Enthesitis-related arthritis, a challenging diagnosis in pediatrics. Case report
DOI:
https://doi.org/10.61708/1pbvtf80Keywords:
juvenil idiopathic arthritis, enthesitis, rheumatology, pediatricsAbstract
Juvenile idiopathic arthritis is the most common rheumatic disease in pediatrics. According to the ILAR 2004 criteria, it has seven subtypes. Its etiology is not clear, although it is related to genetic factors (HLAB27) and viral infections. Enthesitis-related arthritis is even rarer, has no confirmatory tests and is considered the most limiting form. The aim of this publication is to report the case of a 13-year-old male patient who begins with edema, pain in small and large joints that progressively increased in intensity until limiting daily activities, accompanied nocturnal and intermittent fever, palpitations, generalized myalgias, morning facial edema, and morning stiffness up to 4 hours. Physical examination revealed arthritis and joint limitations, as well as decreased dorsolumbar mobility and plantar enthesitis. Criteria for juvenile idiopathic arthritis related to enthesitis was completed, he started treatment with prednisone and disease-modifying drug (sulfasalazine), showing evident clinical improvement.
Downloads
References
Barut K, Adrovic A, Şahin S, Kasapçopur Ö. Juvenile idiopathic arthritis. Balkan Med J. 2017;34(2):90-101. https://doi.org/10.4274/balkanmedj.2017.0111 DOI: https://doi.org/10.4274/balkanmedj.2017.0111
Prakken B, Albani S, Martini A. Juvenile idiopathic arthritis. Lancet [Internet]. 2011;377(9783):2138-49. Available from: http://dx.doi.org/10.1016/S0140-6736(11)60244-4 DOI: https://doi.org/10.1016/S0140-6736(11)60244-4
Bukovac LT, Perica M. Juvenile Idiopathic Arthritis. Reumatizam. 2016;63(7):53-8.
Giancane G, Consolaro A, Lanni S, Davì S, Schiappapietra B, Ravelli A. Juvenile Idiopathic Arthritis: Diagnosis and Treatment. Rheumatol Ther. 2016;3(2):187-207. https://doi.org/10.1007/s40744-016-0040-4 DOI: https://doi.org/10.1007/s40744-016-0040-4
Hashkes PJ, M LR. Medical Treatment of Juvenile Idiopathic Arthritis Philip. Clin Rev. 2015;294(13):1671-84. https://doi.org/10.1001/jama.294.13.1671 DOI: https://doi.org/10.1001/jama.294.13.1671
Jousse-Joulin S, Breton S, Cangemi C, Fenoll B, Bressolette L, De Parscau L, et al. Ultrasonography for detecting enthesitis in juvenile idiopathic arthritis. Arthritis Care Res. 2011;63(6):849-55. https://doi.org/10.1002/acr.20444 DOI: https://doi.org/10.1002/acr.20444
Rosenthal A, Janow G. Enthesitis-Related Juvenile Idiopathic Arthritis. Pediatr Rev. 2019;40(5):256-8. https://doi.org/10.1542/pir.2017-0177 DOI: https://doi.org/10.1542/pir.2017-0177
Weiss PF, Beukelman T, Schanberg LE, Kimura Y, Colbert RA. Enthesitis-related arthritis is associated with higher pain intensity and poorer health status in comparison with other categories of juvenile idiopathic arthritis: The Childhood Arthritis and Rheumatology Research Alliance Registry. J Rheumatol. 2012;39(12):2341-51. https://doi.org/10.3899/jrheum.120642 DOI: https://doi.org/10.3899/jrheum.120642
Rumsey DG, Guzman J, Rosenberg AM, Huber AM, Scuccimarri R, Shiff NJ, et al. Characteristics and Course of Enthesitis in a Juvenile Idiopathic Arthritis Inception Cohort. Arthritis Care Res. 2018;70(2):303-8. https://doi.org/10.1002/acr.23256 DOI: https://doi.org/10.1002/acr.23256
Shih YJ, Yang YH, Lin CY, Chang CL, Chiang BL. Enthesitis-related arthritis is the most common category of juvenile idiopathic arthritis in Taiwan and presents persistent active disease. Pediatr Rheumatol. 2019;17(1):4-11. https://doi.org/10.1186/s12969-019-0363-0 DOI: https://doi.org/10.1186/s12969-019-0363-0
Foeldvari I, Constantin T, Vojinović J, Horneff G, Chasnyk V, Dehoorne J, et al. Etanercept treatment for extended oligoarticular juvenile idiopathic arthritis, enthesitis-related arthritis, or psoriatic arthritis: 6-year efficacy and safety data from an open-label trial. Arthritis Res Ther. 2019;21(1):1-10. https://doi.org/10.1186/s13075-019-1916-9 DOI: https://doi.org/10.1186/s13075-019-1916-9
Clinic A, Augustin S, Nord G, Bremen K, Author C. Etanercept in the Enthesitis-related Arthritis Subtype of Juvenile Idiopathic Arthritis.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Copyright: © Los autores. Publicado por Gaceta Médica JBG.
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
