Детский ревматолог

[Volopas]

Здравствуйте. Посоветуйте, пожалуйста, детского ревматолога (пусть платного) с возможностью онлайн консультирования для утверждения тактики лечения девочки 3,5 года. Поставлен диагноз ревматоидный артрит с 1.5 года.

[Dr.Vad]

В таком возрасте диагноз сомнителен, нужны веские диагн. признаки, отсюда нет таких специалистов даже платных, говоряших по-русски; лучше всего найти инoстр. специалиста, который подтвердит или опровергнет поставл. диагноз

Early-onset oligoarticular juvenile idiopathic arthritis (JIA) is an autoimmune disease that typically affects children between the ages of 2 and 4

диф. диагностика:

juvenile idiopathic arthritis (JIA), septic (SA) or remain undetermined (UA).

Among the 196 included patients,
110 (56.1%) had SA,
20 (10.2%) had JIA and
66 (33.7%) had UA.
Patients with JIA were older when compared to SA (2.7 years [1.8-3.6] versus 1.4 [1.1-2.1], p < 0.001). Presence of fever was not different between JIA and SA or UA. White blood cells in serum were lower in JIA (11.2 × 109/L [10-13.6]) when compared to SA (13.2 × 109/L [11-16.6]), p = 0.01. In synovial fluid leucocytes were higher in SA 105.5 × 103 cells/mm3 [46-211] compared to JIA and UA (42 × 103 cells/mm3 [6.4-59.2] and 7.29 × 103 cells/mm3 [2.1-72] respectively), p < 0.001. Intravenous antibiotics were administered to 95% of children with JIA, 100% of patients with SA, and 95.4% of UA.