Chinese Journal of Evidence-Based Pediatrics ›› 2022, Vol. 17 ›› Issue (1): 53-56.

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15 cases of juvenile idiopathic arthritis complicated with uveitis: A case series report

WANG Xinning, ZHOU Zhixuan, SU Gaixiu, YANG Zhou, LI Shengnan, KANG Min, HOU Jun, CHI Ying, ZHANG Dan, LI Jianguo   

  1. Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China
  • Received:2021-11-09 Revised:2022-01-19 Online:2022-02-25 Published:2022-02-25
  • Contact: LI Jianguo, email: jianguo_li6@hotmail.com

Abstract: Background: Juvenile idiopathic arthritis (JIA) associated uveitis is the most common extraarticular manifestation of JIA. Untimely treatment may lead to serious complications and the risk of blindness. Objective: To investigate the clinical features of JIA patients complicated with uveitis. Design: Case series report. Methods: Patients complicated with uveitis admitted to the department of rheumatology and immunology of the Children's Hospital Affiliated to the Capital Institute of Pediatrics from March 2018 to May 2020 were included. Demographic data, laboratory examination, subtype of JIA, ocular manifestations and complications, treatment, and followup were intercepted from the medical records. Main outcome measures: Uveitis and complications, treatment and outcome. Results: Of the 278 cases with JIA, fifteen cases were complicated with uveitis, including 4 males and 11 females. The onset age was within 8 years old. Among the 15 patients, there were 13 cases of oligoarticular type, 1 case of polyarticular type and 1 case of enthesitisrelated arthritis type; there were 2 patients with the onset of visual impairment and the other 13 cases with the onset of arthritis; eye lesions were found in 12 cases at the initial diagnosis, and in 3 patients at the course of 12.5 years. All of the 15 patients were diagnosed with anterior uveitis with 8 cases of bilateral lesions and 7 cases of unilateral lesions. Visual impairment was detected in 7 cases. There were 12 patients treated with biological agents, 13 with methotrexate, 1 with sulfasalazine and mycophenolate mofetil, and 3 with glucocorticoids. For local medication, 13 cases were treated with glucocorticoids, 11 cases with mydriasis drugs, 11 cases with nonsteroidal antiinflammatory drugs, and 3 cases with antibiotics. During the followup (1441 months), the arthritis of all patients was improved after treatment. Eye lesions recovered in 7 cases, improved in 1 case, and delayed and repeated in 2 cases, remained no changes in 5 cases. Conclusion: Uveitis is the main extraarticular manifestation of JIA, which is more common in oligoarticular type, occult onset, and highly disabling. Without treatment in time, serious complications may occur. Regular visual and fundus examination in children with JIA is very important for early detection and treatment of ocular lesions.

Key words: Juvenile idiopathic arthritis, Uveitis, Clinical features