Clinical analysis of 5 cases of systemic juvenile idiopathic arthritis with coronary artery dilatation.
10.3760/cma.j.cn112140-20210923-00818
- Author:
Sheng Nan LI
1
;
Jian Ming LAI
1
;
Min KANG
1
;
Tong YUE
1
;
Xiao Lei WANG
1
Author Information
1. Department of Rheumatology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China.
- Publication Type:Journal Article
- MeSH:
Arthritis, Juvenile/drug therapy*;
Biological Factors/therapeutic use*;
Child;
Coronary Aneurysm/etiology*;
Coronary Artery Disease/therapy*;
Dilatation;
Dilatation, Pathologic;
Female;
Humans;
Infant;
Male;
Methotrexate;
Prednisone/therapeutic use*;
Retrospective Studies
- From:
Chinese Journal of Pediatrics
2022;60(5):462-465
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the clinical characteristics of systemic juvenile idiopathic arthritis combined with coronary artery dilatation. Methods: A retrospective analysis was performed on the clinical data, including clinical manifestations, blood routine, inflammatory factors, echocardiography, vascular ultrasound and CT angiography, treatment and outcomes, etc, of 5 cases with systemic juvenile idiopathic arthritis combined with coronary artery dilation admitted to Department of Rheumatology in the affiliated Children's Hospital of Capital Institute of Pediatrics from May 2019 to June 2021. Results: There were 2 males and 3 females among 5 cases. The onset age ranged from 7 months to 4 years 7 months.The diagnostic time ranged from 1.5 months to 3.0 months.Four cases were diagnosed as atypical Kawasaki disease. Three cases showed unilateral coronary artery dilation.Two cases showed bilateral coronary artery dilation.Four cases developed multiple organ injuries.Three cases developed macrophage activation syndrome.Three cases developed lung injury.Two cases developed pericardial effusion.One case developed pulmonary hypertension.As for treatment, 3 cases treated with methylprednisolone pulse therapy and methotrexate combined with cyclosporine, improved after the final application of biological agents, and have stopped prednisone. The other 2 cases were treated with adequate oral prednisone and gradually reduced, and methotrexate was added at the same time, 1 case relapsed in the process of reduction. No other vascular involvement was found in 5 cases. Coronary artery dilation recovered completely after 1 to 3 months of treatment. Conclusions: Systemic juvenile idiopathic arthritis combined with coronary artery dilatation has the clinical characteristics of small onset age, long diagnostic time, prone to multiple organ injuries. Corticosteroids and conventional immunosuppressive agents are not sensitive, and biological agents should be used as soon as possible.The prognosis of coronary artery dilation is good after timely treatment.
