ОЦЕНКА ТЯЖЕСТИ БОЛЕЗНИ И ПОДБОРАДЕКВАТНОЙ ДОЗЫ БАЗИСНОЙ ТЕРАПИИМЕТОТРЕКСАТОМ У РЕБЕНКА С ЮВЕНИЛЬНЫМ ПОЛИАРТРИТОМ

The article presents a short review of the current notion of the leading role methotrexate in treatment of most clinical variants ofjuvenile idiopathic arthritis. The authors demonstrate that methotrexate is a “gold standard” of antirheumatic therapy and the key disease-modifying drug of pediatric rheumatology. The emphasis is laid on safety profile and advantages of parenteral administration thereof. The article presents follow-up of a clinical case involving use of dosage form of methotrexate in the dose of 15 mg/m per week for subcutaneous administration in a patient with polyarticular juvenile idiopathic arthritis featuring insufficient effectiveness and low tolerance of the oral drug. Prescription of methotrexate for subcutaneous administration helped to terminate progression of the disease and pain syndrome and improve function of the affected joints and the patient’s quality of life. В статье дан краткий обзор современных представлений о ведущем месте метотрексата в лечении большинства клинических вариантов ювенильного идиопатического артрита. Показано, что метотрексат ― «золотой стандарт» противоревматической терапии, ключевой болезньмодифицирующий препарат в педиатрической ревматологии. Сделан акцент на профиль его безопасности и преимущества парентерального способа введения. В статье представлено наблюдение клинического случая использования дозированной формы метотрексата в дозе 15 мг/м2 в нед для подкожного введения у пациента с полиартикулярным вариантом ювенильного идиопатического артрита с недостаточной эффективностью и плохой переносимостью перорального препарата. Назначение метотрексата для подкожного введения позволило остановить прогрессирование заболевания, купировать болевой синдром, улучшить функцию пораженных суставов и повысить качество жизни пациента.

NOVOSIBIRSK REGION PROGRAM OF THE LIVER TRANSPLANTATION IN CHILDREN

The aim of the study was to analyze the early and late outcomes of pediatric liver transplantation (LTx) program in the Novosibirsk region. Material and Methods. The retrospective study included 24 patients aged 72 ± 74.8 months (from 4 to 212 months, median – 20 months) with a body weight of 21.7 ± 18.1 kg (from 4.5 to 55 kg, median – 12.5 kg). Two (8.3 %) cadaveric whole liver grafts, 19 (79.2 %) living donor liver grafts, and 3 (12.5 %) cadaveric liver fragments (reduced-size or split-liver) were transplanted. Results. The features of vascular and biliary reconstruction in different types of LTx are discussed. The incidence of vascular and biliary complications was 8.3 and 20.8%, respectively. The patients stayed in the intensive care unit for 9 ± 5.1 days (from 4 to 22 days, median 8 days) and total length of hospital stay was for 40 ± 25.4 days (from 19 to 136 days, median 32 days). Two (8.3 %) recipients had early graft dysfunction. Perioperative mortality (up to 90 days) was absent. The overall 5-year patient and graft survival rates were 95 and 88 %, respectively. Conclusion. The Novosibirsk region has a pediatric LTx program with outcomes comparable to the data of the leading world and Russian centers

ТРАНСПЛАНТАЦИЯ ПЕЧЕНИ ПРИ ЭПИТЕЛИОИДНОЙ ГЕМАНГИОЭНДОТЕЛИОМЕ С КАНЦЕРОМАТОЗОМ БРЮШНОЙ ПОЛОСТИ: КЛИНИЧЕСКОЕ НАБЛЮДЕНИЕ

We report the case of a young woman who underwent liver transplantation for epithelioid hemangioendothe- lioma with diffuse intraperitoneal metastases. We observe the 1-year survival without tumor progression on everolimus-based immunosuppression. The different therapies and the results of surgery for this disease are discussed in short literature review. В статье представлен клинической случай трансплантации печени у молодой пациентки со злокачественной эпителиоидной гемангиоэндотелиомой печени и канцероматозом брюшной полости. Мы наблюдаем 1-летнюю выживаемость без признаков опухолевой прогрессии на фоне иммуносупрессии эверолимусом. В кратком литературном обзоре рассмотрены лечебные опции и результаты операций при данном заболевании.

FOLLOW-UP OF METHOTREXATE EFFECTIVENESS IN A PATIENT WITH JUVENILE POLYARTHRITIS

The article presents a short review of the current notion of the leading role methotrexate in treatment of most clinical variants ofjuvenile idiopathic arthritis. The authors demonstrate that methotrexate is a “gold standard” of antirheumatic therapy and the key disease-modifying drug of pediatric rheumatology. The emphasis is laid on safety profile and advantages of parenteral administration thereof. The article presents follow-up of a clinical case involving use of dosage form of methotrexate in the dose of 15 mg/m per week for subcutaneous administration in a patient with polyarticular juvenile idiopathic arthritis featuring insufficient effectiveness and low tolerance of the oral drug. Prescription of methotrexate for subcutaneous administration helped to terminate progression of the disease and pain syndrome and improve function of the affected joints and the patient’s quality of life

FOLLOW-UP OF METHOTREXATE EFFECTIVENESS IN A PATIENT WITH JUVENILE POLYARTHRITIS

The article presents a short review of the current notion of the leading role methotrexate in treatment of most clinical variants ofjuvenile idiopathic arthritis. The authors demonstrate that methotrexate is a “gold standard” of antirheumatic therapy and the key disease-modifying drug of pediatric rheumatology. The emphasis is laid on safety profile and advantages of parenteral administration thereof. The article presents follow-up of a clinical case involving use of dosage form of methotrexate in the dose of 15 mg/m per week for subcutaneous administration in a patient with polyarticular juvenile idiopathic arthritis featuring insufficient effectiveness and low tolerance of the oral drug. Prescription of methotrexate for subcutaneous administration helped to terminate progression of the disease and pain syndrome and improve function of the affected joints and the patient’s quality of life