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Juvenile Arthritiden

Juvenile arthritides

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Zusammenfassung

Gelenkentzündungen bei Kindern stellen eine diagnostische und therapeutische Herausforderung dar. Das Diagnosenspektrum ist breit, die möglichst präzise Indikation für diagnostische und therapeutische Maßnahmen ist insbesondere bei kleinen Kindern wichtig. Neben den akuten Arthritiden – virale Arthritis, reaktive Arthritis, Lyme-Arthritis und septische Arthritis – sind chronische sekundäre Arthritiden im Rahmen anderweitiger Grunderkrankungen und, als häufigste chronisch entzündliche Systemerkrankung im Kindesalter, die juvenile idiopathische Arthritis (JIA) abzugrenzen. Diese Übersicht stellt Differenzialdiagnostik und evidenzbasierte Therapien insbesondere der JIA vor. Diese bestehen derzeit aus einer Kombination von nichtsteroidalen Antirheumatika, systemisch und intraartikulär zu applizierenden Kortikosteroiden, den klassischen Basistherapeutika Sulfasalazin, Methotrexat und Leflunomid, den TNF-Inhibitoren Etanercept, Adalimumab und mit Einschränkungen Infliximab, weiteren Biopharmaka wie Anakinra, Canakinumab und Rilonacept, Tocilizumab und schließlich Abatacept.

Abstract

Arthritis in children represents a diagnostic and therapeutic challenge. The diagnostic spectrum is broad and a very precise indication for diagnostic and therapeutic procedures, especially in small children, is important. In addition to acute arthritides – viral arthritis, reactive arthritis, Lyme arthritis and septic arthritis – secondary chronic arthritis related to an underlying disease as well as juvenile idiopathic arthritis (JIA), the most common chronic inflammatory systemic disease in children, need to be considered. This overview is a guide to the diagnosis of arthritis in childhood and to evidence-based therapy of JIA in particular. This consists of a combination of nonsteroidal anti-inflammatory drugs, systemic and intraarticular corticosteroids, traditional DMARDs such as sulfasalazine, methotrexate and leflunomide, the TNF inhibitors etanercept, adalimumab and, with restrictions, infliximab, other biopharmaceuticals such as anakinra, canakinumab and rilonacept, and tocilizumab and finally, abatacept.

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Literatur

  1. Petty RE, Southwood TR, Manners P et al (2004) International League of Associations for Rheumatology: International League of Aassociations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol 31:390–392

    PubMed  Google Scholar 

  2. Mitchell LA, Tingle AJ, Grace M et al (2000) Rubella virus vaccine associated arthropathy in postpartum immunized women: influence of preimmunization serologic status on development of joint manifestations. J Rheumatol 27:418–423

    CAS  PubMed  Google Scholar 

  3. Anand AJ, Glatt AE (1994) Salmonella osteomyelitis and arthritis in sickle cell disease. Semin Arthritis Rheum 24:211–221

    Article  CAS  PubMed  Google Scholar 

  4. Schmeling H, Hirsch W, Burdach S, Horneff G (2002) Pyogene Sakroiliitis. Monatsschr Kinderheilkd 150:193–195

    Article  Google Scholar 

  5. Barton LL, Dunle LM, Farooq HH (1987) Septic arthritis in childhood. Am J Dis Child 141:898–900

    CAS  PubMed  Google Scholar 

  6. Odio CM, Ramirez T, Arias G et al (2003) Double blind, randomised, placebo-controlled study of dexamethasone therapy for hematogenous septic arthritis in children. Pediatr Infect Dis J 22:883–888

    Article  PubMed  Google Scholar 

  7. Steere AC (2001) Lyme disease. N Engl J Med 345:115–125

    Article  CAS  PubMed  Google Scholar 

  8. Huppertz HI (1990) Childhood Lyme borreliosis in Europe. Eur J Pediatr 149:814–821

    Article  CAS  PubMed  Google Scholar 

  9. Huppertz HI, Karch H, Suschke HJ et al (1995) Lyme arthritis in European children and adolescents. The Pediatric Rheumatology Collaborative Group. Arthritis Rheum 38:361–368

