A case of panuveitis with optic disc neovascularization associated with juvenile idiopathic arthritis which progressed during a clinical trial of etanercept

PURPOSE: To report a case of uveitis associated with juvenile idiopathic arthritis that progressed from iritis to panuveitis with disc neovascularization during a clinical trial of etanercept, a tumor necrosis factor a (TNF-alpha) blocker. CASE: A 12-year-old girl with juvenile idiopathic arthritis, which had begun at the age of 1 year 7 months. The patient was enrolled in a clinical trial of etanercept at 11 years of age. The methotrexate which she has been taking was stopped, and prednisolone was decreased gradually from 7 mg. The iritis worsened and progressed to panuveitis with disc neovascularization when the prednisolone dose had been tapered to 2 mg. The uveitis was controlled by treatment with a steroid pulse and a liposteroid. CONCLUSION: When starting etanercept therapy in a patient with juvenile idiopathic arthritis who has uveitis and the antirheumatic drug is stopped and steroid treatment tapered, special care is needed to avoid the exacerbation of uveitis.