Uveitis bei juveniler idiopathischer Arthritis – leitliniengerechte Diagnostik und Therapie anhand von Kasuistiken

Zusammenfassung

Zielsetzung Darstellung der aktuellen deutschsprachigen interdisziplinären Leitlinie zur Diagnostik und Therapie der JIA-assoziierten Uveitis (JIA: juvenile idiopathische Arthritis) anhand von Kasuistiken.

Material und Methoden Leitlinie der Deutschen Ophthalmologischen Gesellschaft, der Gesellschaft für Kinder- und Jugendrheumatologie, der Deutschen Gesellschaft für Rheumatologie, des Berufsverbandes der Augenärzte Deutschlands unter Beteiligung von Patientenvertretern. Die unlängst publizierte Primärliteratur wurde kritisch bewertet hinsichtlich Evidenz und Empfehlungen; methodisch wurden Konsensfindung mittels Delphi-Runden und eine externe Begutachtung einbezogen. Die Ergebnisse werden anhand von typischen Fallbeispielen erläutert.

Ergebnisse Bei JIA-Erstdiagnose sollten regelmäßige augenärztliche Kontrollen erfolgen mit dem Ziel, dass die Uveitis vor Manifestation irreversibler Folgeschäden diagnostiziert wird. Entsprechend dem individuellen Schweregrad der Uveitis kann eine qualitativ hochwertige Versorgung der Patienten erzielt werden. Zur antientzündlichen Therapie finden aktuell Kortikosteroide, konventionell synthetische (cs) und biologische (b) und andere Disease-modifying anti-rheumatic Drugs (DMARDs) Verwendung.

Schlussfolgerungen Frühzeitige Diagnose und aktuelle leitliniengerechte Therapie können die Langzeitprognose der JIA-assoziierten Uveitis wesentlich verbessern.

Schlüsselwörter

Diagnostik - juvenile idiopathische Arthritis - Therapie - Uveitis

• References/Literatur

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