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Aktuelle Rheumatologie 2019; 44(03): 199-204
DOI: 10.1055/a-0896-2553
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Rheumatologische Differenzialdiagnostik bei Uveitis im Kindesalter

Rheumatological Differential-diagnostic Investigation in Childhood Uveitis
Ivan Foeldvari
Hamburger Zentrum für Kinder- und Jugendrheumatologie, An der Schön Klinik Hamburg Eilbek, Hamburg
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Publication History

Publication Date:
19 June 2019 (online)

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Zusammenfassung

Ungefähr 10% der Uveitiden beginnen im Kindesalter, mit einer Inzidenz von 6,9 auf 100 000 unter 14 Jahren und 26,6 auf 100 000 von 15 bis 24 Jahren. Sie werden unterteilt in infektiöse und nichtinfektiöse Uveitiden. Die Klassifikation der SUN-Gruppe erfolgt je nach Lokalisation des Auftretens und abhängend vom zeitlichen Verlauf. Die häufigste nicht-infektiöse Ursache bei Kindern ist die Juvenile idiopathische Arthritis, gefolgt von Morbus Behcet und Sarkoidose. Auch autoinflammatorischen Erkrankungen können mit einer Uveitis assoziiert sein. Die anteriore Uveitis tritt vorwiegend bei der Juvenilen idiopathischern Arthritis, der lokalisierten Sklerodermie und dem Kawasaki-Syndrom auf. Bei der intermediären Uveitis gibt es vor allem eine Assoziation mit Sarkoidose, Blau Syndrom, Tinu Syndrom und Multipler Sklerose. Eine posteriore Beteiligung ist für Morbus Behcet typisch, kann aber auch beim Cryopirin-assoziiertem Fiebersyndrom oder Cogan-Syndrom auftreten. Eine frühzeitige Diagnosestellung ist wichtig, um rechtzeitg eine effektive Therapie einleiten zu können und das Sehvermögen nicht zu gefährden.

Abstract

Approximately 10% of uveitis cases start developing in childhood with an incidence of 6.9 in 100,000 individuals under 14 years of age and 26.6 in 100,000 individuals aged 15 to 24. Uveitis may be subdivided into infectious and non-infectious uveitis. The classification provided by the SUN working group is based on the anatomic location and the development over time. The most common non-infectious cause of uveitis in children is juvenile idiopathic arthritis, followed by Behcet’s disease and sarcoidosis. Autoinflammatory diseases may also be associated with uveitis. Anterior uveitis predominantly occurs in cases of juvenile idiopathic arthritis, localised scleroderma and Kawasaki’s syndrome. Intermediate uveitis is notably associated with sarcoidosis, Blau’s syndrome, tubulointerstitial nephritis and uveitis (TINU syndrome), and cystic fibrosis. Posterior involvement is characteristic of Behcet’s disease, but may also occur in patients with cryopirin-associated periodic fever syndrome or Cogan’s syndrome. Early diagnosis is important for initiating an effective treatment in due time and preventing loss of eyesight.

Schlüsselwörter

Uveitis - Juvenile idiopathische Arthritis - Sarkoidose - Behcet - autoinflammatorische Erkrankungen

Key words

autoinflammatory diseases - juvenile idiopathic arthritis - uveitis
 

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