Bibliography November 2000

 

1. ARSLANOGLU S, MURAT H, FERAH G: Spondyloepiphyseal dysplasia tarda with progressive arthropathy: an important form of osteodysplasia in the differential diagnosis of juvenile rheumatoid arthritis [In Process Citation]. Pediatr.Int. 2000, 42:561-563.
   Organism:Division of Pediatric Rheumatology, Dr Behcet Uz Children's Hopsital, Alsancak, Izmir, Turkey ssertac@efesnettr
   Internet : PM:0011059550

    

2. BELT EA, KAUPPI MJ, KAARELA K, SAVOLAINEN HA, KAUTIAINEN HJ, LEHTO MU: Development rate of mutilans fingers in patients with rheumatic disease [In Process Citation]. Clin.Exp.Rheumatol 2000, 18:601-604.
   Organism:Department of Orthopedics, Rheumatism Foundation Hospital, Heinola, Finland eerobelt@kolumbusfi
   Abstract: OBJECTIVE: To describe arthritis mutilans (AM) deformity during the progression of rheumatic disease. METHODS: The development of mutilans-like hand deformities in 2 patients with juvenile chronic arthritis (JCA) and in 2 patients with adult onset rheumatoid arthritis (RA) are presented. The hands of these patients were evaluated at least at two time points during the course of disease using two different scoring methods based on differently summed Larsen grades of the hand joints. RESULTS: Two patients (one with JCA and one with RA) showed AM changes after a disease period of less than 10 years and 2 not until after 30 years. The patients with adult onset disease were young at the onset of joint disease. Early wrist fusions were performed on both patients showing a slow development rate. CONCLUSIONS: The development rate of AM is very variable, even in patients with the same diagnoses. Wrist fusion prevents shortening of the carpus and may decrease the development rate of AM
   Internet : PM:0011072601

    

3. BLOOM BJ: Development of diabetes mellitus during etanercept therapy in a child with systemic-onset juvenile rheumatoid arthritis [In Process Citation]. Arthritis Rheum 2000, 43:2606-2608.
   Organism:Pediatric Ambulatory Medicine, Hasbro Children's Hospital, Providence, Rhode Island 02903, USA
   Abstract: Although clinical trials of etanercept in adult and juvenile rheumatoid arthritis have generally revealed few adverse events, significant concern has arisen over the potential evolution of secondary autoimmune disease due to modulation of tumor necrosis factor. There have been few reports of such diseases developing, and none in children receiving this therapy. Reported herein is the case of a 7-year-old girl with a 3-year history of systemic-onset juvenile rheumatoid arthritis with a polyarticular course, in whom type 1 diabetes mellitus developed 5 months after the initiation of etanercept therapy
   Internet : PM:0011083287

    

4. BRACE MJ, SCOTT SM, MCCAULEY E, SHERRY DD: Family reinforcement of illness behavior: a comparison of adolescents with chronic fatigue syndrome, juvenile arthritis, and healthy controls [In Process Citation]. J Dev.Behav.Pediatr. 2000, 21:332-339.
   Organism:Department of Psychiatry, University of Washington, Seattle, USA
   Abstract: Parental encouragement of illness behavior is hypothesized to correlate with psychosocial dysfunction in adolescents with chronic illness. To explore this hypothesis, adolescents aged 11 to 17 years with chronic fatigue syndrome (CFS) (n = 10), juvenile rheumatoid arthritis (JRA) (n = 16), and healthy adolescents (n = 14) were recruited for the study. Measures included the Achenbach parent and youth self report forms, the Family Adaptability and Cohesion Evaluation Scale-II (FACES II), the Children's Depression Rating Scale, and number of days absent from school. The Illness Behavior Encouragement Scale (IBES) generated measures of parental reinforcement of illness behavior. As predicted, the teens with CFS scored statistically higher on measures of depression, total competence, and number of days of school missed in the previous 6 months (mean = 40). Children with JRA scored significantly lower than the CFS group on the measure of parental reinforcement of illness behavior. The healthy group produced intermediate scores. Results and implications for future clinical and research activity are discussed
   Internet : PM:0011064960

    

