A CLINICAL CASE OF SYSTEMIC JUVENILE ARTHRITIS COMPLICATED BY RECURRENT MACROPHAGE ACTIVATION SYNDROME AND CHRONIC OSTEOMYELITIS OF THE CLAVICLE
https://doi.org/10.14412/1995-4484-2018-107-112
Abstract
The paper describes a clinical case of severe systemic juvenile idiopathic arthritis (JIA) in a child with an early disease onset, which is resistant to multicomponent therapy (glucocorticoids, methotrexate, the tumor necrosis factor-α inhibitor etanercept), and the successful use of the anti-interleukin 6 receptor monoclonal antibody tocilizumab with the achievement of sustained (30-month) drug remission. The therapy with tocilizumab was accompanied by unpredictable adverse events (chronic osteomyelitis of the clavicle, macrophage activation syndrome) and their timely treatment permitted avoidance of life-threatening consequences. The presented case shows difficulties in the follow-up of patients with systemic JIA in clinical practice, requiring alertness to the risk of infectious complications and development of macrophage activation syndrome.
About the Authors
M. I. Kaleda
V.A.Nasonova Research Institute of Rheumatology.
Russian Federation
Moscow.
Russian Federation
Moscow.
I. P. Nikishina
V.A.Nasonova Research Institute of Rheumatology.
Russian Federation
Moscow.
Russian Federation
Moscow.
S. V. Arsenyeva
V.A.Nasonova Research Institute of Rheumatology.
Russian Federation
Moscow.
Russian Federation
Moscow.
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Review
For citations:
Kaleda M.I., Nikishina I.P., Arsenyeva S.V. A CLINICAL CASE OF SYSTEMIC JUVENILE ARTHRITIS COMPLICATED BY RECURRENT MACROPHAGE ACTIVATION SYNDROME AND CHRONIC OSTEOMYELITIS OF THE CLAVICLE. Rheumatology Science and Practice. 2018;56(1):107-112. (In Russ.) https://doi.org/10.14412/1995-4484-2018-107-112
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