Yıl: 2020 Cilt: 27 Sayı: 1 Sayfa Aralığı: 34 - 38 Metin Dili: Türkçe

Tek Merkezde Takip Edilen Juvenil İdyopatik Artrit Hastalarının Klinik Değerlendirmesi

Öz:
Amaç: Tek merkezde takip edilen juvenil idyopatik artrit hastalarının klinik ve demografik özelliklerini sunmak, juvenil idyopatik artrithastalarında üveit gelişimi ve görme keskinliği üzerine etkisi olan faktörleri değerlendirmektir.Gereç ve Yöntem: 80 juvenil idyopatik artritli hastanın (30 erkek ve 50 kız) kayıtları retrospektif olarak değerlendirildi. Hastaların cinsiyet, artrit ve üveit başlangıç yaşı, aile hikayesi, takip periyodu, klinik özellikler, üveite bağlı komplikasyonlar, başlangıç sistemik tedavi, tedavi komplikasyonları ve tedavi süresi analiz edildi.Bulgular: Hastalığın ortalama başlangıç yaşı 9,23±4,0 yıl (2-15 arası), ortalama üveit başlangıç yaşı 9,92±3,15 yıl (5-16 arası), ortalama takip süresi ise 2,49±1,72 yıldı (1-7 arası). Hastaların 12’sinde (%15) üveit tespit edildi. Hastalarda üveit tanısı konulduğu andaki ilk görme keskinlikleri 2’sinde (%16,6) 0,1 ve altı, 2’sinde (%16,6) 0,1 ile 0,5 arasında ve 8’inde (%66,6) 0,5 ve üzerinde saptandı.Son görme keskinliği ise tüm hastalarda 0,5 ve üzerinde saptandı. İlk tedavi olarak 6 hastaya (%7,5) nonsteroidal antienflamatuvar ajanlar, 8’ine (%10) sülfasalazin, 3’üne (%3,7) sadece kortikosteroid ve 63’üne (%78,7) metotreksat başlandı. Takiplerinde tedaviye dirençli olan hastalardan 10’nuna (%12,5) etanercept, 4’üne (%5) adalimumab ve 3’üne (%3,7) tosilizumab tedavisi ilave edildi. Juvenil idyopatik artrit ile ilişkili üveiti olan hastaların tamamı tanı anında veya üveit gelişmeden önce metotreksat tedavisi kullanmakta idi. Üveitiolan hastaların takibinde 4 hastaya adalimumab tedavisi ilave edildi.Sonuç: Juvenil idyopatik artrit ile ilişkili üveit gelişen hastalarda zamanında ve etkin olarak başlanan immünomodülatör tedavi görmeprognozunu olumlu olarak etkilemektedir. Hastaların multidisipliner bir yaklaşımla değerlendirilmesi ve rutin tarama programlarınınuygulanması gerekmektedir.
Anahtar Kelime:

Clinical Evaluation of Juvenile Idiopathic Arthritis Patients Followed in One Center

Öz:
Objective: To present clinical and demographical features of juvenile idiopathic arthritis in patients, who all were followed-up at the same care facility. Moreover, to investigate the factors that impacted their development of uveitis and visual acuity. Material and Method: Records of 80 juvenile idiopathic arthritis patients (30 males and 50 girls) were retrospectively evaluated. Gender of patients, onset age of arthritis and uveitis, family history, follow-up period, clinical features, uveitic complications, initial treatment, treatment complications, and duration of treatment were analyzed. Results: The mean age of disease onset of patients were 9.23±4.0 years (range 2-15 years), the mean age of uveitis onset was 9.92±3.15 years (range 5-16 years), and the mean follow-up duration was 2.49±1.72 years (range 1-7 years). Uveitis was diagnosed in 12 patients (15%). Visual acuities at the diagnosis of uveitis were 0.1 or less in 2 patients (16.6%). Likewise, it was between 0.1-0.5 in 2 patients (16.6%) and 0.5 or more in 8 patients (66.6%). Final visual acuity was 0.5 or over in all patients. Initial treatment was non-steroidals in 6 patients (7.5%), sulphasalazine in 8 patients (3.7%), corticosteroids in 3 patients (3.7%) only and methotrexate in 63 patients (78.7%). Throughout the follow-up period, treatment resistant patients received either etanercept (10 patients, 12.5%), adalimumab (4 patients, 5%) or tocilizumab (3 patients, 3.7%). All patients with JIA-associated uveitis had used methotrexate at the time of diagnosis or before development of uveitis. Adalimumab was added to treatment during the follow-up to 4 patients with uveitis. Conclusion: The results suggest that the timely and effective immune-modulatory treatment commenced in juvenile idiopathic arthritis - associated uveitis patients had positive impacts on prognosis. In future studies, it is required to evaluate patients with a multidisciplinary approach and apply routine screening programs.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık
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APA BALBABA M, ULAŞ F, YILDIRIM H, CANLEBLEBİCİ M, GÜRGÖZE M (2020). Tek Merkezde Takip Edilen Juvenil İdyopatik Artrit Hastalarının Klinik Değerlendirmesi. MN Oftalmoloji, 27(1), 34 - 38.
Chicago BALBABA Mehmet,ULAŞ Fatih,YILDIRIM Hakan,CANLEBLEBİCİ Mehmet,GÜRGÖZE Metin Kaya Tek Merkezde Takip Edilen Juvenil İdyopatik Artrit Hastalarının Klinik Değerlendirmesi. MN Oftalmoloji 27, no.1 (2020): 34 - 38.
MLA BALBABA Mehmet,ULAŞ Fatih,YILDIRIM Hakan,CANLEBLEBİCİ Mehmet,GÜRGÖZE Metin Kaya Tek Merkezde Takip Edilen Juvenil İdyopatik Artrit Hastalarının Klinik Değerlendirmesi. MN Oftalmoloji, vol.27, no.1, 2020, ss.34 - 38.
AMA BALBABA M,ULAŞ F,YILDIRIM H,CANLEBLEBİCİ M,GÜRGÖZE M Tek Merkezde Takip Edilen Juvenil İdyopatik Artrit Hastalarının Klinik Değerlendirmesi. MN Oftalmoloji. 2020; 27(1): 34 - 38.
Vancouver BALBABA M,ULAŞ F,YILDIRIM H,CANLEBLEBİCİ M,GÜRGÖZE M Tek Merkezde Takip Edilen Juvenil İdyopatik Artrit Hastalarının Klinik Değerlendirmesi. MN Oftalmoloji. 2020; 27(1): 34 - 38.
IEEE BALBABA M,ULAŞ F,YILDIRIM H,CANLEBLEBİCİ M,GÜRGÖZE M "Tek Merkezde Takip Edilen Juvenil İdyopatik Artrit Hastalarının Klinik Değerlendirmesi." MN Oftalmoloji, 27, ss.34 - 38, 2020.
ISNAD BALBABA, Mehmet vd. "Tek Merkezde Takip Edilen Juvenil İdyopatik Artrit Hastalarının Klinik Değerlendirmesi". MN Oftalmoloji 27/1 (2020), 34-38.