5. BREIT W, FROSCH M, MEYER U, HEINECKE A, GANSER G: A subgroup-specific evaluation of the efficacy of intraarticular triamcinolone hexacetonide in juvenile chronic arthritis [In Process Citation]. J Rheumatol 2000, 27:2696-2702.
   Organism:Department of Pediatric Rheumatology, Northwest German Center of Rheumatology, St Josef Stift, Sendenhorst
   Abstract: OBJECTIVE: To determine the subgroup-specific differences of intraarticular triamcinolone hexacetonide (TH) in the treatment of joint inflammation in patients with juvenile chronic arthritis (JCA). METHODS: A retrospective review of 194 children of all subgroups of JCA, treated by a single or repeated TH injection between 1989 to 1994. Efficacy and duration of benefit were evaluated after a mean duration of 3, 15, 30, and 64 weeks. RESULTS: In all, 1439 TH injections were given to 194 patients; 368 of these were reinjections. The median duration of improvement of all injections was 74 weeks. Responses were significantly different among subgroups (p = 0.0001): there were 121 weeks of efficacy in early-onset pauciarticular JCA type I (223 injections), 47 weeks in late-onset pauciarticular JCA type II (190 injections), 105 weeks in rheumatoid factor negative polyarticular JCA (445 injections), 63 weeks in rheumatoid factor positive polyarticular JCA (127 injections), and 36 weeks in systemic JCA (413 injections). Forty-one injections were done in other rheumatic diseases. In relation to this result there were also differences with regard to joint groups, antinuclear antibody (ANA) and HLA-B27 status, and sex. Side effects were rare: infections of skin or joints were not noted; skin and lipoatrophy were seen after 15 injections, necrosis of the hip in one case, luxation of 2 shoulders of one patient, and periarticular calcification in 3 patients. CONCLUSION: Intraarticular TH is an effective therapy for inflammatory joint disease in all subgroups of JCA. The risk of major complications is low. The median duration of improvement depends on the subgroup of the disease
   Internet : PM:0011093456

    

6. CEPILOVA Z, PORUBSKA M: [In Process Citation]. Cesk.Slov.Oftalmol. 2000, 56:319-324.
   Organism:Ocne oddelenie, OLU RCH, Novy Smokovec
   Abstract: BACKGROUND: Anterior uveitis (iridocyclitis) in association with juvenile chronic arthritis has two different clinical units: the acute and chronic form. They differ as to the clinical picture, course, complications, relation to antinuclear antibodies and HLA B 27 antigen, response to treatment and prognosis of optic functions. OBJECTIVE: To investigate the development of complications in patients with the chronic form of juvenile chronic arthritis in relation to the duration of uveitis. To focus attention on the treatment and prognosis of the disease. PATIENTS: The authors evaluated retrospectively 18 patients with anterior chronic uveitis and diagnosed juvenile chronic arthritis. The group comprised 13 girls and 5 boys, mean age 14.3 years (6-25 years) with a mean duration of uveitis of 7.5 years (2-21 years). RESULTS: Complications and deterioration of vision are frequent and serious in patients with the chronic form of uveitis. With the duration of the disease progression of complications occurs, their number increases and vision deteriorates. The adverse prognosis in some patients is promoted by an inadequate response to treatment. Six patients (8 eyes) were subjected to surgical treatment of complications. The postoperative results are not encouraging. CONCLUSION: The authors wish to draw attention to the need of close collaboration with a rheumatologist, paediatrician, ophthalmologist and the necessity to devote special care to children with juvenile chronic arthritis and uveitis
   Internet : PM:0011059141

    

