UVEITIS IN BEHCET'S DISEASE IN CHILDREN. ANALYSIS OF LITERATURE AND DESCRIPTION OF CASES


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Abstract

The study of peculiarities of the course and results of the treatment of uveitis in Behcet's disease in 4 children and the analysis of literature were conducted. Rare manifestation of Behcet's disease in childhood and differences of clinical implications in children and adults were observed, causing difficulties in making timely diagnosis. More severe course of uveitis in Behcet's disease was observed in children than in adults, resulting in the rapid development of wide range of complications in the absence of adequate therapy. The necessity of early and active anti-inflammatory treatment of uveitis in Behcet's disease was proved; the efficacy of TNF-α inhibitors in refractory uveitis was established. It was demonstrated that early diagnosis and effective treatment can prevent serious complications and preserve good vision in majority of children.

About the authors

L. A Katargina

Federal state budgetary institution «Moscow Helmholtz Institute of Ophthalmology», Ministry of Health of the Russian Federation

E. V Denisova

Federal state budgetary institution «Moscow Helmholtz Institute of Ophthalmology», Ministry of Health of the Russian Federation

A. V Starikova

Federal state budgetary institution «Moscow Helmholtz Institute of Ophthalmology», Ministry of Health of the Russian Federation

N. A Gvozdyuk

Federal state budgetary institution «Moscow Helmholtz Institute of Ophthalmology», Ministry of Health of the Russian Federation

N. V Lyubimova

Federal state budgetary institution «Moscow Helmholtz Institute of Ophthalmology», Ministry of Health of the Russian Federation

