Background: Uveitis is a frequent and potentially vision-threatening manifestation of juvenile idiopathic arthritis (JIA). There are only a few population-based studies providing data on the frequency and severity of ...Background: Uveitis is a frequent and potentially vision-threatening manifestation of juvenile idiopathic arthritis (JIA). There are only a few population-based studies providing data on the frequency and severity of uveitis. Methods: Documentation of patients with JIA was collected in a national database. An analysis of the paediatric rheumatologic and ophthalmologic data collected from all patients that were included in 2002 was performed. Results: Uveitis was documented in 12%of a total of 3271JIA patients: extended oligoarthritis (25%), persistent oligoarthritis (16%), seronegative polyarthritis (4%), seropositive polyarthritis (2%), psoriatic arthritis (10%), enthesitis-related arthritis (ERA) (7%), Systemic arthritis(1%), other arthritis forms (11%) Opthalmologic data were available from 115 uveitis patients (28%). Mean age at onset of uveitis was 5.2 (SD 3.2) years. JIA patients with uveitis were significantly younger at onset of arthritis (3.8 vs. 7.0 years), and were more often girls (74 vs. 63%) or ANA-positive (86 vs. 42%) than the patients without uveitis. Uveitis complications were present in 45%at initial presentation of uveitis. After a mean duration of 5.6 years, complications were noted in 56%, and included band keratopathy (29%), posterior synechiae (27%), cataract (26%), glaucoma (8%), and macula oedema (6%). Final visual acuity was less than 20/50 in 31%and less than 20/200 in 12%of eyes. In patients with uveitis, immunosuppressive or immunomodulatory drugs were used significantly more often than in patients without uveitis (75%vs. 43%). Conclusions: The nationwide data documents the spectrum of uveitis in patients with JIA, the complications and the therapy for uveitis. The high rate of uveitis complications at the time of diagnosis points out the need for early ophthalmologic screening and therapy, and for a close collaboration between ophthalmologist and paediatric rheumatologist.展开更多
Background: Sarcoidosis is a rare cause of uveitis in childhood. Differentiation from other rheumatic diseases may be difficult. We report on five children with uveitis in childhood sarcoidosis and review the previous...Background: Sarcoidosis is a rare cause of uveitis in childhood. Differentiation from other rheumatic diseases may be difficult. We report on five children with uveitis in childhood sarcoidosis and review the previous literature. Results: Children were aged between seven month and 13 years at the time of diagnosis of uveitis. Four of the five patients had panuveitis, the fifth one had intermediate uveitis. In addition, three children had systemic diseasewith skin, joint and central nervous system involvement. The two children younger than 5 years showed the clinical triad of eye, joint and skin disease. Uveitic complications included corneal band keratopathy, cataract, posterior synechiae, macular scars and choroidal neovascularisation. Vision-limiting complications were found in six of nine eyes at the first visit. Conclusion: In childhood sarcoidosis two clinical courses can be differentiated. Younger children aged up to five years express a clinical triad of arthritis, skin lesions and uveitis. In the older group of patients, the clinical course is more similar to that of adults. Rapid diagnosis and quiescence of disease are of particular importance to improve the long-term visual prognosis.展开更多
文摘Background: Uveitis is a frequent and potentially vision-threatening manifestation of juvenile idiopathic arthritis (JIA). There are only a few population-based studies providing data on the frequency and severity of uveitis. Methods: Documentation of patients with JIA was collected in a national database. An analysis of the paediatric rheumatologic and ophthalmologic data collected from all patients that were included in 2002 was performed. Results: Uveitis was documented in 12%of a total of 3271JIA patients: extended oligoarthritis (25%), persistent oligoarthritis (16%), seronegative polyarthritis (4%), seropositive polyarthritis (2%), psoriatic arthritis (10%), enthesitis-related arthritis (ERA) (7%), Systemic arthritis(1%), other arthritis forms (11%) Opthalmologic data were available from 115 uveitis patients (28%). Mean age at onset of uveitis was 5.2 (SD 3.2) years. JIA patients with uveitis were significantly younger at onset of arthritis (3.8 vs. 7.0 years), and were more often girls (74 vs. 63%) or ANA-positive (86 vs. 42%) than the patients without uveitis. Uveitis complications were present in 45%at initial presentation of uveitis. After a mean duration of 5.6 years, complications were noted in 56%, and included band keratopathy (29%), posterior synechiae (27%), cataract (26%), glaucoma (8%), and macula oedema (6%). Final visual acuity was less than 20/50 in 31%and less than 20/200 in 12%of eyes. In patients with uveitis, immunosuppressive or immunomodulatory drugs were used significantly more often than in patients without uveitis (75%vs. 43%). Conclusions: The nationwide data documents the spectrum of uveitis in patients with JIA, the complications and the therapy for uveitis. The high rate of uveitis complications at the time of diagnosis points out the need for early ophthalmologic screening and therapy, and for a close collaboration between ophthalmologist and paediatric rheumatologist.
文摘Background: Sarcoidosis is a rare cause of uveitis in childhood. Differentiation from other rheumatic diseases may be difficult. We report on five children with uveitis in childhood sarcoidosis and review the previous literature. Results: Children were aged between seven month and 13 years at the time of diagnosis of uveitis. Four of the five patients had panuveitis, the fifth one had intermediate uveitis. In addition, three children had systemic diseasewith skin, joint and central nervous system involvement. The two children younger than 5 years showed the clinical triad of eye, joint and skin disease. Uveitic complications included corneal band keratopathy, cataract, posterior synechiae, macular scars and choroidal neovascularisation. Vision-limiting complications were found in six of nine eyes at the first visit. Conclusion: In childhood sarcoidosis two clinical courses can be differentiated. Younger children aged up to five years express a clinical triad of arthritis, skin lesions and uveitis. In the older group of patients, the clinical course is more similar to that of adults. Rapid diagnosis and quiescence of disease are of particular importance to improve the long-term visual prognosis.
