PRACTICE OF INFLIXIMAB TREATMENT OF A PATIENT WITH SEVERE POLIARTICULAR JUVENILE RHEUMATOID ARTHRITIS

Abstract

This article contains observation of severe poliarticular variant of juvenile rheumatoid arthritis, resistant to glucocorticoid treatment and classic immunosuppressive therapy. There is a description of biologic treatment — with chimeriс antibodies to TNF α — infliximab in a patient with protracted aggressive arthritis (duration of the disease more than 5 years). After 6 weeks of treatment there was a considerable decrease in pain syndrome and joint exudation, morning constraint was arrested completely. After 30 days of treatment an inactive phase of the disease was achieved, movements were restored in 15 from 23 affected joints. We managed to stop intraarticular injections with glucocorticoids. Clinical case shown can serve as an example of high efficacy of infliximab in patient with protracted juvenile rheumathoid arthritis and testifies to the availability of a further treatment of patients with aggressive juvenile rheumatoid arthritis, that are resistant to classic immunosuppressive treatment, with TNF α blockers. Key words: children, juvenile rheumatoid arthritis, treatment, infliximab, TNF α inhibitors. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (5): 170–175.)