Abstract
The article describes the case of successful use of human monoclonal antibodies to the tumor necrosis factor- adalimumab in a patient with a severe course of juvenile arthritis associated with enthesitis and uveitis resistant to non-steroidal anti-inflammatory drugs, methotrexate, glucocorticosteroids that have been applied topically and retrobulbarly. After the first adalimumab administration, the pain syndrome was stopped, the duration of morning stiffness was significantly reduced, the laboratory indices of the disease activity were normalized by the 4th week of treatment, uveitis activity was stopped, the inflammatory changes in the joints regressed and the phase of inactive disease was ascertained by the 12th week. The duration of remission of articular syndrome and uveitis during treatment with adalimumab was 26 months. Adverse reactions were not registered during therapy.
Highlights
Национальный медицинский исследовательский центр здоровья детей, Москва, Российская Федерация 2 Первый Московский государственный медицинский университет им
The article describes the case of successful use of human monoclonal antibodies to the tumor necrosis factor-␣ adalimumab in a patient with a severe course of juvenile arthritis associated with enthesitis and uveitis resistant to non-steroidal anti-inflammatory drugs, methotrexate, glucocorticosteroids that have been applied topically and retrobulbarly
After the first adalimumab administration, the pain syndrome was stopped, the duration of morning stiffness was significantly reduced, the laboratory indices of the disease activity were normalized by the 4th week of treatment, uveitis activity was stopped, the inflammatory changes in the joints regressed and the phase of inactive disease was ascertained by the 12th week
Summary
Национальный медицинский исследовательский центр здоровья детей, Москва, Российская Федерация 2 Первый Московский государственный медицинский университет им. Появились боль при движениях, припухлость правого коленного сустава, при этом припухлость в области 4-го пальца правой стопы сохранялась, в связи с чем ребенок был госпитализирован в ревматологический стационар по месту жительства. При поступлении в стационар у ребенка был выявлен суставной синдром с поражением правого коленного сустава, межфаланговых суставов 4-го пальца правой стопы; длительность утренней скованности составила 1 ч. Учитывая неэффективность противовоспалительной терапии ребенку был назначен метотрексат для подкожного введения в дозе 10 мг/м2 поверхности тела в неделю (9 мг/нед). Развитие острого иридоциклита, неэффективность терапии метотрексатом, глюкокортикостероидами (местно и в виде ретробульбарных инъекций), прогрессирование костно-хрящевой деструкции и воспалительных изменений в левом глазу с высоким риском развития слепоты, по жизненным показаниям ребенку была назначена терапия человеческими моноклональными антителами к TNF ␣ адалимумабом. Clinical and laboratory indicators’ dynamics of disease activity in the patient Danila B., age 11, in the setting of therapy with adalimumab
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