Kiss Judit, Gaál Valéria, Nyul Zoltán, Mosdósi Bernadett
Klinikai Központ, Gyermekgyógyászati Klinika, Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs.
Klinikai Központ, Szemészeti Klinika, Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs.
Orv Hetil. 2019 Aug;160(34):1335-1339. doi: 10.1556/650.2019.31459.
Uveitis is characterized by inflammation of the middle layer of the eye. Its overall incidence is low. Autoimmune diseases and infections are the most common underlying diseases. Out of the autoimmune diseases, juvenile idiopathic arthritis is associated most frequently with uveitis. The topical ophthalmological treatment may fail in a significant proportion of the patients and immunomodulatory therapy may be required. In a retrospective study, data of 33 children diagnosed and treated with uveitis at the Department of Pediatrics and Ophthalmology, University of Pécs during the last 5 years were collected and analyzed. The mean age of the patients was 9.3 (0.3-17.8) years. Boys and girls were equally affected with an exception of patients with juvenile idiopathic arthritis where female predominance was found. An underlying disease could be identified in 60% of the cases (20/33). Uveitis was associated in 12 patients with juvenile idiopathic arthritis, in 2 patients with Behcet's disease and in a single case with inflammatory bowel disease. Infections have been proven in 5 patients. The autoimmune diseases caused an eye inflammation typically in anterior localization, in contrast to the infections that resulted in posterior uveitis. The majority of the patients required systemic treatment. 3 of them received systemic corticosteroid and 18 patients methotrexate as disease-modifying antirheumatic drug. 13 children with severe disease activity required biological therapy (adalimumab injection). Remission could be achieved in 1.45 (0.75-2.5) months. Pediatric uveitis is of great importance. Early diagnosis, adequate therapy and follow-up require multidisciplinary cooperation. Orv Hetil. 2019; 160(34): 1335-1339.
葡萄膜炎的特征是眼球中层发炎。其总体发病率较低。自身免疫性疾病和感染是最常见的潜在病因。在自身免疫性疾病中，幼年特发性关节炎与葡萄膜炎的关联最为频繁。相当一部分患者的局部眼科治疗可能无效，可能需要免疫调节治疗。在一项回顾性研究中，收集并分析了过去5年在佩奇大学儿科和眼科诊断和治疗的33例葡萄膜炎患儿的数据。患者的平均年龄为9.3（0.3 - 17.8）岁。除幼年特发性关节炎患者中女性占优势外，男孩和女孩受影响的程度相同。60%（20/33）的病例可确定有潜在病因。12例葡萄膜炎患者与幼年特发性关节炎有关，2例与白塞病有关，1例与炎症性肠病有关。5例患者已证实有感染。自身免疫性疾病通常引起前部葡萄膜炎，而感染则导致后部葡萄膜炎。大多数患者需要全身治疗。其中3例接受全身皮质类固醇治疗，18例接受甲氨蝶呤作为改善病情的抗风湿药物治疗。13例疾病活动严重的儿童需要生物治疗（注射阿达木单抗）。1.45（0.75 - 2.5）个月可实现缓解。儿童葡萄膜炎非常重要。早期诊断、适当治疗和随访需要多学科合作。《匈牙利医学周报》。2019年；160（34）：1335 - 1339。
