Prieur A M
Unité d'Immunologie et d'hématologie pédiatriques, Hôpital des Enfants-Malades, Fédération de Pédiatrie, Université Paris V, France.
Baillieres Clin Rheumatol. 1998 May;12(2):287-307. doi: 10.1016/s0950-3579(98)80020-4.
The concept of spondyloarthropathies in childhood is emerging. It should now be more easily recognized since more specific diagnostic criteria are available for young patients. It probably accounts for about 20% of the whole group of chronic arthritides seen in paediatric rheumatology clinics. Juvenile ankylosing spondylitis stricto sensu is very rare in childhood. Most children who present with peripheral arthritis at onset meet the diagnostic criteria of undifferentiated spondylo-arthropathies such as those of the SEA syndrome, or those of the ESSG or Amor criteria. At follow-up, quite a large proportion of children may develop axial involvement. Psoriatic arthritis differs from the other spondyloarthropathies with a different sex ratio, and an earlier onset. The role of immunogenetic, environmental and ethnic factors are important for a better understanding of these diseases.
儿童脊柱关节病的概念正在逐渐形成。由于有了更具体的诊断标准，现在应该更容易识别了。它可能占儿科风湿病诊所所见慢性关节炎患者总数的20%左右。严格意义上的幼年强直性脊柱炎在儿童期非常罕见。大多数起病时表现为外周关节炎的儿童符合未分化脊柱关节病的诊断标准，如SEA综合征、ESSG或Amor标准。在随访中，相当大比例的儿童可能会出现轴向受累。银屑病关节炎与其他脊柱关节病不同，其性别比例不同，发病更早。免疫遗传、环境和种族因素对于更好地理解这些疾病很重要。