    Article  CAS  PubMed  Google Scholar 

  10. Nadelman RB, Nowakowski J, Fish D et al (2001) Prophylaxis with single-dose doxycycline for the prevention of Lyme disease after an Ixodes scapularis tick bite. N Engl J Med 345:79–84

    Article  CAS  PubMed  Google Scholar 

  11. Wormser GP, Nadelman RB, Dattwyler RJ et al (2000) Practice guidelines for the treatment of Lyme disease. The Infectious Diseases Society of America. Clin Infect Dis 31(Suppl 1):1–14

    Article  PubMed  Google Scholar 

  12. Deutsche Gesellschaft für Pädiatrische Infektiologie (DGPI) e.V. (2009) 5., vollst. überarb. und erw. Aufl.

  13. Steere AC, Sikand VK, Meurice F et al (1998) Vaccination against Lyme disease with recombinat borrelia burgdorferi outer-surface lipoprotein a with adjuvant. N Engl J Med 339:209–215

    Article  CAS  PubMed  Google Scholar 

  14. Bowyer S, Roettcher P, members of the Pediatric Rheumatology Database Research Group (1996) Pediatric rheumatology clinic populations in the United States: results of a 3 year survey. J Rheumatol 23:1968–1974

    CAS  PubMed  Google Scholar 

  15. Malleson PN, Fung MY, Rosenberg AM (1996) The incidence of pediatric rheumatic diseases: results from the Candian Pediatric Rheumatology Aassociation Disease Registry. J Rheumatol 23:1831–1837

    Google Scholar 

  16. Symmons DP, Jones M, Osborne J et al (1996) Juvenile rheumatoid arthritis in the United Kingdom: data from the British Pediatric Rheumatology Group National diagnostic Register. J Rheumatol 23:1975–1980

    CAS  PubMed  Google Scholar 

  17. Putschky N, Pott HG, Kuipers JG et al (2006) Comparing 10-day and 4-month doxycycline courses for treatment of chlamydia trachomatis-reactive arthritis: a prospective, double-blind trial. Ann Rheum Dis 65:1521–1524

    Article  CAS  PubMed  Google Scholar 

  18. Tomai M, Koth B, Majundar C, Beachey EA (1990) Superantigenicity of streptococcal M protein. J Exp Med 172:359–362

    Article  CAS  PubMed  Google Scholar 

  19. Bessen D, Jones KF, Fischetti VA (1989) Evidence for two distinct classes of streptococcal M protein and their relationship to rheumatic fever. J Exp Med 169:269–283

    Article  CAS  PubMed  Google Scholar 

  20. Ayoub EM, Barret DJ, McLaren NK, Krischer JP (1986) Association of class II huiman histocompatibility leukocyte antigens with rheumatic fever. J Clin Invest 77:2019–2025

    Article  CAS  PubMed  Google Scholar 

  21. Dajani AS and special writing group (1992) Guidelines for the diagnosis of rheumatic fever. Jones Criteria 1992 update. JAMA 268:2069–2073

    Article  Google Scholar 

  22. Thatai D, Turi ZG (1999) Current guidelines for the treatment of patients with rheumatic fever. Drugs 57:545–555

    Article  CAS  PubMed  Google Scholar 

  23. Cardoso F, Vargas AP, Oliveira LD et al (1999) Persistent Sydenham’s chorea. Mov Disord 14:805–807

    Article  CAS  PubMed  Google Scholar 

  24. Dajani A, Taubert K, Ferrieri P et al (1995) Treatment of acute streptococcal pharyngitis and prevention of rheumatic fever: a statement for health professionals. Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young, the American Heart Association. Pediatrics 96:758–764

    CAS  PubMed  Google Scholar 

  25. Majeed HA, Shaltout A, Yousof AM (1984) Recurrence of acute rheumatic fever. Am J Dis Child 138:341–345

    CAS  PubMed  Google Scholar 

  26. Mackie SL, Keat A (2004) Poststreptococcal reactive arthritis: what is it and how do we know? Rheumatology (Oxford) 43:949–954

