vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v11i6.505vsp-413Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL OBSERVATIONSОПЫТ ПРИМЕНЕНИЯ МЕТОТРЕКСАТА ДЛЯ ПАРЕНТЕРАЛЬНОГО ВВЕДЕНИЯ У БОЛЬНОЙ ПАУЦИАРТИКУЛЯРНЫМ ВАРИАНТОМ ЮНОШЕСКОГО АРТРИТАTHE EXPERIENCE OF PARENTERAL METHOTREXATE TREATMENT IN A PATIENT WITH PAUCIARTICULAR JUVENILE RHEUMATOID ARTHRITISСлепцоваТ. В.SleptsovaT. V.alekatya@ya.ruАлексееваЕ. И.AlexeevaE. I.

Алексеева Екатерина Иосифовна, доктор медицинских наук, профессор, заведующая ревматологическим отделением ФГБУ «НЦЗД» РАМН, декан педиатрического факультета Первого МГМУ им. И.М. Сеченова

alekatya@ya.ruДенисоваР. В.DenisovaR. V.alekatya@ya.ruБзароваТ. М.BzarovaT. M.alekatya@ya.ruИсаеваК. Б.IsaevaK. B.alekatya@ya.ruМитенкоЕ. В.MitenkoE. V.alekatya@ya.ruНаучный центр здоровья детей РАМН, МоскваРоссияScientific Centre of Children Health, RAMS, MoscowRussian FederationНаучный центр здоровья детей РАМН, Москва; Первый Московский государственный медицинский университет им. И.М. СеченоваРоссияScientific Centre of Children Health, RAMS, Moscow; I.M. Sechenov First Moscow State Medical University,Russian FederationНаучный центр здоровья детей РАМН, Москва,РоссияScientific Centre of Children Health, RAMS, MoscowRussian Federation201219112012116Вопросы современной педиатрии131137Copyright © Слепцова Т.В., Алексеева Е.И., Денисова Р.В., Бзарова Т.М., Исаева К.Б., Митенко Е.В., 20122012Слепцова Т.В., Алексеева Е.И., Денисова Р.В., Бзарова Т.М., Исаева К.Б., Митенко Е.В.Sleptsova T.V., Alexeeva E.I., Denisova R.V., Bzarova T.M., Isaeva K.B., Mitenko E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/413

В статье представлен случай раннего дебюта пауциартикулярного юношеского артрита, резистентного к стандартной иммуносупрессивной терапии метотрексатом в дозе 15 мг/м2 поверхности тела в нед перорально, с развитием контрактур и деструктивных изменений в суставах. Описано успешное преодоление резистентности к препарату путем переключения на внутримышечное введение и повышения дозы до 25мг/м2 поверхности тела в нед. Спустя 6 мес от момента начала терапии у ребенка купировались островоспалительные изменения в суставах, артралгии, утренняя скованность, снизились лабораторные показатели активности болезни. Через 12 мес полностью восстановился объем движений в 3 из 4 пораженных суставов. Фаза неактивной болезни и ремиссия были зарегистрированы через 6 и 12 мес, соответственно. Ремиссия сохраняется в течение 18 мес.

The article contains a history case of early onset of pauciarticular juvenile rheumatoid arthritis resistant to standard immunosuppressive treatment with methotrexate at a dose of 15 mg/m2 per week orally, with development of contractures and destructive changes in the joints. The resistance was successfully overcome with conversion to intravenous introduction at a dose of 25 mg/m2 per week. After 6 months of treatment acute inflammatory changes in the joins, arthralgia and morning joint stiffness were arrested, as well as laboratory markers of the active stage of disease lowered. After 12 months of treatment the motion capacity was completely restored in 3 of 4 affected joints. The non-active stage and remission were registered in 6 and 12 months, respectively. The remission has remained for 18 months.

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The authors declare that there are no conflicts of interest present.