Combined plasmapheresis (PP) with methotrexate was used in 39 children aged 2–15 with severe system variant juvenile rheumatoid artritis. Juvenile rheumatoid artritis accomponied persistence infection and septic complication.
PP was conducted every other day 5 times. After each PP followed by immunosupressants therapy (PIT) (bolus methylprednisolone, methotrexate). Total dose was at most 15 mg/week.
Then patients received injections immunoglobulines every other day 3 times. Total dose immunoglobulines was 0,4–0,6 mg/kg. 12 patients had herpes infection. Before intensive therapy patients received zovirax.
During first week by used intensive methods of therapy used to disappear basic indication of disease. After 2 weeks state of patients was stably and not required intensive therapy.
9 patients from 39 had remission about 12 months. These patients used intensive methods of therapy repeatedly.
12 patients had exacerbation a year later after intensive therapy. These patients received only basic therapy.
1 died 2 years after the end of the treatment.
17 patients developed complete remission in 16–36 months. All these patients received basic therapy (prednisolone, methotrexate).
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