    Google Scholar 

  27. Ahmed S, Ayoub EM, Scornik JC et al (1998) Poststreptococcal reactive arthritis: clinical characteristics and association with HLA-DR alleles. Arthritis Rheum 41:1096–1102

    Article  CAS  PubMed  Google Scholar 

  28. Moon RY, Greene MG, Rehe GT, Katona IM (1995) Poststreptococcal reactive arthritis in children: a potential predecessor of rheumatic heart disease. J Rheumatol 22:529–532

    CAS  PubMed  Google Scholar 

  29. Schaffer FM, Agarwal R, Helm J et al (1994) Poststreptococcal reactive arthritis and silent carditis: a case report and review of the literature. Pediatrics 93:837–839

    CAS  PubMed  Google Scholar 

  30. Minden K, Niewerth M, Listing J et al (2002) Long-term outcome in patients with juvenile idiopathic arthritis. Arthritis Rheum 46:2392–2401

    Article  PubMed  Google Scholar 

  31. Petty RE (1999) Prognosis in children with rheumatic diseases: justification for consideration of new therapies. Rheumatology 38:739–742

    Article  CAS  PubMed  Google Scholar 

  32. Flatø B, Aasland A, Vinje O, Førre O (1998) Outcome and predictive factors in juvenile rheumatoid arthritis and juvenile spondyloarthropathy. J Rheumatol 25:366–375

    PubMed  Google Scholar 

  33. Brunner J, Sitzmann FC (2006) The diagnostic value of anti-cyclic citrullinated peptide (CCP) antibodies in children with juvenile idiopathic arthritis. Clin Exp Rheumatol 4:449–451

    Google Scholar 

  34. Magni-Manzoni S, Epis O, Ravelli A et al (2009) Comparison of clinical versus ultrasound-determined synovitis in juvenile idiopathic arthritis. Arthritis Rheum 61:1497–504

    Article  PubMed  Google Scholar 

  35. Rossi F, Di Dia F, Galipo O et al (2006) Use of the Sharp and Larsen scoring methods in the assessment of radiographic progression in juvenile idiopathic arthritis. Arthritis Rheum 5:717–722

    Article  Google Scholar 

  36. Billiau AD, Hu Y, Verdonck A et al (2007) Temporomandibular joint arthritis in juvenile idiopathic arthritis: prevalence, clinical and radiological signs, and relation to dentofacial morphology. J Rheumatol 34:1925–1933

    PubMed  Google Scholar 

  37. Singh-Grewal D, Schneider R, Bayer N, Feldman BM (2006) Predictors of disease course and remission in systemic juvenile idiopathic arthritis: significance of early clinical and laboratory features. Arthritis Rheum 5:1595–1601

    Article  Google Scholar 

  38. Frosch M, Ahlmann M, Vogl T et al (2009) The myeloid-related proteins 8 and 14 complex, a novel ligand of toll-like receptor 4, and interleukin-1beta form a positive feedback mechanism in systemic-onset juvenile idiopathic arthritis. Arthritis Rheum 60:883–891

    Article  CAS  PubMed  Google Scholar 

  39. Lotito AP, Campa A, Silva CA et al (2007) Interleukin 18 as a marker of disease activity and severity in patients with juvenile idiopathic arthritis. J Rheumatol 34:823–830

    CAS  PubMed  Google Scholar 

  40. Heiligenhaus A, Niewerth M, Ganser G et al (2007) German Uveitis in Childhood Study Group. Prevalence and complications of uveitis in juvenile idiopathic arthritis in a population-based nation-wide study in Germany: suggested modification of the current screening guidelines. Rheumatology (Oxford) 46(6):1015–1019

    Google Scholar 

  41. Horneff G, Burgos-Vargas R (2009) Juvenile idiopathic arthritis. Subgroup characteristics and comparisons between rheumatoid arthritis-like subgroups and ankylosing spondylitis-like subgroups. Clin Exp Rheumatol 27(4 Suppl 55):131–138

    Google Scholar 

  42. Shore A, Ansell BM (1982) Juvenile psoriatic arthritis – an analysis of 60 cases. J Pediatr 100:529–535

    Article  CAS  PubMed  Google Scholar 

  43. Haapasaari J, Wuolijoki E, Ylijoki H (1983) Treatment of juvenile rheumatoid arthritis with diclofenac sodium. Scand J Rheumatol 12:325–330

