2015 Volume 6 Issue 1 Pages 33-38
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．
