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Oligoarticular juvenile idiopathic arthritis — SCE Rheumatology MCQ

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HardPaediatric RheumatologyOligoarticular juvenile idiopathic arthritisSCE Rheumatology

A patient with Behçet syndrome develops rapidly progressive bilateral posterior uveitis with occlusive retinal vasculitis and falling visual acuity. Infection has been excluded. Which urgent disease-directed regimen is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — High-dose systemic glucocorticoid plus infliximab or another effective steroid-sparing ocular immunosuppressant

Explanation lettering: E = shown as A · A = shown as B · B = shown as C · C = shown as D · D = shown as E

D is correct. EULAR treats sight-threatening posterior uveitis as an emergency requiring systemic glucocorticoid together with potent immunosuppression; infliximab or interferon-alpha are established severe-ocular options, with azathioprine or ciclosporin used according to the wider course. A is inadequate for posterior disease. B does not control retinal vasculitis. C uses the TNF construct with weaker ocular efficacy. E ignores inflammatory vessel-wall disease and risks bleeding without controlling Behçet activity.

Reference: EULAR recommendations for management of Behçet syndrome: https://ard.bmj.com/content/77/6/808