7. CUNNINGHAM JM, CHIU EJ, LANDGRAF JM, GLIKLICH RE: The health impact of chronic recurrent rhinosinusitis in children [In Process Citation]. Arch.Otolaryngol.Head Neck Surg. 2000, 126:1363-1368.
   Organism:Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA 02114, USA
   Abstract: OBJECTIVES: To report and quantify the health-related quality of life of children who require surgical intervention for chronic recurrent rhinosinusitis and to assess the perspective of the child vs that of the parent. DESIGN: Prospective, observational. PATIENTS AND INTERVENTION: Twenty-one of a consecutive sample of 35 children undergoing endoscopic sinus surgery for infectious indications completed, along with their parents, the Child Health Questionnaire. The Child Health Questionnaire measures in parallel both child and parent perceptions of health by means of separate parent proxy report (Child Health Questionnaire-Parent Form 50) and child self-report (Child Health Questionnaire-Child Form 87) questionnaires concerning physical and psychosocial functioning. MAIN OUTCOME MEASURES: Tabulated scores from both the Child Health Questionnaire-Parent Form 50 and Child Health Questionnaire-Child Form 87 were compared with published data from age-matched normative populations and several pediatric chronic disease groups. RESULTS: Significant decrements in the general health of children with chronic recurrent rhinosinusitis compared with a normative sample were observed for both c
   Internet : PM:0011074834

    

8. DE MARCO R, VITTONE P: Treatment of non infectious childhood uveitis. Gaslini 2000, 32:232-237.
   Organism:R. De Marco, Divisione Oculistica, Istituto G. Gaslini, l.go G. Gaslini, Genova
   Abstract: Six percent of all uveitis occurs in children and the uveitis associated with Juvenile Rheumatoid Arthritis continues to blind 12% of the patients who develop this form for iridocyclitis. Uveitis beginning in childhood is a serious disease associated with sight threatening complications. Increased awareness by pediatricians, rheumatologists and ophthalmologists of the seriousness of ocular complications of uveitis in childhood may lead to earlier diagnosis and more effective treatment regimens in the future. Eye drops steroids remains the mainstay and cornerstone of treatment, but some patients continue to have episodes of active inflammation each time the topical drops are reduced and discontinued. We describe a recent method of treatment through 'a stepladder' approach in aggressiveness of therapy divided by five steps: topical steroids, regional injection steroid, oral non steroid antiinflammatory drug therapy, systemic steroids and chemotherapy

    

9. DEGOTARDI PJ, REVENSON TA, ILOWITE NT: Family-level coping in juvenile rheumatoid arthritis: assessing the utility of a quantitative family interview [In Process Citation]. Arthritis Care Res 1999, 12:314-324.
   Organism:Graduate School, City University of New York, USA
   Abstract: OBJECTIVE: To explore the viability of a quantitative family interview to describe family-level coping strategies used to deal with juvenile rheumatoid arthritis (JRA)-related stressors for early and late adolescents. METHOD: A structured interview protocol with 30 adolescents with JRA and family members assessed ways JRA disrupts or changes family functioning. Emotional reactions, sequential phases of family response, and treatment adherence were discussed. Interviews were coded for family-level coping. To assess adjustment, family members completed the Youth Self Report and the Family Environment Scale. The pediatric rheumatologist provided medical information. RESULTS: The family interview produced both quantitative and qualitative data. Families reported multiple JRA-related stressors (mean 6.6). For many adolescents, treatment adherence was problematic. Families used all 3 types of coping strategies (appraisal-, problem-, and emotion-focused) to varying degrees. Problem-focused approaches were most commonly used and included seeking support (used by 73% of families), self-reliance (70%), and family coordination (70%) for dealing with specific problems, and seeking information about JRA (67%). Emotion-focused approaches, such as impulsive outbursts and diminished awareness of others' feelings, were associated with problematic adjustment. Few differences were found between the families of early and late adolescents. CONCLUSION: The quantitative family interview has the potential to be a useful tool in documenting JRA-related stressors, family-level coping processes, and how family-level coping is associated with treatment adherence and psychosocial adjustment
   Internet : PM:0011081000

    

10. ETI E, DABOIKO J-C, ANOMAN M-C, OUALI B, OUATTARA B, GABLA A, KOUAKOU NM, KONAN MT, OULAI M, KOUAME J: Chronic juvenile arthritis in an ivory coast pediatric hospital. Rhumatologie 2000, 52:13-16.
    Organism:Service de Rhumatologie, CHU de Cocody, Abidjan Ivory Coast
    Abstract: Still's disease appears as a rare affection in Ivorian Pediatrics Hospitals with three cases within six years. The young boy about the age of nine is concerned with the illness. And it appears through a polyarthritis which is always associated with an hyperthermia without viscerals signs. Usually an inflammatory anaemia is associated in the half of the cases with an hyperleucocytosis. The rheumatoid factor is found in two cases. At the first stage, the radiographic signs are those of polyarthritis. Generally, the evolution is good under corticotherapy