    Article  CAS  PubMed  Google Scholar 

  44. Giannini EH, Brewer EJ, Miller ML et al (1990) Ibuprofen suspension in the treatment of juvenile rheumatoid arthritis. Pediatric Rheumatology Collaborative Study Group. J Pediatr 117:645–652

    Article  CAS  PubMed  Google Scholar 

  45. Kvien TK, Hoyeraal HM, Sandstad B (1984) Naproxen and acetylsalicylic acid in the treatment of pauciarticular and polyarticular juvenile rheumatoid arthritis. Assessment of tolerance and efficacy in a single-centre 24-week double-blind parallel study. Scand J Rheumatol 13:342–350

    Article  CAS  PubMed  Google Scholar 

  46. Mäkelä AL (1977) Naproxen in the treatment of juvenile rheumatoid arthritis. Metabolism, safety and efficacy. Scand J Rheumatol 6:193–205

    Article  PubMed  Google Scholar 

  47. Garcia-Morteo O, Maldonado-Cocco JA, Cuttica R, Garay SM (1987) Piroxicam in juvenile rheumatoid arthritis. Eur J Rheumatol Inflamm 8:49–53

    CAS  PubMed  Google Scholar 

  48. Ruperto N, Nikishina I, Pachanov ED et al (2005) Pediatric Rheumatology International Trials Organization. A randomized, double-blind clinical trial of two doses of meloxicam compared with naproxen in children with juvenile idiopathic arthritis: short- and long-term efficacy and safety results. Arthritis Rheum 52:563–572

    Article  CAS  PubMed  Google Scholar 

  49. Reiff A, Lovell DJ, Adelsberg JV et al (2006) Evaluation of the comparative efficacy and tolerability of rofecoxib and naproxen in children and adolescents with juvenile rheumatoid arthritis: a 12-week randomized controlled clinical trial with a 52-week open-label extension. J Rheumatol 33:985–995

    CAS  PubMed  Google Scholar 

  50. Foeldvari I, Szer IS, Zemel LS et al (2009) A prospective study comparing celecoxib with naproxen in children with juvenile rheumatoid arthritis. J Rheumatol 36:174–182

    PubMed  Google Scholar 

  51. Zernikow B, Hechler T (2008) Schmerztherapie bei Kindern und Jugendlichen. Dtsch Arztebl 105:511–522

    Google Scholar 

  52. Brewer EJ, Giannini EH, Kuzmina N, Alekseev L (1986) Penicillamine and hydroxychloroquine in the treatment of severe juvenile rheumatoid arthritis. Results of the U.S.A.-U.S.S.R. double-blind placebo-controlled trial. N Engl J Med 314:1269–1276

    Article  CAS  PubMed  Google Scholar 

  53. Giannini EH, Brewer EJ Jr, Kuzmina N et al (1990) Auranofin in the treatment of juvenile rheumatoid arthritis. Results of the USA-USSR double-blind, placebo-controlled trial. The USA Pediatric Rheumatology Collaborative Study Group. The USSR Cooperative Children’s Study Group. Arthritis Rheum 33:466–476

    Article  CAS  PubMed  Google Scholar 

  54. Kvien TK, Hoyeraal HM, Sandstad B (1986) Azathioprine versus placebo in patients with juvenile rheumatoid arthritis: a single center double blind comparative study. J Rheumatol 13:118–123

    CAS  PubMed  Google Scholar 

  55. Ruperto N, Ravelli A, Castell E et al (2006) Cyclosporine A in juvenile idiopathic arthritis. Results of the PRCSG/PRINTO phase IV post marketing surveillance study.Clin Exp Rheumatol 5:599–605

    Google Scholar 

  56. Giannini EH, Brewer EJ, Kuzmina N et al (1992) Methotrexate in resistant juvenile rheumatoid arthritis. Results of the U.S.A.-U.S.S.R. double-blind, placebo-controlled trial. The Pediatric Rheumatology Collaborative Study Group and The Cooperative Children’s Study Group. N Engl J Med 326:1043–1049

