Aggiornamento monografico
Le spondiloartropatie in età pediatrica
DIAGNOSIS AND TREATMENT OF SPONDYLOARTHROPATHIES IN CHIL
ALESSANDRO LENHARDT1, FEDERICO MARCHETTI2, GABRIELE CONT2, ALESSIA SACCARI2, ANNAMARTINA FRANZIL2, LOREDANA LEPORE2
1UO di Pediatria, ASS 2, Gorizia e Monfalcone
2Clinica Pediatrica, IRCCS “Burlo Garofolo”, Trieste
Settembre 2006 - pagg. 429 -437
Abstract
Spondyloarthropathies are a heterogeneous group of morbid conditions, characterized by familiarity, by their association with specific HLA and by extra-articular localisations. In the present article the different morbid conditions, their most recent pathogenetic hypotheses and their diagnostic criteria are described in detail. Indications for treatment with biological agents are also discussed.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Burgos-Vargas R. Spondyloarthropathies
and psoriatic arthritis in children. Curr Opin
Rheumatol 1993;5:634-43.
2. Rosenberg AM, Petty RE. A syndrome of seronegative enthesopathy and arthropathy in children. Arthritis Rheum 1982;25:1041-7.
3. Burgos-Vargas R, Pacheco-Tena C, Vazquez- Mellado J. Juvenile-onset spondyloarthropathies. Rheum Dis Clin North Am 1997;23: 569-98.
4. Baeten D, Kruithof E, Van den Bosch F, et al. Immunomodulatory effects of anti-tumor necrosis factor alpha therapy on synovium in spondyloarthropathy: histologic findings in eight patients from an open-label pilot study. Arthritis Rheum 2001;44:186-95.
5. Van den Bosch F, Kruithof E, Baeten D, De Keyser F, Mielants H, Veys EM. Effects of a loading dose regimen of three infusions of chimeric monoclonal antibody to tumour necrosis factor alpha (infliximab) in spondyloarthropathy. An open pilot study. Ann Rheum Dis 2000;59:428-33.
6. Van den Bosch F, Kruithof E, Baeten D, et al. Randomized double-blind comparison of chimeric monoclonal antibody to tumor necrosis factor alpha (infliximab) versus placebo in active spondyloarthropathy. Arthritis Rheum 2002;46:755-65.
7. Braun J, Brandt J, Listing J, et al. Treatment of active ankylosing spondylitis with infliximab: a randomized controlled multicenter trial. Lancet 2002;359:1187-93.
8. Braun J, Xiang J, Brandt J, et al. Treatment of spondyloarthropathies with antibodies against tumour necrosis factor alpha: first clinical and laboratory experiences. Ann Rheum Dis 2000;59(suppl I):i85-9.
9. Lawrence RC, Helmick CG, Arnett FC, et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum 1998;41:778-99.
10. Malleson PN, Fung MY, Rosenberg AM. The incidence of pediatric rheumatic diseases: results from the Canadian Pediatric Rheumatology Disease Registry. J Rheumatol 1996; 23:1981-7.
11. Symmons DP, Jones M, Osborne J, Sills J, Southwood TR, Woo P. Pediatric rheumatology in the United Kingdom: data from the British Paediatric Rheumatology Group National Diagnostic Register. J Rheumatol 1996;23: 1975-80.
12. Bowyer S, Roettcher P. Pediatric rheumatology clinic populations in the United States: results of a 3 year survey. Pediatric Rheumatology Database Research Group. J Rheumatol 1996;23:1968-74.
13. Hamilton ML, Gladman DD, Shore A, Laxer RM, Silverman ED. Juvenile psoriatic arthritis and HLA antigens. Ann Rheum Dis 1990;49:694-7.
14. Pacheco-Tena C, Alvarado de la Barrera C, Lopez-Vidal Y, et al. Bacterial DNA in synovial fluid cells of patients with juvenile-onset spondyloarthropathies. Rheumatology 2001; 40:920-7.
15. Masi AT. Do sex hormones play a role in ankylosing spondylitis? Rheum Dis Clin North Am 1992;18:153-76.
16. Chikanza IC, Kuis W, Heijnen CJ. The influence of the hormonal system on pediatric rheumatic diseases. Rheum Dis Clin North Am 2000;26:911-25.
17. Khan MA. Update: the twenty subtypes of HLA-B27. Curr Opin Rheumatol 2000;12:235-8.
18. Sieper J, Braun J. Pathogenesis of spondylarthropathies. Persistent bacterial antigen, autoimmunity, or both? Arthritis Rheum1995; 38:1547-54.