References

  1. Катаргина Л.А., Хватова А.В. Эндогенные увеиты у детей и подростков. М.: Медицина; 2000.
  2. Катаргина Л.А., Архипова Л.Т. Увеиты: патогенетическая и иммуносупрессивная терапия. Тверь: ООО «Издательство «Триада»; 2004.
  3. BenEzra D., Cohen Е., Maftzir G. Uveitis in children and adolescents. Br. J. Ophthalmol. 2005; 89 (4): 444—8.
  4. de Boer J., Wulffraat N., Rothova A. Visual loss in uveitis of childhood. Br. J. Ophthalmol. 2003; 87 (7): 879—84.
  5. Smith J.A., Mackensen F., Sen H.N., Leigh J.F., Watkins A.S., Pyatetsky D. et al. Epidemiology and course of disease in childhood uveitis. Ophthalmology. 2009; 116 (8): 1544—51.
  6. Tugal-Tutkun I. Pediatric uveitis. J. Ophthalm. Vis. Res. 2011; 6 (4): 259—69.
  7. Алекберова З.С. Болезнь Бехчета. Вестник РАМН. 2008; 6: 33—7.
  8. Zierhut М., Stubiger N., Deuter С, Kotter I. Behçet’s disease. In: Pleyer U., Mondino B., eds. Uveitis and immunological disorders. Springer; 2005: 173—200.
  9. Citiric M., Berker N., Songur M.S. Soykan E., Zilelioglu O. Ocular findings in Childhood-onset Behçet’s disease. J. AAPOS. 2009; 13 (4): 391—5.
  10. Kari J.A., Shah V., Dillon M.J. Behçet’s disease in UK children: clinical features and treatment including thalidomide. Rheumatology (Oxford). 2001; 40 (8): 933—8.
  11. Kesen M.R., Goldstein D.A., Tessler H.H. Uveitis associated with pediatric Behçet’s disease in the American Midwest. Am. J. Ophthalmol. 2008; 146 (6): 819—27.
  12. Kone-Paut I., Yurdakul S., Bahabri S.A., Shafae N., Ozen S., Ozdogan H. et al. Clinical features of Behçet’s disease in children: an international collaborative study of 86 cases. J. Pediatr. 1998; 132 (4): 721—5.
  13. Kramer M., Amer R., Mukamel M., Snir M., Jaouni Т., Friling R. Uveitis in juvenile Behçet’s disease: clinical course and visual outcome compared with adult patients. Eye. 2009; 23 (11): 2034—41.
  14. Laghmari M., Karim A., Allali-F., Elmadani A., Ibrahimy W., Hajjaj Hassouni N. et al. Childhood Behçet’s disease: clinical and evolutive aspects. About 13 cases. J. Fr. Ophtalmol. 2002; 25 (9): 904—8.
  15. Mundy T.M., Miller J.J. 3rd Behçet’s disease presenting as chronic aphthous stomatitis in a child. Pediatrics. 1978; 62 (2): 205—8.
  16. Tugal-Tutkun I. Ur gancioglu M. Childhood-onset uveitis in Be-hçet disease: a descriptive study of 36 cases. Am. J. Ophthalmol. 2003; 136 (6): 1114—9.
  17. Criteria for diagnosis of Behçet’s disease. Lancet. 1990; 335: 1078—80.
  18. Pivetti-Pezzi P., Accorinti M., Abdulaziz M.A., La Cava M., Torella M., Riso D. Behçet’s disease in children. Jpn J. Ophthalmol. 1995; 39 (3): 309—14.
  19. Karincaoglu Y., Borlu M., Toker S.C., Akman A., Onder M., Gunasti S. et al. Demographic and clinical properties of juvenile-on-set Behçet’s disease: A controlled multicenter study. J. Am. Acad. Dermatol. 2008; 58 (4): 579—84.
  20. Krause I., Uziel Y., Guedj D., Mukamel M., Harel L., Molad Y. et al. Childhood Behçet’s disease: clinical features and comparison with adult-onset disease. Rheumatology (Oxford). 1999; 38 (5): 457—62.
  21. Borlu M., Uksal U., Ferahbas A., Evereklioglu C. Clinical features of Behçet’s disease in children. Int. J. Dermatol. 2006; 45 (6): 713—6.
  22. Jabs D.A., Rosenbaum J.T., Foster C.S., Holland G.N., Jaffe G.J., Louie J.S. et al. Guidelines for the use of immunosuppressive drugs in patients with ocular inflammatory disorders: recommendations of an expert panel. Am. J. Ophthalmol. 2000; 130 (4): 492—513.
  23. Hamuryudan V., Ozyazgan Y., Hizli N., Mat C, Yurdakul S., Tuztin Y. et al. Azathioprine in Behçet’s syndrome: effects on longterm prognosis. Arthr. and Rheum. 1997; 40 (4): 769—74.
  24. Ozdal P.C., Ortaç S., Taskintuna I., Firat E. Long-term therapy with low dose cyclosporin A in ocular Behçet’s disease. Docum. Ophthalmol. 2002; 105 (3): 301—12.
  25. Kilmartin D.J., Forrester J.V., Dick A.D. Tacrolimus (FK506) in failed cyclosporin A therapy in endogenous posterior uveitis. Ocul. Immunol. Inflamm. 1998; 6 (2): 101—9.
  26. Guillaume-Czitrom S., Berger C., Pajot C., Bodaghi В., Wechsler В., Kone-Paut I. Efficacy and safety of interferon-alpha in the treatment of corticodependent uveitis of paediatric Behçet’s disease. Rheumatology (Oxford). 2007; 46 (10): 1570—3.
  27. Wechsler В., Bodaghi В., Huong D.L., Fardeau C., Amoura Z., Cassoux N. et al. Efficacy of interferon alfa-2a in severe and refractory uveitis associated with Behçet’s disease. Ocul. Immunol. Inflamm. 2000; 8 (4): 293—301.
  28. Accorinti M., Pirraglia M.P., Paroli M.P., Priori R., Conti F., Pivetti -Pezzi P. Infliximab treatment for ocular and extraocular manifestations of Behçet’s disease. Jpn J. Ophthalmol. 2007; 51 (3): 191—6.
  29. Sfikakis P.P. Behçet’s disease: a new target for anti-tumour necrosis factor treatment. Ann. Rheum. Dis. 2002; 61 (Suppl. 2): 51—3.
  30. Tugal-Tutkun I., Mudun A., Urgancioglu M., Kamali S., Kasapoglu E., Inane M. et al. Efficacy of infliximab in the treatment of uveitis that is resistant to treatment with the combination of azathioprine, cyclosporine, and corticosteroids in Behçet’s disease: an open-label trial. Arthr. and Rheum. 2005; 52 (8): 2478—84.

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