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Medikamentöse Prophylaxe während intensivierter Immunsuppression bei Kindern und Jugendlichen

Teil 2

Medicinal prophylaxis during intensified immunosuppression in children and adolescents

Part 2

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Zusammenfassung

Ziel einer modernen Rheumatherapie ist eine möglichst gute Kontrolle der Grunderkrankung. Dies wird im Einzelfall durch die Kombination verschiedener Wirkstoffe erzielt. Dabei ergibt sich eine immer umfangreichere Immunsuppression (IS). Im Sinne einer Risikobegrenzung wäre bei intensivierter IS eine standardisierte Überwachung auf immunologische Veränderungen wünschenswert. Dies kann anhand von Checklisten erfolgen (s. Teil 1 „Vorsorgeuntersuchungen während intensivierter Immunsuppression bei Kindern und Jugendlichen“). Eine individuelle Risikostratifizierung der geplanten IS erlaubt eine Vorhersage von Infektionsrisiken und ermöglicht so eine auf den Patienten zugeschnittene Infektionsprophylaxe. Zusätzlich sollte ein standardisiertes Vorgehen betreffend Diagnostik und Therapie bei Fieber unter intensivierter IS vor weiteren Komplikationen schützen.

Abstract

The goal of modern antirheumatic therapy is to achieve an optimized disease control. This is individually achieved by an intensified immunosuppression (IS) frequently combining different immunosuppressive agents. Intensified IS should be accompanied by a standardized protocol to monitor immunological changes in the patient. This should include checklists (see Part 1 Screening during intensified IS in children and adolescents). An individual risk stratification according to the planned IS allows a prediction of infectious disease risks for the patient and, thus, individual infection prophylaxis. In addition, standardized management of patients with fever while receiving intensified IS may prevent further complications.

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  1. Deutsches Zentrum für Kinder- und Jugendrheumatologie (DZKJR), Gehfeldstr. 24, 82467, Garmisch-Partenkirchen, Deutschland

    F. Speth &  J.-P. Haas

  2. MVZ Labor Dr. Gärtner & Kollegen, Ravensburg, Deutschland

    N. Wellinghausen

  3. Gesellschaft für Kinder- und Jugendrheumatologie (GKJR), Berlin, Deutschland

    J.-P. Haas

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  1. F. Speth
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Speth, F., Wellinghausen, N. & Haas, JP. Medikamentöse Prophylaxe während intensivierter Immunsuppression bei Kindern und Jugendlichen. Z. Rheumatol. 72, 896–909 (2013). https://doi.org/10.1007/s00393-013-1203-0

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