Seropositive juvenile rheumatoid arthritis with Sjo gren's syndrome: features of diagnosis and treatment choice (a case report)

The paper describes a clinical case of rheumatoid factor-seropositive polyarticular juvenile rheumatoid arthritis (JRA) concurrent with new-onset Sjo gren's syndrome (SS) in a teenage girl. It discusses the clinical features of SS and the problems of its diagnosis in pediatric practice. Erosive...

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Main Authors: M. I. Kaleda, I. P. Nikishina, A. N. Latypova
Format: Article
Language:Russian
Published: IMA-PRESS LLC 2019-09-01
Series:Современная ревматология
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Online Access:https://mrj.ima-press.net/mrj/article/view/933
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author M. I. Kaleda
I. P. Nikishina
A. N. Latypova
author_facet M. I. Kaleda
I. P. Nikishina
A. N. Latypova
author_sort M. I. Kaleda
collection DOAJ
description The paper describes a clinical case of rheumatoid factor-seropositive polyarticular juvenile rheumatoid arthritis (JRA) concurrent with new-onset Sjo gren's syndrome (SS) in a teenage girl. It discusses the clinical features of SS and the problems of its diagnosis in pediatric practice. Erosive arthritis with rapidly progressive joint destruction concurrent with SS that was highly active according to biopsy findings, as well as the nature of the immunological parameters served as the basis for using rituximab (RTM), a chimeric anti-CD20 monoclonal antibody. Although RTM is not registered for use for this disease in childhood, an alternative biological agent was unavailable in this clinical situation. The therapy was observed to be highly effective. Just after the first cycle of RTM therapy, the values of acute-phase markers became normal, arthralgias and exudative joint phenomena diminished, and morning stiffness ceased. Twelve months after therapy initiation, the patient achieved remission of JRA with positive changes confirmed by control sialography and sialometry.The given clinical example convincingly demonstrates the feasibility of using RTM in patients with JRA concurrent with SS with resistance to therapy with classical immunosuppressive drugs and with the undesirability of using tumor necrosis factor-а inhibitors due to the increased risk of lymphoproliferation in SS.
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spelling doaj-art-7188b7fce05e4733b7127f336ca491302025-08-20T03:01:22ZrusIMA-PRESS LLCСовременная ревматология1996-70122310-158X2019-09-01133606510.14412/1996-7012-2019-3-60-652189Seropositive juvenile rheumatoid arthritis with Sjo gren's syndrome: features of diagnosis and treatment choice (a case report)M. I. Kaleda0I. P. Nikishina1A. N. Latypova2V.A. Nasonova Research Institute of RheumatologyV.A. Nasonova Research Institute of RheumatologyV.A. Nasonova Research Institute of RheumatologyThe paper describes a clinical case of rheumatoid factor-seropositive polyarticular juvenile rheumatoid arthritis (JRA) concurrent with new-onset Sjo gren's syndrome (SS) in a teenage girl. It discusses the clinical features of SS and the problems of its diagnosis in pediatric practice. Erosive arthritis with rapidly progressive joint destruction concurrent with SS that was highly active according to biopsy findings, as well as the nature of the immunological parameters served as the basis for using rituximab (RTM), a chimeric anti-CD20 monoclonal antibody. Although RTM is not registered for use for this disease in childhood, an alternative biological agent was unavailable in this clinical situation. The therapy was observed to be highly effective. Just after the first cycle of RTM therapy, the values of acute-phase markers became normal, arthralgias and exudative joint phenomena diminished, and morning stiffness ceased. Twelve months after therapy initiation, the patient achieved remission of JRA with positive changes confirmed by control sialography and sialometry.The given clinical example convincingly demonstrates the feasibility of using RTM in patients with JRA concurrent with SS with resistance to therapy with classical immunosuppressive drugs and with the undesirability of using tumor necrosis factor-а inhibitors due to the increased risk of lymphoproliferation in SS.https://mrj.ima-press.net/mrj/article/view/933seropositive juvenile rheumatoid arthritissjo gren's syndromerituximabchildhood
spellingShingle M. I. Kaleda
I. P. Nikishina
A. N. Latypova
Seropositive juvenile rheumatoid arthritis with Sjo gren's syndrome: features of diagnosis and treatment choice (a case report)
Современная ревматология
seropositive juvenile rheumatoid arthritis
sjo gren's syndrome
rituximab
childhood
title Seropositive juvenile rheumatoid arthritis with Sjo gren's syndrome: features of diagnosis and treatment choice (a case report)
title_full Seropositive juvenile rheumatoid arthritis with Sjo gren's syndrome: features of diagnosis and treatment choice (a case report)
title_fullStr Seropositive juvenile rheumatoid arthritis with Sjo gren's syndrome: features of diagnosis and treatment choice (a case report)
title_full_unstemmed Seropositive juvenile rheumatoid arthritis with Sjo gren's syndrome: features of diagnosis and treatment choice (a case report)
title_short Seropositive juvenile rheumatoid arthritis with Sjo gren's syndrome: features of diagnosis and treatment choice (a case report)
title_sort seropositive juvenile rheumatoid arthritis with sjo gren s syndrome features of diagnosis and treatment choice a case report
topic seropositive juvenile rheumatoid arthritis
sjo gren's syndrome
rituximab
childhood
url https://mrj.ima-press.net/mrj/article/view/933
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AT ipnikishina seropositivejuvenilerheumatoidarthritiswithsjogrenssyndromefeaturesofdiagnosisandtreatmentchoiceacasereport
AT anlatypova seropositivejuvenilerheumatoidarthritiswithsjogrenssyndromefeaturesofdiagnosisandtreatmentchoiceacasereport