| Treatment of refractory juvenile idiopathic arthritis via pulse therapy using methylprednisolone and cyclophosphamide. | |
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MedLine Citation:
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PMID: 12920473 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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CONTEXT: Patients with refractory juvenile idiopathic arthritis can benefit from aggressive therapy. CASE REPORT: We followed the clinical course of 4 patients (2 male, 2 female) aged 9.1-17.8 years (mean of 14.5 years) with polyarticular onset of juvenile rheumatoid arthritis and one 16-year-old boy with juvenile spondyloarthropathy associated with inflammatory bowel disease. All the juvenile rheumatoid arthritis patients fulfilled the diagnostic criteria established by the American College of Rheumatology. All patients had unremitting arthritis despite maximum therapy. All patients began receiving treatment using intravenous cyclophosphamide at 500-750 mg/m and intravenous methylprednisolone at 30 mg/kg, for 3 days monthly (1 g maximum). The patients received between 3 and 11 monthly treatments, and/or 3-5 treatments every two months for 12 months, according to the severity of the disease and/or response to the therapy. All but one patient were evaluated retrospectively at the start (time 0) and 6 months (time 1), and 12 months (time 2) after the beginning of the treatment. A rapid and clinically significant suppression of systemic and articular manifestations was seen in all patients. Our results showed the favorable effect of this treatment on the clinical and some laboratory manifestations of juvenile idiopathic arthritis. |
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Authors:
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Tania Caroline Monteiro de Castro; Maria Teresa Terreri; Claudio Len; Maria Odete Esteves Hilário |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2003-08-08 |
Journal Detail:
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Title: São Paulo medical journal = Revista paulista de medicina Volume: 121 ISSN: 1516-3180 ISO Abbreviation: Sao Paulo Med J Publication Date: 2003 May |
Date Detail:
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Created Date: 2003-08-15 Completed Date: 2003-10-06 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 100897261 Medline TA: Sao Paulo Med J Country: Brazil |
Other Details:
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Languages: eng Pagination: 117-20 Citation Subset: IM |
Affiliation:
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Clinical Immunology and Rheumatology, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Anti-Inflammatory Agents / administration & dosage* Antirheumatic Agents / administration & dosage* Arthritis, Juvenile Rheumatoid / drug therapy* Child Cyclophosphamide / administration & dosage* Drug Therapy, Combination Female Humans Male Methotrexate / administration & dosage Methylprednisolone / administration & dosage* Pulse Therapy, Drug Spondylarthropathies / drug therapy Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents; 0/Antirheumatic Agents; 50-18-0/Cyclophosphamide; 59-05-2/Methotrexate; 83-43-2/Methylprednisolone |
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