Theoretical and practical basis for early aggressive therapy in paediatric autoimmune disorders.
OBJECTIVE
The clinical practice of introducing anti-inflammatory therapies in paediatric autoimmune disorders has changed substantially in the last two decades. This is partly due to the fact that we are able to put disease into remission with potent drugs, and so the issue of when to introduce these drugs is important. This review will seek to highlight the consequences of chronic inflammation and the change to outcomes if adequate or 'aggressive' treatment is given early to induce remission.


RESULTS
The review not only highlights publications on this topic over the past 12-18 months but also refers to key publications before when appropriate. The disorders reviewed are juvenile idiopathic arthritis, systemic lupus erythematosis, Wegener's granulomatosis, juvenile dermatomyositis, juvenile scleroderma and autoinflammatory syndromes.


CONCLUSIONS
Outcomes can be influenced by potent anti-inflammatory therapies. Their use early in the evolution of the disorder in question can limit damage and allow the possibility of normal life and function in the child.
Woo
Patricia
P
Centre for Paediatric and Adolescent Rheumatology, University College London, London, UK. Patricia.woo@ucl.ac.uk
D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000188:drug therapy; D001327:Autoimmune Diseases / Q000188:drug therapy*; D002648:Child; D003882:Dermatomyositis / Q000188:drug therapy; D010505:Familial Mediterranean Fever / Q000188:drug therapy; D014890:Granulomatosis with Polyangiitis / Q000188:drug therapy; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy; D012594:Scleroderma, Localized / Q000188:drug therapy; D013577:Syndrome
D000893:Anti-Inflammatory Agents