    Article  CAS  PubMed  Google Scholar 

  57. Woo P, Southwood TR, Prieur A et al (2005) Randomized, placebo-controlled, crossover trial of low-dose oral methotrexate in children with extended oligoarticular or systemic arthritis. Arthritis Rheum 43:1849–1857

    Article  Google Scholar 

  58. Ruperto N, Murray KJ, Gerloni V et al (2004) Pediatric Rheumatology International Trials Organization. A randomized trial of parenteral methotrexate comparing an intermediate dose with a higher dose in children with juvenile idiopathic arthritis who failed to respond to standard doses of methotrexate. Arthritis Rheum 50:2191–2201

    Article  CAS  PubMed  Google Scholar 

  59. Horneff G (2007) Wirksamkeit und Verträglichkeit der Therapie mit Methotrexat bei Patienten mit juveniler idiopathischer Arthritis – Analyse aus dem Deutschen Methotrexatregister. Tagung der Gesellschaft Kinder- und Jugendrheumatologie, Meerbusch

  60. van der Meer A, Wulffraat NM, Prakken BJ et al (2007) Psychological side effects of MTX treatment in juvenile idiopathic arthritis: a pilot study. Clin Exp Rheumatol 25:480–485

    Google Scholar 

  61. Ansell BM, Hall MA, Loftus JK et al (1991) A multicentre pilot study of sulphasalazine in juvenile chronic arthritis. Clin Exp Rheumatol 9:201–203

    CAS  PubMed  Google Scholar 

  62. Van Rossum MA, Fiselier TJ, Franssen MJ et al (1998) Sulfasalzin in the treatment of juvenile chronic arthritis. A randomized double-blind placebo-controlled multicenter study. Arthritis Rheum 41:808–816

    Article  Google Scholar 

  63. Burgos-Vargas R, Vazquez-Mellado J, Pacheco-Tena C et al (2002) A 26 week randomised, double blind, placebo controlled exploratory study of sulfasalazine in juvenile onset spondyloarthropathies. Ann Rheum Dis 61:941–942

    Article  CAS  PubMed  Google Scholar 

  64. Silverman E, Mouy R, Spiegel L et al (2005) Leflunomide in Juvenile Rheumatoid Arthritis (JRA) Investigator Group. Leflunomide or methotrexate for juvenile rheumatoid arthritis. N Engl J Med 352:1655–1666

    Article  CAS  PubMed  Google Scholar 

  65. Giannini EH, Ruperto N, Raveli A et al (1997) Preliminary definition of improvement in juvenile arthritis. Arthritis Rheum 40:1202–1209

    CAS  PubMed  Google Scholar 

  66. Lovell DJ, Giannini EH, Reiff A Cawkwell GD et al (2000) Etanercept in children with polyarticular juvenile rheumatoid arthritis. N Engl J Med 342:763–769

    Article  CAS  PubMed  Google Scholar 

  67. Quartier P, Taupin P, Bourdeaut F et al (2003) Efficacy of etanercept for the treatment of juvenile idiopathic arthritis according to the onset type. Arthritis Rheum 48:1093–1101

    Article  CAS  PubMed  Google Scholar 

  68. Horneff G, Schmeling H, Biedermann T et al (2004) The German Etanercept Registry for treatment of juvenile idiopathic arthritis (JIA). Ann Rheum Dis 63:1638–1644

    Article  CAS  PubMed  Google Scholar 

  69. Horneff G (2005) Einsatz von Biologika bei der juvenilen idiopathischen Arthritis. Konsensusstatement des 7. Wörlitzer Expertengespräches 2004 für die Arbeitsgemeinschaft Kinder- und Jugendrheumatologie. Monatsschr Kinderheilkd 153:473–479

    Article  Google Scholar 

  70. Lovell DJ, Reiff A, Jones OY et al (2006) Long-term safety and efficacy of etanercept in children with polyarticular-course juvenile rheumatoid arthritis. Arthritis Rheum 54:1987–1994

