监测和治疗幼年特发性关节炎相关葡萄膜炎：巴西循证实践指南。
Monitoring and Treatment of Juvenile Idiopathic Arthritis-associated Uveitis: Brazilian Evidence-based Practice Guidelines.
机构信息
Ophthalmology Department, Instituto Nacional De Saúde Da Mulher, Da Criança E Do Adolescente Fernandes Figueira- Fundação Oswaldo Cruz, Rio De Janeiro, RJ, Brazil.
Brazilian Society of Pediatric Ophthalmology (SBOP), Sao Paulo/SP, Brazil.
出版信息
Ocul Immunol Inflamm. 2022 Aug;30(6):1384-1398. doi: 10.1080/09273948.2021.1876886. Epub 2021 Apr 7.
PURPOSE
To present a national guideline for ophthalmologic care and surveillance of juvenile idiopathic arthritis-associated uveitis (JIA-uveitis).
METHODS
Review article based on medical literature and the experience of an Expert Committee composed of members of the Brazilian Society of Pediatric Ophthalmology/Brazilian Council of Ophthalmology and the Brazilian Society of Pediatrics/Brazilian Society of Rheumatology. Studies with a high level of evidence were selected by searching the PubMed/Medline database. The final document was approved by the experts.
RESULTS
The main recommendations are that children/adolescents with JIA should undergo screening according to their risk factors. Ophthalmological checkups should also consider ocular inflammation and therapy. Topical glucocorticoids should be the first line of therapy, with systemic glucocorticoids acting as bridge treatments in severe uveitis. Methotrexate should be the first-line systemic therapy and anti-tumor necrosis factor (anti-TNF alpha) the second for uncontrolled uveitis.
CONCLUSIONS
This evidence-based guideline for JIA-uveitis will be useful for both ophthalmology and rheumatology practice.
目的
提出一份关于青少年特发性关节炎相关葡萄膜炎（JIA-葡萄膜炎）眼科护理和监测的国家指南。
方法
基于医学文献和由巴西儿科学会/巴西眼科学会和巴西儿科学会/巴西风湿病学会成员组成的专家委员会的经验，撰写一篇综述文章。通过搜索 PubMed/Medline 数据库，选择具有较高证据水平的研究。最终文件由专家批准。
结果
主要建议是，患有 JIA 的儿童/青少年应根据其危险因素进行筛查。眼科检查还应考虑眼内炎症和治疗。局部糖皮质激素应作为一线治疗药物，对于严重的葡萄膜炎，全身糖皮质激素可作为桥接治疗。甲氨蝶呤应作为一线全身治疗药物，对于未得到控制的葡萄膜炎，抗肿瘤坏死因子（抗 TNF-α）为二线治疗药物。
结论
本 JIA-葡萄膜炎循证指南将有助于眼科和风湿病学实践。
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