One case report of systemic onset juvenile idiopathic arthritis with atlantoaxial subluxation as the initial manifesta-tion
10.3969/j.issn.1000-3606.2016.02.014
- VernacularTitle:以寰枢关节半脱位为首发表现的全身型幼年特发性关节炎1例
- Author:
Zhi LIN
;
Zhihui LI
;
Yi ZHANG
;
Liang ZHANG
;
Mai XUN
- Publication Type:Journal Article
- Keywords:
juvenile idiopathic arthritis;
atlantoaxial subluxation;
macrophage activation syndrome;
child
- From:
Journal of Clinical Pediatrics
2016;(2):139-141
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical features of systemic onset of juvenile idiopathic arthritis (SoJIA) with atlantoaxial subluxation as the initial manifestation. Methods The clinical data from one SoJIA patient with atlantoaxial subluxation as the initial manifestation were retrospectively analyzed. Results A 9-year-old boy presented the head and neck movement disorder as the ifrst symptom, developed fever on the third day, then rapidly progressed on 23rd day, with a sharp decline in red blood cell, platelet, and hemoglobin, blood coagulation dysfunction, and a large number of bilateral pulmonary exudation. Ultrasonography showed excess lfuid in abdomen, chest, and pericardium. According to the 2001 version of the revised International College of Rheumatology standard, the diagnosis of SoJIA combined macrophage activation syndrome was conifrmed. Then treated with hemoperfusion, ifltration, and methylprednisolone combined with cyclosporine A, the disease was in remission. Conclusion For children with spontaneous atlantoaxial subluxation accompanied by the systemic symptoms, with no obvious skeletal deformity or acute inlfammation etc., should be alerted to the consideration of systemic juvenile idiopathic arthritis.