    Article  PubMed  Google Scholar 

  71. Lovell DJ, Reiff A, Ilowite NT et al (2008) Pediatric Rheumatology Collaborative Study Group. Safety and efficacy of up to eight years of continuous etanercept therapy in patients with juvenile rheumatoid arthritis. Arthritis Rheum 58:1496–1504

    Article  CAS  PubMed  Google Scholar 

  72. Horneff G, De Bock F, Foeldvari I et al (2009) Safety and efficacy of combination of etanercept and methotrexate compared to treatment with etanercept only in patients with juvenile idiopathic arthritis (JIA). Preliminary data from the German JIA Registry. Ann Rheum Dis 68:519–525

    Article  CAS  PubMed  Google Scholar 

  73. Kuemmerle-Deschner JB, Horneff G (2007) Safety and efficacy of once-weekly application of etanercept in children with juvenile idiopathic arthritis. Rheumatol Int 28:153–156

    Article  CAS  PubMed  Google Scholar 

  74. Prince FH, Twilt M, Jansen-Wijngaarden NC, Suijlekom-Smit LW van (2007) Effectiveness of a once weekly double dose of etanercept in patients with juvenile idiopathic arthritis: a clinical study. Ann Rheum Dis 66:704–705

    Article  PubMed  Google Scholar 

  75. Horneff G, Ebert A, Fitter S et al (2009) Safety and efficacy of once weekly etanercept 0.8 mg/kg in a multicentre 12 week trial in active polyarticular course juvenile idiopathic arthritis. Rheumatology (Oxford) 48:916–919

    Google Scholar 

  76. Lovell DJ, Ruperto N, Goodman S et al (2008) Pediatric Rheumatology Collaborative Study Group; Pediatric Rheumatology International Trials organisation. Adalimumab with or without methotrexate in juvenile rheumatoid arthritis. N Engl J Med 359:810–820

    Article  CAS  PubMed  Google Scholar 

  77. Ruperto N, Lovell DJ, Cuttica R et al (2007) Paediatric Rheumatology International Trials Organisation; Pediatric Rheumatology Collaborative Study Group: a randomized, placebo-controlled trial of infliximab plus methotrexate for the treatment of polyarticular-course juvenile rheumatoid arthritis. Arthritis Rheum 56:3096–3106

    Article  CAS  PubMed  Google Scholar 

  78. Ruperto N, Lovell DJ, Cuttica R et al (2010) Long-term efficacy and safety of infliximab plus methotrexate for the treatment of polyarticular course juvenile rheumatoid arthritis: findings from an open-label treatment extension. Ann Rheum Dis 69:718–722

    Article  CAS  PubMed  Google Scholar 

  79. Ilowite N, Porras O, Reiff A et al (2009) Anakinra in the treatment of polyarticular-course juvenile rheumatoid arthritis: safety and preliminary efficacy results of a randomized multicenter study. Clin Rheumatol 28:129–137

    Article  PubMed  Google Scholar 

  80. Quartier P, Allantaz F, Cimaz R et al (2008) A multicentric, double-blind trial of Anakinra versus placebo in Systemic-Onset Juvenile Idiopathic Arthritis (ANAJIS trial): efficacy and tolerance over 12 month. Ann Rheum Dis 58:S632

    Google Scholar 

  81. Lovell DJ, Gianinni EH, Kimura Y et al (2006) Prelimonary evidence for bioactivity of IL-1 trap (Rilonacept), a long acting il-1 inhibitor, in systemic juvenile idiopathic arthritis (sJIA). Arthritis Rheum 54:325

    Article  Google Scholar 

  82. Ruperto N, Quartier P, Wulfraat N et al for PRINTO (2009) Evaluation of safety and preliminary efficacy of canakinumab (ACZ885), a new IL-1-beta blocking monoclonal antibody, in children with systemic juvenile idiopathic arthritis (sJIA). Arthritis Rheum 60:S2055

    Article  Google Scholar 

  83. Yokota S, Imagawa T, Mori M et al (2008) Efficacy and safety of tocilizumab in patients with systemic-onset juvenile idiopathic arthritis: a randomised, double-blind, placebo-controlled, withdrawal phase III trial. Lancet 371:998–1006

