Lepore L, Agosti E, Pitacco F, Panizon F
Clinica Pediatrica dell'Università di Trieste, Italia.
Pediatr Med Chir. 1987 May-Jun;9(3):321-4.
Two cases of JRA refractory to NSAID' steroids and long-acting drugs were successfully treated with plasmapheresis and combined lympho- and plasma-apheresis respectively. Case 1. A 8 year old female child who had been suffering from systemic JRA for 6 years received a course of three plasmapheresis followed by a 6 month cycle of azathioprine. Clinical and laboratory remission was promptly achieved and is still present after 18 months. Case 2. A 12-year old boy affected by poliarticular JRA received a course of 4 plasmapheresis followed by a 6 month cycle with azathioprine. The opportunity of performing plasma or lymphoplasmapheresis reinforced by immunosuppressive drugs such as azathioprine or methotrexate at low doses in refractory cases of JRA is discussed.
两例对非甾体抗炎药、类固醇及长效药物治疗无效的青少年类风湿性关节炎（JRA）患者，分别通过血浆置换及联合淋巴细胞和血浆置换成功治愈。病例1：一名8岁女童，患全身型JRA 6年，接受了一个疗程的三次血浆置换，随后进行了为期6个月的硫唑嘌呤治疗周期。临床和实验室指标迅速缓解，18个月后仍保持缓解状态。病例2：一名12岁患多关节型JRA的男孩，接受了一个疗程的4次血浆置换，随后进行了为期6个月的硫唑嘌呤治疗周期。文中讨论了在JRA难治性病例中，采用低剂量硫唑嘌呤或甲氨蝶呤等免疫抑制药物强化的血浆置换或淋巴细胞血浆置换的可能性。
