Juvenile idiopathic arthritis combined with atopic dermatitis: choice of therapy

Abstract

A rare clinical case of a combined diagnosis in a child is presented, which demonstrates the difficulty of choosing a genetically engineered biological therapy for two severe disabling diseases in one patient. The initial clinical picture of the child included manifestations of atopic dermatitis from an early age, followed by the addition of joint syndrome at school age, which made it difficult to treat both diseases. A single option for immunosuppressive therapy of both competing diseases was considered in the form of prescribing methotrexate. During the examination and dynamic monitoring of the patient, it was decided to initiate therapy with a genetically engineered biological drug from the TNF-α inhibitor group. A special feature of this clinical case is the trajectory of the therapeutic search. Etanercept therapy proved to be effective, quickly relieving the joint syndrome and reducing the severity of the skin syndrome. Regular use of the drug made it possible to achieve stable stabilization of the child's condition and prevent the development of complications of the combined disease. This case highlights the need for high vigilance regarding the combination of these diseases, as well as the importance of choosing the right treatment and starting it on time.