RESUMEN
OBJECTIVE: Several case reports have been published on the effect of janus kinase inhibitors (JAK-I) on juvenile idiopathic arthritis-associated uveitis (JIAU). Both tofacitinib and baricitinib have been described as therapeutically effective in JIAU. METHODS: We here present a case of a 24-years-old female with refractory course of JIAU receiving upadacitinib therapy. RESULTS: After failing multiple conventional and biologic disease-modifying antirheumatic drugs, the patient finally achieved clinical remission on upadacitinib monotherapy, despite a previously unsatisfactory clinical response of both arthritis and uveitis to tofacitinib monotherapy. CONCLUSION: This case suggests that switching JAK-I might be a successful strategy in the treatment of JIAU, despite previously incomplete response to other preparations.
Asunto(s)
Antirreumáticos , Artritis Juvenil , Inhibidores de las Cinasas Janus , Uveítis , Adulto , Humanos , Femenino , Adulto Joven , Artritis Juvenil/complicaciones , Artritis Juvenil/diagnóstico , Artritis Juvenil/tratamiento farmacológico , Antirreumáticos/uso terapéutico , Uveítis/diagnóstico , Uveítis/tratamiento farmacológico , Uveítis/etiología , Inhibidores de las Cinasas Janus/uso terapéuticoRESUMEN
Syphilis is a bacterial infectious disease transmitted by the spirochaete Treponema pallidum. The rate of infection has increased during the last decade. Ocular syphilis is an underestimated presentation of the disease, and it is increased in HIV-positive patients. Even though every part of the eye may be affected, syphilis most commonly occurs with posterior or panuveitis. A distinctive pattern is acute syphilitic placoid chorioretinitis, with typical features in multimodal imaging. If syphilis is suspected, specific and nonspecific Treponema pallidum serological diagnostic tests are mandatory. Clinical outcome, or morphology and vision are commonly improved if antibiotic therapy (penicillin is the drug of choice) is instituted early. Additional corticosteroids are carefully applied according to individual need, and should be initiated after the start of antibiotics.