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[Optic neuritis in juvenile idiopathic arthritis patient]. / Neurite óptica em paciente com artrite idiopática juvenil.
Lourenço, Daniela M R; Buscatti, Izabel M; Lourenço, Benito; Monti, Fernanda C; Paz, José Albino; Silva, Clovis A.
Afiliação
  • Lourenço DM; Unidade de Reumatologia Pediátrica, Departamento de Pediatria, Faculdade de Medicina da Universidade São Paulo, São Paulo, SP, Brasil.
  • Buscatti IM; Unidade de Reumatologia Pediátrica, Departamento de Pediatria, Faculdade de Medicina da Universidade São Paulo, São Paulo, SP, Brasil.
  • Lourenço B; Unidade do Adolescente, Departamento de Pediatria, Faculdade de Medicina da Universidade São Paulo, São Paulo, SP, Brasil.
  • Monti FC; Unidade de Neurologia Pediátrica, Departamento de Neurologia, Faculdade de Medicina da Universidade São Paulo, São Paulo, SP, Brasil.
  • Paz JA; Unidade de Neurologia Pediátrica, Departamento de Neurologia, Faculdade de Medicina da Universidade São Paulo, São Paulo, SP, Brasil.
  • Silva CA; Unidade de Reumatologia Pediátrica, Departamento de Pediatria, Faculdade de Medicina da Universidade São Paulo, São Paulo, SP, Brasil; Divisão de Reumatologia, Faculdade de Medicina da Universidade São Paulo, São Paulo, SP, Brasil. Electronic address: clovisaasilva@gmail.com.
Rev Bras Reumatol ; 54(6): 486-9, 2014.
Article em Pt | MEDLINE | ID: mdl-25438805
Optic neuritis (ON) was rarely reported in juvenile idiopathic arthritis (JIA) patients, particularly in those under anti-tumor necrosis factor alpha blockage. However, to our knowledge, the prevalence of ON in JIA population has not been studied. Therefore, 5,793 patients were followed up at our University Hospital and 630 (11%) had JIA. One patient (0.15%) had ON and was reported herein. A 6-year-old male was diagnosed with extended oligoarticular JIA, and received naproxen and methotrexate subsequently replaced by leflunomide. At 11 years old, he was diagnosed with aseptic meningitis, followed by a partial motor seizure with secondary generalization. Brain magnetic resonance imaging (MRI) and electroencephalogram showed diffuse disorganization of the brain electric activity and leflunomide was suspended. Seven days later, the patient presented acute ocular pain, loss of acuity for color, blurred vision, photophobia, redness and short progressive visual loss in the right eye. A fundoscopic exam detected unilateral papilledema without retinal exudates. Orbital MRI suggested right ON. The anti-aquaporin 4 (anti-AQP4) antibody was negative. Pulse therapy with methylprednisolone was administered for five days, and subsequently with prednisone, he had clinical and laboratory improvement. In conclusion, a low prevalence of ON was observed in our JIA population. The absence of anti-AQP4 antibody and the normal brain MRI do not exclude the possibility of demyelinating disease associated with chronic arthritis. Therefore, rigorous follow up is required.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artrite Juvenil / Neurite Óptica Tipo de estudo: Risk_factors_studies Limite: Child / Humans / Male Idioma: Pt Revista: Rev Bras Reumatol Ano de publicação: 2014 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artrite Juvenil / Neurite Óptica Tipo de estudo: Risk_factors_studies Limite: Child / Humans / Male Idioma: Pt Revista: Rev Bras Reumatol Ano de publicação: 2014 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil