CAJ | 학술논문

幼年特发性关节炎(JIA)是指发生在16岁以下儿童以慢性关节炎为主要临床表现的全身多系统自身免疫性疾病,临床表现为不明原因的持续6周以上的关节肿胀或炎症.大约有10％的患者伴有葡萄膜炎症,具有发病隐匿、炎症反应轻、并发症多和视力损害重等特点.好发人群为关节炎发病年龄小、抗核抗体阳性的女性少关节型关节炎患者.典型临床表现为双眼不对称的慢性轻度前葡萄膜炎,常见致盲性并发症有角膜带状变性、虹膜后粘连、并发性白内障和继发性青光眼等.局部应用糖皮质激素、非甾体抗炎剂和散瞳剂是主要治疗措施,顽固性患者需全身加用糖皮质激素、免疫抑制剂或生物制剂治疗,并发性白内障患者在围手术期需加强抗炎治疗.对幼年关节炎患儿进行密切眼部随访和及早诊治,可减轻葡萄膜炎病情和降低致盲性并发症的损害.
유년특발성관절염(JIA)시지발생재16세이하인동이만성관절염위주요림상표현적전신다계통자신면역성질병,림상표현위불명원인적지속6주이상적관절종창혹염증.대약유10％적환자반유포도막염증,구유발병은닉、염증반응경、병발증다화시력손해중등특점.호발인군위관절염발병년령소、항핵항체양성적녀성소관절형관절염환자.전형림상표현위쌍안불대칭적만성경도전포도막염,상견치맹성병발증유각막대상변성、홍막후점련、병발성백내장화계발성청광안등.국부응용당피질격소、비치체항염제화산동제시주요치료조시,완고성환자수전신가용당피질격소、면역억제제혹생물제제치료,병발성백내장환자재위수술기수가강항염치료.대유년관절염환인진행밀절안부수방화급조진치,가감경포도막염병정화강저치맹성병발증적손해.
Juvenile idiopathic arthritis (JIA) that persists for at least 6 weeks is a group of the most common chronic arthritis conditions occurring in children under 16 years of age.Uveitis accompanies JIA in about 10％ of patients.The characteristics of uveitis are usually asymptomatic with silent onset,light inflammation,more complications and severe visual damage.Traditional risk factors for uveitis development include children less than 7 years old at the time of arthritis onset,a positive antinuclear antibody (ANA) test result,female sex and oligoarthritis.The classic clinical pictures are bilateral chronic asymptomatic anterior uveitis and the major complications include band keratopathy,complicated cataract,posterior iris synechiae and secondary glaucoma.Treatment consists of topical corticosteroids,nonsteroidal anti-inflammatory drugs and mydriatics.In severe cases,treatment may include oral corticosteroids,immunosuppressive agents or biological therapies.Patients with complicated cataract need surgical management and aggressive perioperative control of intraocular inflammation for successful cataract surgery with lens implantation.In view of the asymptomatic nature of uveitis,careful screening of eyes in JIA patients and early diagnosis and treatment of uveitis are crucial to prevent complications and blindness.