19. Maki-Ikola O, Yli-Kerttula U, Saario R, Tiovanan P, Granfors K. Salmonella specific antibodies in serum and synovial fluid in patients with reactive arthritis. Br J Rheumatol 1992; 31:25-9.
20. Granfors K, Jalkanen S, Toivanen P, Koski J, Lindberg AA. Bacterial lipopolysaccharide in synovial fluid cells in Shigella triggered reactive arthritis. J Rheumatol 1992;19:500.
21. Maki-Ikola O, Lahesmaa R, Heesemann J, et al. Yersinia-specific antibodies in serum and synovial fluid in patients with Yersinia triggered arthritis. Ann Rheum Dis 1994;53:535-9.
22. Braun J, Latiko S, Treharne J, et al. Chlamydia pneumoniae: a new causative agent of reactive arthritis and undifferentiated oligoarthritis. Ann Rheum Dis 1994;53:100-5.
23. Sieper J, Braun J, Wu P, Kingsley G. T cells are responsible for the enhanced synovial cellular immune response to triggering antigen in reactive arthritis. Clin Exp Immunol 1993;91:96-102.
24. Maki-Ikola O, Nissila M, Lehtinen K, Granfors K. IgA class serum antibodies against three different Klebsiella serotypes in ankylosing spondylitis. Br J Rheumatol 1998;37: 1299-302.
25. Scofield RH, Kurien B, Gross T, Warren WL, Harley JB. HLA-B27 binding of peptide from its own sequence and similar peptides from bacteria: implications for spondyloarthropathies. Lancet 1995;345:1542-4.
26. Gratacos J, Collado A, Filella X, et al. Serum cytokines (IL-6, TNF-alpha, IL-1 beta and IFN-gamma) in ankylosing spondylitis: a close correlation between serum IL-6 and disease activity and severity. Br J Rheumatol 1994;33: 927-31.
27. Braun J, Bollow M, Neure L, et al. Use of immunohistologic and in situ hybridization techniques in the examination of sacroiliac joint biopsy specimens from patients with ankylosing spondylitis. Arthritis Rheum 1995;38:499- 505.
28. Cabral DA, Oen KG, Petty RE. SEA syndrome revisited: a long term follow-up of children with a syndrome of seronegative enthesopathy and arthropathy. J Rheumatol 1992; 19:1282-5.
29. Stamato T, Laxer RM, de Freitas C, et al. Prevalence of cardiac manifestations of juvenile ankylosing spondylitis. Am J Cardiol 1995;75:744-6.
30. Huppertz H, Voigt I, Muller-Scholden J, et al. Cardiac manifestations in patients with HLA B27-associated juvenile arthritis. Pediatr Cardiol 2000;21:141-7.
31. Mielants H, Veys EM, Cuvelier C, et al. The evolution of spondyloarthropathies in relation to gut histology. III. Relation between gut and joint. J Rheumatol 1995;22:2279-84.
32. Mielants H, Veys EM, Cuvelier C, et al. The evolution of spondyloarthropathies in relation to gut histology. II. Histological aspects. J Rheumatol 1995;22:2273-8.
33. Mielants H, Veys EM, Cuvelier C, et al. Gut inflammation in children with late onset pauciarticular juvenile chronic arthritis and evolution to adult spondyloarthropathy: a prospective study. J Rheumatol 1993;20:1567-72.
34. De Vos M, Mielants H, Cuvelier C, et al. Long-term evolution of gut inflammation in patients with spondyloarthropathy. Gastroenterology 1996;110:1696-703.
35. Laukens D, Peeters H, Marichal D, et al. CARD15 gene polymorphisms in patients with spondyloarthropathies identify a specific phenotype previously related to Crohn’s disease. Ann Rheum Dis 2005;64:930-5.
36. Minden K, Kiessling U, Listing J, et al. Prognosis of patients with juvenile chronic arthritis and juvenile spondyloarthropathy. J Rheumatol 2000;27:2256-63.
37. Calin A, Elswood S. The natural history of juvenile onset ankylosing spondylitis: 24 year retrospective case control study. Br J Rheumatol 1988;27:91-3.
38. Petty RE, Southwood TR, Baum J, et al. Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. J Rheumatol 1998;25:1991-4.
39. Burgos-Vargas R, Rudwaleit M, Sieper J. The place of juvenile onset spondyloarthropathies in the Durban 1997 ILAR classification criteria of juvenile idiopathic arthritis. International League of Associations for Rheumatology. J Rheumatol 2002;29:869-74.
