无多器官受累的全身性青少年特发性关节炎1例报告

P. Khan, Sarah Nousheen Bb, Asfiya Begum, Raqshan Jabeen, Yousuf Hussain
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摘要

系统性发作的幼年特发性关节炎(SoJIA)是一种罕见的幼年特发性关节炎(JIA),表现为一个或多个关节的日常发热和关节炎。其特征包括特征性的橙红色皮疹,伴淋巴结病、肝脾肿大和浆液炎。据我们所知,这是印度罕见的JIA形式,文献中很少有没有多器官受累的病例。以下病例报告了一名12岁男孩,他以高热和膝关节、踝关节和髋关节关节炎病史来医院就诊。SoJIA的诊断在随后的实验室调查后得到确认;治疗包括长期非甾体类抗炎药和甲氨蝶呤。然而,由于药物成本的增加和对疾病的“治愈”没有保证,本患者从对抗疗法转向顺势疗法药物。他仍然经历与疾病相关的频繁发作,在此期间服用乙酰氯芬酸缓解症状。这一案例也突出了“治愈”疾病而不是“以症状为导向”的治疗措施的重要性。当不能保证治愈时,患者可能会转向疗效有限的廉价替代疗法。风湿病学领域的进一步研究,特别是针对罕见疾病的研究,是有必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A CASE REPORT ON SYSTEMIC-ONSET JUVENILE IDIOPATHIC ARTHRITIS (SOJIA) WITHOUT MULTIORGAN INVOLVEMENT
Systemic-onset juvenile idiopathic arthritis (SoJIA) is a rare form of juvenile idiopathic arthritis (JIA) which manifests as quotidian fevers and arthritis in one or more joints. Features include characteristic salmon pink-colored rash associated with lymphadenopathy, hepatosplenomegaly, and serositis. To the best of our knowledge, this is a rare form of JIA in India and very few cases without multiorgan involvement have been published in literature. The following case reports a 12-year-old male child who presented to the hospital with a history of spiking fevers and arthritis in the knees, ankle, and hip joints. Diagnosis of SoJIA was confirmed after subsequent laboratory investigations; treatment included long-term nonsteroidal anti-inflammatory drugs, and methotrexate. However, due to increased cost of medicines and no guaranteed “cure” for the disease, the present patient switched from allopathic to homeopathic medicines. He still experiences frequent flare-ups associated with the disease, during which aceclofenac is taken for symptom relief. This case also highlights the importance of a “cure” for diseases rather than “symptom-oriented” treatment measures. When a cure is not guaranteed, patients may transition to inexpensive alternate therapies portraying limited efficacy. Further research in the field of rheumatology, specifically for rare diseases, is warranted.
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