    Article  CAS  PubMed  Google Scholar 

  84. Lovell DJ, Ruperto N, Prieur AM et al (2006) Assessment of open label co-stimulation blockade with abatacept in children and adolescents with active juvenile idiopathic arthritis (JIA). Arthritis Rheum 54:326

    Google Scholar 

  85. Giannini EH, Ruperto N, Prieur AM et al (2006) Efficacy and safety of abatacept in children and adolescents with active juvenile idiopathic arthritis (JIA): results of double-blind withdrawal phase. 2006 Annual Scientific Meeting of the American College of Rheumatology, October 16–21, Washington, USA. Arthritis Rheum 54:482

    Article  Google Scholar 

  86. Wallace CA, Ruperto N, Giannini E (2004) Preliminary criteria for clinical remission for select categories of juvenile idiopathic arthritis. J Rheumatol 31:2290–2294

    PubMed  Google Scholar 

  87. Huppertz HI, Tschammler A, Horwitz AE, Schwab KO (1995) Intraarticular corticosteroids for chronic arthritis in children: effciacy and effects on cartilage and growth. J Pediatr 127:317–321

    Article  CAS  PubMed  Google Scholar 

  88. Zulian F, Martini G, Gobber D et al (2004) Triamcinolone acetonide and hexacetonide intra-articular treatment of symmetrical joints in juvenile idiopathic arthritis: a double-blind trial. Rheumatology (Oxford) 43:1288–1291

    Google Scholar 

  89. Beukelman T, Guevara JP, Albert DA (2007) Outcome in the initial treatment of knee monoarthritis in JIA: results of a decision analysis model. Arthritis Rheum (54 Suppl)

  90. Heiligenhaus A, Mingels A, Heinz C, Ganser G (2007) Methotrexate for uveitis associated with juvenile idiopathic arthritis: value and requirement for additional anti-inflammatory medication. Eur J Ophthalmol 17(5):743–748

    CAS  PubMed  Google Scholar 

  91. Saurenmann RK, Rose JB, Tyrrell P et al (2007) Epidemiology of juvenile idiopathic arthritis in a multiethnic cohort: ethnicity as a risk factor. Arthritis Rheum 56:1974–1984

    Article  CAS  PubMed  Google Scholar 

  92. Saurenmann RK, Levin AV, Feldman BM et al (2010) Risk factors for development of uveitis differ between girls and boys with juvenile idiopathic arthritis. Arthritis Rheum [Epub ahead of print]

  93. Foeldvari I, Nielsen S, Kümmerle-Deschner J et al (2007) Tumor necrosis factor-alpha blocker in treatment of juvenile idiopathic arthritis-associated uveitis refractory to second-line agents: results of a multinational survey. J Rheumatol 34:1146–1150

    CAS  PubMed  Google Scholar 

  94. Simonini G, Zannin ME, Caputo R et al (2008) Loss of efficacy during long-term infliximab therapy for sight-threatening childhood uveitis. Rheumatology (Oxford) 47:1510–1514

    Google Scholar 

  95. Tynjälä P, Kotaniemi K, Lindahl P et al (2008) Adalimumab in juvenile idiopathic arthritis-associated chronic anterior uveitis. Rheumatology (Oxford) 47:339–344

    Google Scholar 

  96. Biester S, Deuter C, Michels H et al (2007) Adalimumab in the therapy of uveitis in childhood. Br J Ophthalmol 91:319–324

    Article  PubMed  Google Scholar 

  97. Bennett AE, Silverman ED, Miller JJ et al (1988) Insulin-like-growth-factor-1 and -2 in children with systemic onset juvenile arthritis. J Rheumatol 15:655–658

    CAS  PubMed  Google Scholar 

  98. Davis UM, Jones J, Reeve J et al (1997) Juvenile rheumatoid arthritis. Effects of disease activity and recombinant human growth hormone on insulin-like growth factor 1, insulin-like growth factor binding proteins 1 and 3, and osteocalcin. Arhritis Rheum 40:332–340