40. Braun J, Bollow M, Sieper J. Radiologic diagnosis and pathology of the spondyloarthropathies. Rheum Dis Clin North Am 1998;24: 697-735.
41. Braun J, Van der Heijde D. Imaging and scoring in ankylosing spondylitis. Best Pract Res Clin Rheumatol 2002;16:573-604.
42. Braun J, Baraliakos X, Golder W, et al. Ankylosing spondylitis (AS) development and evaluation of a spinal scoring system (ASspi- MIR) using magnetic resonance imaging (MRI) in patients with active disease. Arthritis Rheum 2002;46:S426.
43. Uhrin Z, Kuzis S, Ward MM. Exercise and changes in health status in patients with ankylosing spondylitis. Arch Intern Med 2000;160: 2969-75.
44. Calin A, Elswood J. A prospective nation wide cross-sectional study of NSAID usage in 1331 patients with ankylosing spondylitis. J Rheumatol 1990;17:801-3.
45. Burgos-Vargas R: Juvenile onset spondyloarthropathies: therapeutic aspects. Ann Rheum Dis 2002;61(suppl 3):iii33–iii39.
46. Tse SML, Laxer RM. Juvenile spondyloarthropathy. Curr Opin Rheumatol 2003;15: 374-9.
47. Sampaio-Barros PD, Costallat LTL, Bertolo MB, Neto JFM, Samara AM. Methotrexate in the treatment of ankylosing spondylitis. Scand J Rheumatol 2000;29:160-2.
48. Chen J, Liu C. Methotrexate for ankylosing spondylitis. Cochrane Database of Systematic Reviews. 3, 2005.
49. Brooks CD. Sulfasalazine for the management of juvenile rheumatoid arthritis. J Rheumatol 2001;28:845-53.
50. Burgos-Vargas R, Vazquez-Mellado J, Pacheco- Tena C, et al. A 26 week randomised, double blind, placebo controlled exploratory study of sulfasalazine in juvenile onset spondyloarthropathies. Ann Rheum Dis 2002;61:941-2.
51. Chen J, Liu C. Sulfasalazine for ankylosing spondylitis. Cochrane Database of Systematic Reviews. 3, 2005.
52. Davis JC, van der Heijde D, Braun J, et al. Recombinant human tumor necrosis factor receptor (etanercept) for treating ankylosing spondylitis. Arthritis Rheum 2003;48:3230-6.
53. Reiff A, Henrickson M. Prolonged efficacy of etanercept in refractory juvenile ankylosing spondylitis [abstract]. Arthritis Rheum 2001; 44(suppl):292S.
54. Collantes-Estevez E, Munoz-Villanueva MC, Canete-Crespillo JD, et al. Infliximab in refractory spondyloarthropathies: a multicentre 38 week open study. Ann Rheum Dis 2003; 62:1239-40.
2. Rosenberg AM, Petty RE. A syndrome of seronegative enthesopathy and arthropathy in children. Arthritis Rheum 1982;25:1041-7.
3. Burgos-Vargas R, Pacheco-Tena C, Vazquez- Mellado J. Juvenile-onset spondyloarthropathies. Rheum Dis Clin North Am 1997;23: 569-98.
4. Baeten D, Kruithof E, Van den Bosch F, et al. Immunomodulatory effects of anti-tumor necrosis factor alpha therapy on synovium in spondyloarthropathy: histologic findings in eight patients from an open-label pilot study. Arthritis Rheum 2001;44:186-95.
5. Van den Bosch F, Kruithof E, Baeten D, De Keyser F, Mielants H, Veys EM. Effects of a loading dose regimen of three infusions of chimeric monoclonal antibody to tumour necrosis factor alpha (infliximab) in spondyloarthropathy. An open pilot study. Ann Rheum Dis 2000;59:428-33.
6. Van den Bosch F, Kruithof E, Baeten D, et al. Randomized double-blind comparison of chimeric monoclonal antibody to tumor necrosis factor alpha (infliximab) versus placebo in active spondyloarthropathy. Arthritis Rheum 2002;46:755-65.
7. Braun J, Brandt J, Listing J, et al. Treatment of active ankylosing spondylitis with infliximab: a randomized controlled multicenter trial. Lancet 2002;359:1187-93.
8. Braun J, Xiang J, Brandt J, et al. Treatment of spondyloarthropathies with antibodies against tumour necrosis factor alpha: first clinical and laboratory experiences. Ann Rheum Dis 2000;59(suppl I):i85-9.
