%0 Journal Article
%T Psoriatic Juvenile Idiopathic Arthritis Associated with Uveitis: A Case Report
%A Davide Moretti
%A Ilaria Cianchi
%A Gaia Vannucci
%A Rolando Cimaz
%A Gabriele Simonini
%J Case Reports in Rheumatology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/595890
%X According to the definition proposed by the International League of Associations for Rheumatology (ILAR), juvenile idiopathic arthritis (JIA) is defined as an arthritis of unknown etiology, starting under 16 years of age and lasting for at least 6 weeks, once other known conditions have been excluded. JIA represents the most common chronic rheumatic disease of childhood and is considered an important cause of short- and long-term acquired disability in children. It is currently estimated that psoriatic JIA represents up to 10% of all JIA subtypes, and chronic uveitis may occur in 10 to 15% of children with psoriatic JIA. In this report we describe a case of psoriatic JIA complicated by uveitis, in a child failing previous treatments with nonsteroidal anti-inflammatory drugs, methotrexate, and etanercept. Finally, adalimumab was prescribed, which led to sustained clinical remission in both arthritis and uveitis. 1. Background According to the definition proposed by the International League of Associations for Rheumatology (ILAR), juvenile idiopathic arthritis (JIA) is defined as an arthritis of unknown etiology, starting before 16 years of age, and lasting for at least 6 weeks, once other known conditions have been excluded [1]. JIA represents the most common chronic rheumatic disease of childhood and is considered an important cause of short- and long-term acquired disability in children [2]. JIA encompasses seven different subcategories based on the predominant clinical manifestations and laboratory features seen in the first 6 months of disease. Its prevalence is unknown and varies considerably among populations, depending on race, immunogenetic susceptibility, and environmental influences. Currently, the annual incidence of JIA is estimated at around 100 new cases per 1,000,000 population [3]. JIA is considered an autoimmune disease, potentially resulting from an abnormal immunologic response caused or triggered by environmental factors such as infection or trauma in a genetically predisposed subject. Adaptive immune activation against self-epitopes has been suggested, and a typical synovial membrane inflammation has been observed [4¨C6]. The synovia shows pronounced hyperplasia of the lining layer, along with an exuberant infiltration of the sublining layer with mononuclear cells, including memory T cells, B cells, macrophages, dendritic cells, and plasma cells [2]. Psoriatic JIA represents up to 10% of all JIA subtypes and has a predilection for females. Anti-nuclear antibodies (ANAs) are positive in more than 50% of affected patients. According to
%U http://www.hindawi.com/journals/crirh/2013/595890/