CASE REPORTS
JOURNAL ARTICLE
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Favorable response to high-dose infliximab for refractory childhood uveitis.

Ophthalmology 2006 May
OBJECTIVE: Uveitis in children most commonly is associated with juvenile idiopathic arthritis. In addition to topical glucocorticoids, treatment may include systemic immunosuppressive agents. Tumor necrosis factor alpha (TNF-alpha) has been implicated in the pathogenesis of uveitis; therefore, TNF-alpha blockade seems to be a reasonable therapeutic option to investigate. We report successful treatment of children with uveitis using infliximab.

STUDY DESIGN: A retrospective study of our complete experience using infliximab for the treatment of childhood uveitis was conducted.

PARTICIPANTS: Seventeen children (14 females, 3 males) with chronic uveitis were administered high-dose infliximab (10-20 mg/kg/dose).

MAIN OUTCOME MEASURES: Our main outcome measure was the ability to eliminate all signs of intraocular inflammation.

RESULTS: All 17 patients demonstrated a dramatic, rapid response, with no observed inflammation in 13 patients after the second infusion, and 4 patients requiring 3 to 7 infusions to achieve disease quiescence. Additional immunosuppressives and topical glucocorticoids were tapered when patients achieved no intraocular inflammation.

CONCLUSIONS: In this series, high-dose infliximab was a rapidly effective, well-tolerated therapeutic agent for the treatment of chronic, medically refractory, noninfectious uveitis.

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