文档介绍：幼年性类风湿性关节炎(JRA)
Juvenile Rheumatoid Arthritis
儿科医院邬惊雷
是一种少年儿童常见的结缔组织病
One of the mon connective tissue diseases of children
以慢性关节炎(滑膜炎)为主要特点
Characterized by chronic arthritis (synovitis of the joints)
多脏器受累,如肝脾肿大、淋巴结肿大、浆膜炎(心包积液)等
Visceral involvement ,such as hepatosplenomegaly, lym-
phadenopathy and serositis (pericardial effusion)
分类 Classification
全身型
systemic-onset disease
多关节型::5个或以上关节受累
Polyarthritis:5 or more inflamed joints
少关节型:5个以下关节受累
Oligoarthritis: < 5 inflamed joints
流行病学 Epidemiology
发病率约113/10万
Overall prevalence approximately 113/100,000
%-%
Accounts for about %-% hospitalizations
女性发病较多
Females affected more frequently than males
病因 Etiology
病因尚不清楚,可能与下列因素有关:
Etiology is unknown,maybe related to the follows:
免疫遗传易感性
ic suseptibility
外源性触发因素(病毒感染)
External triggers (virus infection)
易感儿童在感染(环境因素)作用下出现免疫
异常的结果
Exaggerated immune reactivity in predisposed
children in response to exposure to certain
infections (environmental factors)
病理变化 Pathologic changes
关节:绒毛状增厚为特征的滑膜炎
Synovitis characterized by villous hypertrophy
滑膜下组织充血、水肿
Hyperemia and edema of the subsynovial tissues
血管翳形成
Pannus formation
关节软骨和邻近骨组织的破坏
Erosion of articular cartilage and contiguous bone
皮下结节:Subcutaneous (Rheumatoid) nodules
见于肘关节伸侧面
Found on extensor surfaces of elbows
眼部病变
虹膜睫状体炎,尤见于少关节型病例
Iridocyclitis ,mainly in the cases of
oligoarthritis
临床表现 Clinical manifestations
:占10%-20%JRA病例
Systemic-onset disease,10%-20% cases
发热:呈弛张热型是此型特点,体温高峰达40oC,
热退时一般情况好
Fever: Characterized by a remmitent fever with
temperature spikes to 40oC .Present well when
fever going down
肛门体温
oC
3 岁JRA女孩:-发烧多天-经反复应用退烧药无效