9. Lawrence RC, Helmick CG, Arnett FC, et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum 1998;41:778-99.
10. Malleson PN, Fung MY, Rosenberg AM. The incidence of pediatric rheumatic diseases: results from the Canadian Pediatric Rheumatology Disease Registry. J Rheumatol 1996; 23:1981-7.
11. Symmons DP, Jones M, Osborne J, Sills J, Southwood TR, Woo P. Pediatric rheumatology in the United Kingdom: data from the British Paediatric Rheumatology Group National Diagnostic Register. J Rheumatol 1996;23: 1975-80.
12. Bowyer S, Roettcher P. Pediatric rheumatology clinic populations in the United States: results of a 3 year survey. Pediatric Rheumatology Database Research Group. J Rheumatol 1996;23:1968-74.
13. Hamilton ML, Gladman DD, Shore A, Laxer RM, Silverman ED. Juvenile psoriatic arthritis and HLA antigens. Ann Rheum Dis 1990;49:694-7.
14. Pacheco-Tena C, Alvarado de la Barrera C, Lopez-Vidal Y, et al. Bacterial DNA in synovial fluid cells of patients with juvenile-onset spondyloarthropathies. Rheumatology 2001; 40:920-7.
15. Masi AT. Do sex hormones play a role in ankylosing spondylitis? Rheum Dis Clin North Am 1992;18:153-76.
16. Chikanza IC, Kuis W, Heijnen CJ. The influence of the hormonal system on pediatric rheumatic diseases. Rheum Dis Clin North Am 2000;26:911-25.
17. Khan MA. Update: the twenty subtypes of HLA-B27. Curr Opin Rheumatol 2000;12:235-8.
18. Sieper J, Braun J. Pathogenesis of spondylarthropathies. Persistent bacterial antigen, autoimmunity, or both? Arthritis Rheum1995; 38:1547-54.
19. Maki-Ikola O, Yli-Kerttula U, Saario R, Tiovanan P, Granfors K. Salmonella specific antibodies in serum and synovial fluid in patients with reactive arthritis. Br J Rheumatol 1992; 31:25-9.
20. Granfors K, Jalkanen S, Toivanen P, Koski J, Lindberg AA. Bacterial lipopolysaccharide in synovial fluid cells in Shigella triggered reactive arthritis. J Rheumatol 1992;19:500.
21. Maki-Ikola O, Lahesmaa R, Heesemann J, et al. Yersinia-specific antibodies in serum and synovial fluid in patients with Yersinia triggered arthritis. Ann Rheum Dis 1994;53:535-9.
22. Braun J, Latiko S, Treharne J, et al. Chlamydia pneumoniae: a new causative agent of reactive arthritis and undifferentiated oligoarthritis. Ann Rheum Dis 1994;53:100-5.
23. Sieper J, Braun J, Wu P, Kingsley G. T cells are responsible for the enhanced synovial cellular immune response to triggering antigen in reactive arthritis. Clin Exp Immunol 1993;91:96-102.
24. Maki-Ikola O, Nissila M, Lehtinen K, Granfors K. IgA class serum antibodies against three different Klebsiella serotypes in ankylosing spondylitis. Br J Rheumatol 1998;37: 1299-302.
25. Scofield RH, Kurien B, Gross T, Warren WL, Harley JB. HLA-B27 binding of peptide from its own sequence and similar peptides from bacteria: implications for spondyloarthropathies. Lancet 1995;345:1542-4.
26. Gratacos J, Collado A, Filella X, et al. Serum cytokines (IL-6, TNF-alpha, IL-1 beta and IFN-gamma) in ankylosing spondylitis: a close correlation between serum IL-6 and disease activity and severity. Br J Rheumatol 1994;33: 927-31.
27. Braun J, Bollow M, Neure L, et al. Use of immunohistologic and in situ hybridization techniques in the examination of sacroiliac joint biopsy specimens from patients with ankylosing spondylitis. Arthritis Rheum 1995;38:499- 505.
28. Cabral DA, Oen KG, Petty RE. SEA syndrome revisited: a long term follow-up of children with a syndrome of seronegative enthesopathy and arthropathy. J Rheumatol 1992; 19:1282-5.
29. Stamato T, Laxer RM, de Freitas C, et al. Prevalence of cardiac manifestations of juvenile ankylosing spondylitis. Am J Cardiol 1995;75:744-6.
30. Huppertz H, Voigt I, Muller-Scholden J, et al. Cardiac manifestations in patients with HLA B27-associated juvenile arthritis. Pediatr Cardiol 2000;21:141-7.
