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首页> 外文期刊>Sao Paulo Medical Journal >Treatment of refractory juvenile idiopathic arthritis via pulse therapy using methylprednisolone and cyclophosphamide
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Treatment of refractory juvenile idiopathic arthritis via pulse therapy using methylprednisolone and cyclophosphamide

机译：使用甲基强的松龙和环磷酰胺的脉冲疗法治疗难治性幼年特发性关节炎

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CONTEXT: Patients with refractory juvenile idiopathic arthritis can benefit from aggressive therapy. CASE REPORT: We followed the clinical course of 4 patients (2 male, 2 female) aged 9.1-17.8 years (mean of 14.5 years) with polyarticular onset of juvenile rheumatoid arthritis and one 16-year-old boy with juvenile spondyloarthropathy associated with inflammatory bowel disease. All the juvenile rheumatoid arthritis patients fulfilled the diagnostic criteria established by the American College of Rheumatology. All patients had unremitting arthritis despite maximum therapy. All patients began receiving treatment using intravenous cyclophosphamide at 500-750 mg/m2 and intravenous methylprednisolone at 30 mg/kg, for 3 days monthly (1 g maximum). The patients received between 3 and 11 monthly treatments, and/or 3-5 treatments every two months for 12 months, according to the severity of the disease and/or response to the therapy. All but one patient were evaluated retrospectively at the start (time 0) and 6 months (time 1), and 12 months (time 2) after the beginning of the treatment. A rapid and clinically significant suppression of systemic and articular manifestations was seen in all patients. Our results showed the favorable effect of this treatment on the clinical and some laboratory manifestations of juvenile idiopathic arthritis.
机译：背景：患有难治性幼年特发性关节炎的患者可以从积极治疗中受益。病例报告：我们追踪了4例（1-1.78岁，平均14.5岁）年龄为9.1-17.8岁的多发性青少年类风湿关节炎患者和一名16岁男孩伴发炎性脊椎关节炎的临床病历肠病。所有的青少年类风湿关节炎患者均符合美国风湿病学会制定的诊断标准。尽管进行了最大程度的治疗，所有患者均患有不缓解的关节炎。所有患者开始接受每月3天（最大1 g）的静脉内环磷酰胺（500-750 mg / m2）和静脉内甲泼尼龙（30 mg / kg）的治疗。根据疾病的严重程度和/或对治疗的反应，患者每月接受3-11次治疗，和/或每两个月接受3-5次治疗，共12个月。在治疗开始后（时间0）和6个月（时间1）以及12个月（时间2）对除一名患者外的所有患者进行回顾性评估。在所有患者中均观察到对全身和关节表现的快速且临床上显着的抑制。我们的结果表明，这种治疗对青少年特发性关节炎的临床和一些实验室表现具有良好的效果。

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