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the patient had persistent disease activity and developed severe left coxitis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41; in the beginning of 2009&#44; which did not respond to ultrasound guided joint injection with triamcinolone hexacetonide&#46; Due to the persistence of arthritis and elevated inflammatory markers she was started on Anakinra &#40;1<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day&#41; in July 2009&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Since then there has been sustained improvement with resolution of clinical symptoms&#44; including complete imagiological regression of coxitis &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#44; which allowed discontinuation of methotrexate and corticosteroids&#46; The patient is in clinical remission on medication with Anakinra 100<span class="elsevierStyleHsp" style=""></span>mg&#47;day &#40;2&#8211;2&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day&#41; since 2011&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">sJIA is an autoinflammatory rheumathologic disease that accounts for 5&#8211;10&#37; of all patients classified as JIA&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> Hip involvement in sJIA is relatively common and is a cause of significant functional impairment and a marker of poor prognosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">2&#44;3</span></a> A significant number of patients with sJIA has persistent disease despite the treatments used&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Anakinra is a recombinant form of human IL-1 receptor antagonist &#40;IL-1Ra&#41; that is recommended as first line disease-modifying therapy in sJIA selected patients and in refractory disease&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a> In this case&#44; the authors report the therapeutic success with Anakinra in a patient with refractory systemic and articular disease&#44; emphasizing the regression of structural damage of the hip joint&#44; which is rarely reported in these cases&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflict of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that there are no conflicts of interest&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Ethical disclosures</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Protection of human and animal subjects</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Confidentiality of data</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Right to privacy and informed consent</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appears in this article&#46;</p></span></span></span>"
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Images in Clinical Rheumatology
Structural damage to the hip in systemic juvenile idiopathic arthritis: A case of regression with Anakinra
Daño estructural de la cadera en la artritis idiopática juvenil sistémica: un caso de regresión con Anakinra
Francisca Aguiara,
Corresponding author
francisca.ra@hotmail.com

Corresponding author.
, Iva Britoa,b
a Rheumatology Department, Centro Hospitalar São João, Porto, Portugal
b Faculty of Medicine of Porto University, Porto, Portugal
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the patient had persistent disease activity and developed severe left coxitis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41; in the beginning of 2009&#44; which did not respond to ultrasound guided joint injection with triamcinolone hexacetonide&#46; Due to the persistence of arthritis and elevated inflammatory markers she was started on Anakinra &#40;1<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day&#41; in July 2009&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Since then there has been sustained improvement with resolution of clinical symptoms&#44; including complete imagiological regression of coxitis &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#44; which allowed discontinuation of methotrexate and corticosteroids&#46; The patient is in clinical remission on medication with Anakinra 100<span class="elsevierStyleHsp" style=""></span>mg&#47;day &#40;2&#8211;2&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day&#41; since 2011&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">sJIA is an autoinflammatory rheumathologic disease that accounts for 5&#8211;10&#37; of all patients classified as JIA&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> Hip involvement in sJIA is relatively common and is a cause of significant functional impairment and a marker of poor prognosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">2&#44;3</span></a> A significant number of patients with sJIA has persistent disease despite the treatments used&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Anakinra is a recombinant form of human IL-1 receptor antagonist &#40;IL-1Ra&#41; that is recommended as first line disease-modifying therapy in sJIA selected patients and in refractory disease&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a> In this case&#44; the authors report the therapeutic success with Anakinra in a patient with refractory systemic and articular disease&#44; emphasizing the regression of structural damage of the hip joint&#44; which is rarely reported in these cases&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflict of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that there are no conflicts of interest&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Ethical disclosures</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Protection of human and animal subjects</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Confidentiality of data</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Right to privacy and informed consent</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appears in this article&#46;</p></span></span></span>"
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Article information
ISSN: 21735743
Original language: English
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Idiomas
Reumatología Clínica (English Edition)
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