31. Mielants H, Veys EM, Cuvelier C, et al. The evolution of spondyloarthropathies in relation to gut histology. III. Relation between gut and joint. J Rheumatol 1995;22:2279-84.
32. Mielants H, Veys EM, Cuvelier C, et al. The evolution of spondyloarthropathies in relation to gut histology. II. Histological aspects. J Rheumatol 1995;22:2273-8.
33. Mielants H, Veys EM, Cuvelier C, et al. Gut inflammation in children with late onset pauciarticular juvenile chronic arthritis and evolution to adult spondyloarthropathy: a prospective study. J Rheumatol 1993;20:1567-72.
34. De Vos M, Mielants H, Cuvelier C, et al. Long-term evolution of gut inflammation in patients with spondyloarthropathy. Gastroenterology 1996;110:1696-703.
35. Laukens D, Peeters H, Marichal D, et al. CARD15 gene polymorphisms in patients with spondyloarthropathies identify a specific phenotype previously related to Crohn’s disease. Ann Rheum Dis 2005;64:930-5.
36. Minden K, Kiessling U, Listing J, et al. Prognosis of patients with juvenile chronic arthritis and juvenile spondyloarthropathy. J Rheumatol 2000;27:2256-63.
37. Calin A, Elswood S. The natural history of juvenile onset ankylosing spondylitis: 24 year retrospective case control study. Br J Rheumatol 1988;27:91-3.
38. Petty RE, Southwood TR, Baum J, et al. Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. J Rheumatol 1998;25:1991-4.
39. Burgos-Vargas R, Rudwaleit M, Sieper J. The place of juvenile onset spondyloarthropathies in the Durban 1997 ILAR classification criteria of juvenile idiopathic arthritis. International League of Associations for Rheumatology. J Rheumatol 2002;29:869-74.
40. Braun J, Bollow M, Sieper J. Radiologic diagnosis and pathology of the spondyloarthropathies. Rheum Dis Clin North Am 1998;24: 697-735.
41. Braun J, Van der Heijde D. Imaging and scoring in ankylosing spondylitis. Best Pract Res Clin Rheumatol 2002;16:573-604.
42. Braun J, Baraliakos X, Golder W, et al. Ankylosing spondylitis (AS) development and evaluation of a spinal scoring system (ASspi- MIR) using magnetic resonance imaging (MRI) in patients with active disease. Arthritis Rheum 2002;46:S426.
43. Uhrin Z, Kuzis S, Ward MM. Exercise and changes in health status in patients with ankylosing spondylitis. Arch Intern Med 2000;160: 2969-75.
44. Calin A, Elswood J. A prospective nation wide cross-sectional study of NSAID usage in 1331 patients with ankylosing spondylitis. J Rheumatol 1990;17:801-3.
45. Burgos-Vargas R: Juvenile onset spondyloarthropathies: therapeutic aspects. Ann Rheum Dis 2002;61(suppl 3):iii33–iii39.
46. Tse SML, Laxer RM. Juvenile spondyloarthropathy. Curr Opin Rheumatol 2003;15: 374-9.
47. Sampaio-Barros PD, Costallat LTL, Bertolo MB, Neto JFM, Samara AM. Methotrexate in the treatment of ankylosing spondylitis. Scand J Rheumatol 2000;29:160-2.
48. Chen J, Liu C. Methotrexate for ankylosing spondylitis. Cochrane Database of Systematic Reviews. 3, 2005.
49. Brooks CD. Sulfasalazine for the management of juvenile rheumatoid arthritis. J Rheumatol 2001;28:845-53.
50. Burgos-Vargas R, Vazquez-Mellado J, Pacheco- Tena C, et al. A 26 week randomised, double blind, placebo controlled exploratory study of sulfasalazine in juvenile onset spondyloarthropathies. Ann Rheum Dis 2002;61:941-2.
51. Chen J, Liu C. Sulfasalazine for ankylosing spondylitis. Cochrane Database of Systematic Reviews. 3, 2005.
52. Davis JC, van der Heijde D, Braun J, et al. Recombinant human tumor necrosis factor receptor (etanercept) for treating ankylosing spondylitis. Arthritis Rheum 2003;48:3230-6.
53. Reiff A, Henrickson M. Prolonged efficacy of etanercept in refractory juvenile ankylosing spondylitis [abstract]. Arthritis Rheum 2001; 44(suppl):292S.
54. Collantes-Estevez E, Munoz-Villanueva MC, Canete-Crespillo JD, et al. Infliximab in refractory spondyloarthropathies: a multicentre 38 week open study. Ann Rheum Dis 2003; 62:1239-40.
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