     

11. GARCIA-CONSUEGRA MJ, MERINO MR: [TREATMENT OF IDIOPATHIC JUVENILE ARTHRITIS WITH INTRAARTICULAR TRIAMCINOLONE ACETONIDE INJECTIONS]. An Esp.Pediatr. 2000, 53:314-317.
    Organism:Unidad de Reumatologia Pediatrica Hospital La Paz Madrid
    Abstract: AIM: To evaluate the therapeutic response to intraarticular triamcinolone acetonide injections in patients with juvenile idiopathic arthritis.METHODS: Eight-eight patients were prospectively evaluated after receiving one or more intraarticular triamcinolone acetonide injections. A total of 194 joints were injected: 68 joints in 39 children with oligoarticular onset juvenile idiopathic arthritis, 36 joints in 17 children with polyarticular onset, 67 joints in 20 children with systemic onset, and 23 joints in 12 children with spondyloarthropathy.RESULTS: Full resolution of signs of inflammation was achieved in 131 of 194 joints (67.5%). The percentage of remission was significantly lower in patients with systemic onset of the disease (36% versus 80% in the other groups). At the 6-month follow-up, 70% of the joints remained in remission. No significant complications were observed.CONCLUSIONS: Intraarticular triamcinolone injections are safe and effective in children with chronic arthritis
    Internet : PM:0011083979

     

12. GILLUM JD, BENNETT LB, PASCUAL V, BOWCOCK AM, LOVETT M, WISE CA: Localization of a novel form of juvenile rheumatoid arthritis (familial recurrent arthritis) to human chromosome 15q. Am.J.Hum.Genet. 2000, 67:384
    Organism:Research, Texas Scottish Rite Hosp., Dallas, TX USA

     

13. GORNICKA G, POSTEPSKI J, KOROBOWICZ A, KIMBER Z, GORSKA M: [In Process Citation]. Pol.Merkuriusz.Lek. 2000, 9 Suppl 1:18-20.
    Organism:Kliniki Pediatrii, Chorob Pluc i Reumatologii AM w Lublinie
    Abstract: The aim of this study was an evaluation of the mucociliary clearance of airways with saccharine test in children with juvenile chronic arthritis. In tested group the displacement time of saccharine was significantly longer than in healthy children. In control group the displacement time of saccharine was longer in children older 13 years, but in tested group the quality of mucociliary clearance was independent of age and of arthritis duration. The mucociliary clearance impairment wasn't dependent of increasing incidence of infections of respiratory system
    Internet : PM:0011081336

     

14. GUPTA SK, FITZGERALD JF: Diagnostic challenges posed by inflammatory myofibroblastic tumors (IMT). Jpgn 2000, 31:S41
    Organism:James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN USA

     

15. HAYATA ANDRE LS, RODRIGUES CJ, KOCHEN JUSSARA AL, PEREIRA ROSA MR, GOLDENSTEIN-SCHAINBERG C: Familial hypertrophic synovitis. Rinsho Ganka 2000, 27:2522-2523.
    Organism:Disciplina de Reumatologia, Reumatologia, Av. Dr. Arnaldo 455 3rd Andar, Cerqueira Cesar, Sao Paulo, SP Brazil

     

16. HERRMANN M, SCHOLMERICH J, STRAUB RH: Stress and rheumatic diseases. Rheumatic Disease Clinics of North America 2000, 26:737-763.
    Organism:Dr. R.H. Straub, Department of Internal Medicine I, University Medical Center, D-93042 Regensburg
    Abstract: This study was done to review the literature concerning the influence of minor and major stress factors on onset and course of rheumatoid arthritis (RA), juvenile chronic arthritis (JCA), systemic lupus erythematosus (SLE), and fibromyalgia syndrome (FS). Major life events and chronic minor stress seem to be very important factors in JCA and are significantly associated with the onset of the disease. With respect to RA and FS, stress may be a provoking factor but the data in the literature are equivocal. However, during the course of the disease, minor stress aggravates SLE, FS, JCA, and RA. Patients with FS and RA may profit from phsychological therapies. Optimistic and confronting coping strategies were found most frequently and perceived to be most effective. Very important for psychological function is the social background, especially the functioning of the family is of outstanding importance for clinical and psychological outcome
    Internet : rainer.straub@klinik.uni-regensburg.de