    Article  Google Scholar 

  99. Horneff G (2004) Wachstumsstörungen bei chronisch-entzündlichen Erkrankungen: Juvenile idiopathische Arthritis. In: Ranke MB, Schönau E (Hrsg) Wachstumsstörungen im Kindes- und Jugendalter aus der Perspektive des Knochens. Verlag Wissenschaftliche Scripten, Zwickau, S 109–116

  100. Schmeling H, Seliger E, Horneff G (2003) Growth reconstitution in juvenile idiopathic arthritis treated with etanercept. Clin Exp Rheumatol 21:779–784

    CAS  PubMed  Google Scholar 

  101. Zak M et al (1999) Final height, armspan, subischial leg length and body proportions in juvenile chronic arthritis. Horm Res 52:80–85

    Article  CAS  PubMed  Google Scholar 

  102. Simon D, Prieur AM, Quartier P et al (2007) Early recombinant human growth hormone treatment in glucocorticoid-treated children with juvenile idiopathic arthritis: a 3-year randomized study. J Clin Endocrinol Metab 92:2567–2573

    Article  CAS  PubMed  Google Scholar 

  103. Bechtold S, Ripperger P, Dalla Pozza R et al (2007) Growth hormone increases final height in patients with juvenile idiopathic arthritis: data from a randomized controlled study. J Clin Endocrinol Metab 92:3013–3018

    Article  CAS  PubMed  Google Scholar 

  104. Okuda Y, Takasugi K (2006) Successful use of a humanized anti-interleukin-6 receptor antibody, tocilizumab, to treat amyloid A amyloidosis complicating juvenile idiopathic arthritis. Arthritis Rheum 9:2997–3000

    Article  Google Scholar 

  105. Burnham JM, Shults J, Weinstein R et al (2006) Childhood onset arthritis is associated with an increased risk of fracture: a population based study using the General Practice Research Database. Ann Rheum Dis 8:1074–1079

    Article  Google Scholar 

  106. Polito C, Strano CG, Rea L et al (1995) Reduced bone mineral content and normal serum osteocalcin in non-steroid-treated patients with juvenile rheumatoid arthritis. Ann Rheum Dis 54:193–196

    Article  CAS  PubMed  Google Scholar 

  107. Lovell DJ, Glass D, Ranz J et al (2006) A randomized controlled trial of calcium supplementation to increase bone mineral density in children with juvenile rheumatoid arthritis. Arthritis Rheum 53:2235–2242

    Article  Google Scholar 

  108. Vastert SJ, Wijk R van, D’Urbano LE et al (2010) Mutations in the perforin gene can be linked to macrophage activation syndrome in patients with systemic onset juvenile idiopathic arthritis. Rheumatology (Oxford) 49:441–449]

    Google Scholar 

  109. Kelly A, Ramanan AV (2008) A case of macrophage activation syndrome successfully treated with anakinra. Nat Clin Pract Rheumatol 4:615–620

    Article  CAS  PubMed  Google Scholar 

  110. Bruck N, J Hamel, Suttorp M et al (2009) Remission of Macrophage Activation Syndrome (MAS) associated with systemic-onset juvenile idiopathic arthritis by treatment with anakinra but without cyclosporine. ACR Abstract 234

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Der korrespondierende Autor weist auf folgende Beziehungen hin: Der Autor gibt an, mit folgenden Firmen vertragliche Bindungen betreffend Vortragshonorationen, Beratungen, Forschungsförderungen erhalten zu haben, ohne dass sich hieraus ein Konflikt mit den getätigten Aussagen und Empfehlungen ergibt. Abbott, Pfizer, Novartis, Sandoz, Genzyme, Chugai, Nycomed, Wyeth.

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  1. Zentrum für Allgemeine Pädiatrie und Neonatologie und Kinderrheumazentrum, Asklepios Klinik Sankt Augustin, Arnold Janssen Str. 29, 53757, Sankt Augustin, Deutschland

    G. Horneff

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  1. G. Horneff
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Correspondence to G. Horneff.

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Horneff, G. Juvenile Arthritiden. Z. Rheumatol. 69, 719–737 (2010). https://doi.org/10.1007/s00393-010-0664-7

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  • DOI: https://doi.org/10.1007/s00393-010-0664-7

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