幼年特发性关节炎

最后审阅: 28 八月 2022
最后更新: 07 九月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 存在危险因素
  • 持续 6 周以上
  • 关节痛
  • 关节肿胀
  • 发热
更多 关键诊断因素

其他诊断因素

  • 晨僵
  • 跛行步态
  • 活动受限
  • 皮疹
  • 附着点炎
  • 下肢不等长
  • 葡萄膜炎
  • 类风湿结节
其他诊断因素

危险因素

  • 女性
  • 人类白细胞抗原 (HLA) 多态性
  • 6 岁以下
  • 自身免疫性疾病家族史
  • 儿童期抗生素暴露
更多 危险因素

诊断性检查

首要检查

  • 全血细胞计数 (FBC)
  • 红细胞沉降率
  • C 反应蛋白
  • 抗核抗体 (ANA)
  • 类风湿因子 (RF)
更多 首要检查

需考虑的检查

  • 抗环瓜氨酸肽抗体
  • 沙眼衣原体检查
  • 铁蛋白水平
  • 受累关节的超声检查
  • 磁共振成像 (MRI)
更多 需考虑的检查

治疗流程

持续性治疗

多关节型 JIA:累及 5 个或更多关节

少关节型 JIA:累及 4 个或更少关节

活动性骶髂关节炎

活动性附着点炎

全身型 JIA

撰稿人

作者

Jacqui Clinch, MRCP, FRCPCH

Consultant Paediatric Rheumatologist

Department of Paediatric Rheumatology

Bristol Royal Hospital for Children

Bristol

UK

利益声明

JC declares that she has no competing interests.

鸣谢

Dr Jacqui Clinch would like to gratefully acknowledge Dr Ripal Shah, Dr Eve Bassett, Dr Sheila Angeles-Han, and Dr Sampath Prahalad, the previous contributors to this topic. RS and EB declare that they have no competing interests. SAH and SP are authors of a number of references cited in this topic. SP is the recipient of research funding from the National Institute of Health and Arthritis Foundation.

同行评议者

Paul Rosen, MD

Clinical Director

Division of Pediatric Rheumatology

Children's Hospital of Pittsburgh

Pittsburgh

PA

利益声明

PR declares that he has no competing interests.

Murray Passo, MD

Director

Division of Rheumatology

Professor of Pediatrics

Department of Pediatrics

Medical University of South Carolina

Charleston

SC

利益声明

MP is an author of a number of references cited in this monograph. He is a consultant to Pfizer Pharmaceuticals as the chairman of the Expert Advisory Panel to review toxicity of celecoxib. He has been a visiting professor from the American College of Rheumatology, and from the American Academy of Pediatrics.

Patricia Woo, CBE

Professor of Paediatric Rheumatology

University College London

London

UK

利益声明

Not disclosed.

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