| Sažetak | Reumatološke bolesti dječje dobi često budu komplicirane očnim manifestacijama poput uveitisa, skleritisa, episkleritisa i vaskulitisa mrežnice, čije neprepoznavanje, nepravodobno ili nepravilno liječenje dovodi do komplikacija i dugotrajnih posljedica. Ciljevi su ovog istraživanja proučiti pojavnost očnih komplikacija upalnih reumatskih bolesti dječje dobi, istražiti međuovisnost dobi, spola, ANA i RF titra te tipa reumatološke bolesti i pojave očnih komplikacija i odgovora na terapiju. U ovo retrospektivno istraživanje uključeno je 32 djece koja su od 2009. do 2017. godine liječena zbog reumatološke bolesti i bolesti vidnog sustava u KBC-u Zagreb. Od 32 bolesnika (81% djevojčice) 29 je bolovalo od JIA-e, a po jedan bolesnik od juvenilnog dermatomiozitisa, Behçetove bolesti i sarkoidoze. Uveitis je imalo 27 bolesnika, dvoje je imalo episkleritis, a po troje keratitis i vaskulitis retine. Prosječna je dob djevojčica pri dijagnozi JIA-a 3.6 (1-14) godina, dječaka 7.6 (1 – 14.5) godina, a pri pojavi očne manifestacije 5.1 godina u djevojčica i 8.2 godine u dječaka. Svi bolesnici imali su negativan RF, 65% je imalo pozitivan titar ANA-e, od kojih je 81% oboljelo od JIA-e prije 6. godine i sve su bile djevojčice. Remisija uveitisa postignuta je u dvoje bolesnika topikalnim kortikosteroidima uz primjenu nesteroidnih protuupalnih lijekova i metotreksata. Neaktivnost uveitisa postignuta je u 81% bolesnika, najuspješnije kada je u liječenje uključena i biološka terapija. Za istaknuti je skupinu djevojčica oboljelih od više tipova JIA-e i uveitisa, s početkom bolesti prije 6. godine života i pozitivnom ANA-om, što govori u prilog potrebi za reklasifikacijom JIA-e i uvođenjem nove skupine s ovim osobinama. Nije utvrđena povezanost između pozitivne ANA-e i učestalosti komplikacija i relapsa uveitisa. |
| Sažetak (engleski) | Ocular manifestations in the form of uveitis, scleritis, episcleritis, and retinal vasculitis complicate the course of rheumatic diseases. Furthermore, these conditions can cause long lasting consequences when unrecognized, untimely, or incorrectly treated. Aim of this research was to examine ocular manifestations of childhood rheumatic diseases and to explore the relation between age, gender, ANA, RF titer along with type of rheumatic disease, and ocular manifestations as well as treatment response. The retrospective study included 32 children treated for rheumatologic and ocular diseases in the period 2009-2017 at KBC Zagreb. Out of 32 patients (81% female), 29 suffered from juvenile idiopathic arthritis (JIA), one patient from juvenile dermatomyositis, one from Behçet’s disease, and one from sarcoidosis. 27 patients had uveitis, two episcleritis, three had keratitis, and three retinal vasculitis. Average age at JIA onset in girls was 3.6 (1-14) years and in boys 7.6 (1-14.5) years, while girls had in average 5.1 years at first ocular manifestation and boys 8.2 years. All patients were RF negative. 65% of patients was ANA positive, out of which 81% had onset of JIA before the age of 6 (all girls). Remission of uveitis was achieved in two patients treated with topical corticosteroids, with non-steroid anti-inflammatory medication, and methotrexate. 81% had inactive uveitis, most frequently achieved with a combined therapy which included biologics. One group of patients was distinguished, a group of females suffering from different subtypes of JIA and uveitis, with onset occurring before the age of 6, and positive ANA, concurring the need for reclassification of JIA and forming a new subtype with these characteristics. No relation between ANA titer and the frequency of complications or uveitis relapses was determined. |
