONCLUSIONS

The observations suggest that the uveitis that accompanies juvenile psoriatic arthritis might be a distinct disease that is particularly severe when its onset affects children aged 6 years or younger.

摘要

目的

描述伴发青少年银屑病关节炎或银屑病的葡萄膜炎的表型。

设计

观察性病例系列。

方法

地点:两家大学附属医院转诊诊所,一家在英国,一家在美国。

研究人群

5例患有葡萄膜炎和银屑病关节炎的儿童以及1例患有葡萄膜炎和银屑病的儿童。观察程序:回顾性病历审查。

主要观察指标

受试者的人口统计学特征,如年龄和性别;眼部和关节疾病的描述;手术及其他并发症;药物治疗。

结果

该系列6名儿童中有5名在6岁及6岁之前发病(与儿童银屑病关节炎的预期发病年龄相比,P = 0.0008)。该系列所有儿童对局部用皮质类固醇反应不佳。大多数儿童接受全身皮质类固醇治疗数月,但他们最终都需要甲氨蝶呤治疗。全身用甲氨蝶呤治疗并不足够,因为所有患者还需要某种形式的生物治疗。6名患者中有5名接受了诸如玻璃体切除术、白内障摘除术或青光眼控制手术等手术。

结论

观察结果表明,伴发青少年银屑病关节炎的葡萄膜炎可能是一种独特的疾病,当其发病影响6岁及以下儿童时尤为严重。

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