     

17. HERRMANN M, SCHOLMERICH J, STRAUB RH: Stress and rheumatic diseases [In Process Citation]. Rheum Dis.Clin.North Am. 2000, 26:737-63, viii.
    Organism:Department of Internal Medicine, University Medical Center, Regensburg, Bavaria, Germany
    Abstract: This study was done to review the literature concerning the influence of minor and major stress factors on onset and course of rheumatoid arthritis (RA), juvenile chronic arthritis (JCA), systemic lupus erythematosus (SLE), and fibromyalgia syndrome (FS). Major life events and chronic minor stress seem to be very important factors in JCA and are significantly associated with the onset of the disease. With respect to RA and FS, stress may be a provoking factor but the data in the literature are equivocal. However, during the course of the disease, minor stress aggravates SLE, FS, JCA, and RA. Patients with FS and RA may profit from psychological therapies. Optimistic and confronting coping strategies were found most frequently and perceived to be most effective. Very important for psychological function is the social background, especially the functioning of the family is of outstanding importance for clinical and psychological outcome
    Internet : PM:0011084942

     

18. KONO T, ISHII M, TANIGUCHI S, NEGORO N: Psoriasis in a patient with juvenile rheumatoid arthritis [In Process Citation]. Dermatology 2000, 201:275-276.
    Organism:Department of Dermatology, Osaka City University Medical School, Osaka, Japan
    Abstract: A 20-year-old woman had polyarticular-onset type of juvenile rheumatoid arthritis with a chronic and destructive course since 6 years of age. She had developmental retardation, deformity and disability. Asymptomatic erythematous scaly plaques developed on the trunk. A skin biopsy specimen revealed psoriasis. This is the first report of psoriasis developing in a patient with juvenile rheumatoid arthritis. Copyright 2000 S. Karger AG, Basel
    Internet : PM:0011096206

     

19. LARES-ASSEFF I, JUAREZ-OLGUIN H, FLORES-PEREZ J, FLORES-LACAYO M, SOSA-MACIAS M, COVARRUBAIS-VENZOR V: Pharmacokinetics changes of acetyl salicyclic acid and its metabolites by effect of the age in children with autoimmune disease. Journal of Clinical Pharmacology 2000, 40:1061

     

20. LEI PS, LOWICHIK A, ALLEN W, MAUCH TJ: Acute Renal Failure: Unusual Complication of Epstein-Barr Virus-Induced Infectious Mononucleosis. Clin.Infect.Dis. 2000, 31:1519-1524.
    Organism:Department of Pediatrics, University of Utah School of Medicine and Primary Children's Medical Center, Salt Lake City, UT 84132, USA tmauch@hscutahedu
    Abstract: A 17-year-old boy with juvenile rheumatoid arthritis presented with jaundice, confusion, hemolytic anemia, thrombocytopenia, and acute renal failure secondary to titer-confirmed acute Epstein-Barr virus (EBV). Renal biopsy specimen revealed interstitial nephritis with an inflammatory infiltrate composed of cytotoxic/suppressor T cells, and interstitial mononuclear cell nuclei expressed EBV encoded RNA-1 (EBER-1) mRNA. Methylprednisolone treatment resulted in rapid improvement
    Internet : PM:0011096030

     

