与附着点炎相关关节炎(enthesitis related arthritis,ERA)是幼年特发性关节炎(juvenile idiopathic arthritis,JIA)的亚型之一,是一组以关节炎、炎症、中轴关节受累和人类白细胞抗原-B27阳性为特征的疾病总称.在既往的分类标准中,由于其定义不能包括所有幼年脊柱关节病的类型,2019年儿童风湿病国际试验组织基于循证的方法重新定义JIA并进行了新的分类,将ERA命名为与附着点炎/脊柱关节炎相关的JIA.新的定义增加了脊柱关节炎一词,纳入了影像学的标准,并采用了背痛的新定义.该文阐述了 ERA的发病机制、分类标准的演变及预后,以加强临床医生认识,提高对中轴关节受累患儿的诊疗水平,从而改善预后.
Advances in enthesitis-related arthritis
Enthesitis related arthritis(ERA)is one of the subtypes of juvenile idiopathic arthritis(JIA).It is a group of diseases characterized by arthritis,inflammation,axial lesions,and human leucocyte antigen-B27 positive.In the previous classification criteria,ERA does not include all of the subsets of juvenile spondyloarthritis(JSpA).Based on an evidence-based approach,the Pediatric Rheumatology International trials Organization developed the latest classification criteria in 2019,and proposed the classification criteria of ERA/SpA,to distinguish it from other subtypes of JIA.The new definition added the term spondylitis,included imaging criteria,and adopted a new definition of back pain.The pathogenesis,evolution of classification criteria and prognosis of spondyloarthritis are described in this paper,in order to improve the level of diagnosis and treatment of patients with axial joint involvement,so as to improve the prognosis.
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