Abstract
Uveitis is one of the lost important symptoms other than arthritis in juvenile idiopathic arthritis（JIA）．
In some cases, uveitis is refractory to anti－inflammatory treatments and can cause loss of vision． Recently，
adalimumab (ADA), a monoclonal antibody against tumor necrosis factor α， has been gaining recognition as
an important therapeutic modality for refractory uveitis． We report two patients with refractory JlA associated
uveitis, successfully treated with ADA． Patient 1；A 2-year-old Japanese girl was referred to us with arthritis of
right ankle． The diagnosis of oligo-articular JlA was made． She had uveitis． Her uveitis was refractory and oral
corticosteroid was started since she was six years old． However, her uveitis subsequently became steroid
dependent． ADA was initiated， following which her uveitis markedly improved． Oral corticosteroid therapy
was successfully tapered． She is currently undergoing treatment with ADA， and no adverse effects have
occurred． Patient 2；A 5-year-old Japanese boy was referred to us with arthritis of left knee． The diagnosis of
oligo-articular JIA was lnade． He also had u、icitis． Methotrexate（MTX）and topical steroid was started and his
arthritis and uveitis were improved． At the six-year of age， he suffered infectious mononucleosis and MTX
treatment was stopped．His uveitis was relapsed three months later． The treatment with MTX， oral and topical
corticosteroid was stated， but his uveitis subsequently became steroid dependent． ADA was initiated，following
which his uveitis markedly improved. Oral corticosteroid therapy was successfully tapered． He is currently
undergoing treatment with ADA． and no adverse effects have occurred， ADA is considered effective for the
treatment of childhood refractory uveitis，including JIA associated uveitis． Additional indication of ADA for
refractory uveitis is desired．
