Pediatric Uveitis - Edubirdie

University:
The University Of Western Ontario
Course:
Biology 2290F | Scientific Method in Biology
Academic year:

2022
Views:

311

Pages:

3
Author:

Kyuwon J.

Pediatric Uveitis ● Jia Associated/non-JIA ● Chronic inflammation of uveal tract ○ iris ○ Ciliary body ○ Choroid ● JIA associated ○ Most common type of chronic pediatric uveitis ● HLA-B27 associated ● Infx ○ Toxoplamosis ○ Tuberculosis ○ HSV ● Sarcoidosis Clinical features ● Is often asymptomatic ○ Especially for JIA ● Redness in eye ● Phtophobia ● Vision blur ● Floaters Complications ● Cataracts ● Glaucoma ● Keratopathy ● Loss of visions Kawaki Disease vs Systemic JIA Important because their s/smx in early stage overlaps ● Both are present with fever, rahs and lymphadenopathy ○ Arthritis ○ Elevation of CRP/ESR ● Early systemic JIA ○ Might mimic incomplete Kawasaki disease Clinical features and comparison Feature Kawasaki Disease Systemic JIA Fever ≥5 days, less spiking Quotidian spikes (same time daily) Rash Polymorphous Salmon-pink, evanescent Arthritis Mild or late Prominent, early or delayed Conjunctivitis Non-purulent Uncommon Lymph nodes Cervical LN >1.5 cm Generalized Mucous membranes Strawberry tongue Usually normal Extremities Edema, peeling No peeling Cardiac Coronary aneurysm Pericarditis, myocarditis Labs ● Kawasaki ○ Increase in CRP/ESR ○ Increase in platelets ■ Especially high in subacute phase ○ Mild increase in ALT ○ Sterile pyuria ● Systemic JIA ○ Increase in CRO/ESR ○ Low platelet level in early MAS ■ Could be normal ○ Hyperferritinemia ■ If MAS developing ○ Anaemia, leukocytosis Differences in treatments ● Kawasaki ○ IVIG ○ Aspirin ○ Echocariography monitoring ● Systemic JIA ○ Steroids ○ IL-1 inhibitors ■ Anakinra ○ IL-6 inhibitors ■ Tocilizumab ○ Methotrexate on chronic disease Pediatric SLE Common differentials if ANA is positive ● Malar rash ● Photosentitivity ● Oral ulcer ● Arthritis ○ Non-erosives ● Cytopenias ● Nephirits ○ Proteinuria ○ Hematuria ● Neurologic involvements Pediatric JIA Joint damage Non-erosive Often erosive (polyarticular) Autoantibodie s dsDNA, Sm, ANA ANA/RF depending on subtype Rash Malar, photosensitive Salmon (systemic JIA) or psoriasis (PsA) Kidneys Frequent involvement Rare except MAS-LKD Systemic fever Possible Classic for systemic JIA