21. MAMPAEY S, VANHOENACKER F, BOVEN K, VAN HUL W, DE SCHEPPER A: Progressive pseudorheumatoid dysplasia [In Process Citation]. Eur.Radiol. 2000, 10:1832-1835.
    Organism:Department of Radiology, University Hospital Antwerp, Edegem, Belgium
    Abstract: A rare case of progressive pseudorheumatoid dysplasia (PPD) in a 9-year-old girl is presented. Clinically, chronic painless swollen joints, accompanied by progressive motion restriction and progressive walking difficulties, were found. Radiologically, there was enlargement of the epimetaphyseal portions of the large joints, metacarpal heads, and phalanges, and generalized platyspondyly with irregular delineation of the endplates of the vertebral bodies. The radioclinical features at the peripheral joints were originally misdiagnosed as juvenile rheumatoid arthritis (JRA), and the structural spinal abnormalities were neglected and interpreted as Scheuermann's disease. However, the absence of active inflammatory parameters argues against JRA, whereas the low age of onset of the irregularities at the vertebral endplates is an argument against the diagnosis of Scheuermann's disease. The combination of the dysplastic abnormalities of the spine, with platyspondyly and Scheuermann-like lesions at an unusually low age of onset, and radiological features mimicking JRA of the peripheral joints, is the clue to the diagnosis of this rare autosomal-recessive disease. This case is the first to document the MRI features of PPD of the spine
    Internet : PM:0011097416

     

22. MAMPAEY S, VANHOENACKER F, BOVEN K, VAN HUL W, DE SCHEPPER A: Progressive pseudorheumatoid dysplasia. European Radiology 2000, 10:1832-1835.
    Organism:F. Vanhoenacker, Department of Radiology, St. Maarten Hospital, Campus Duffel, Rooienberg, 25, 2570 Duffel
    Abstract: A rare case of progressive pseudorheumatoid dysplasia (PPD) in a 9-year-old girl is presented. Clinically, chronic painless swollen joints, accompanied by progressive motion restriction and progressive walking difficulties, were found. Radiologically, there was enlargement of the epimetaphyseal portions of the large joints, metacarpal heads, and phalanges, and generalized platyspondyly with irregular delineation of the endplates of the vertebral bodies. The radioclinical features at the peripheral joints were originally misdiagnosed as juvenile rheumatoid arthritis (JRA), and the structural spinal abnormalities were neglected and interpreted as Scheuermann's disease. However, the absence of active inflammatory parameters argues against JRA, whereas the low age of onset of the irregularities at the vertebral endplates is an argument against the diagnosis of Scheuermann's disease. The combination of the dysplastic abnormalities of the spine, with platyspondyly and Scheuermann-like lesions at an unusually low age of onset, and the radiological features mimicking JRA of the peripheral joints, is the clue to the diagnosis of this rare autosomal-recessive disease. This case is the first to document the MRI features of PPD of the spine

     

23. MAZZANTINI M, DI MUNNO O: Methotrexate and bone mass. Clinical And Experimental Rheumatology 2000, 18:S87-S92
    Organism:Dr. M. Mazzantini, Sezione di Reumatologia, Dipartimento di Medicina Interna, Universita di Pisa, via Roma 67, 56126 Pisa
    Abstract: In rheumatoid arthritis (RA), methotrexate (MTX) is probably the most frequently used disease-modifying antirheumatic drug. It is also prescribed for other rheumatic and non-rheumatic diseases, such as juvenile RA, psoriatic arthritis, polymyositis, polymyalgia rheumatica, Horton's arteritis, inflammatory bowel disease, etc. MTX has been reported to have negative effects on bone: the term 'MTX osteopathy' was first used to refer to a clinical syndrome characterized by stress fractures of the lower extremities, diffuse bone pain, and osteoporosis in children who had been placed on long-term maintenance therapy with low-dose MTX for acute lymphoblastic leukemia. Sporadic reports of similar cases among patients taking low-dose MTX for rheumatic diseases, primarily RA, have appeared more recently. Furthermore, in vitro studies have suggested that MTX may exert toxic effects on osteoblasts. These findings have raised concern about the long-term effects of MTX on bone. However, densitometric studies in RA patients have so far failed to detect decreased bone mass in patients on MTX treatment

     

24. MELIKOGLU M, OZDOGAN H, KORKMAZ C, KASAPCOPUR O, ARISOY N, AKKUS S, FRESKO I, YAZICI H: A survey of phenotype II in familial Mediterranean fever. Annals of the Rheumatic Diseases 2000, 59:910-913.
    Organism:Dr. H. Ozdogan, Kasaneler sok 2/5, Erenkoy, Istanbul 81060
    Abstract: Objective - Phenotype II in familial Mediterranean fever (FMF) is the onset of amyloidosis before the onset of FMF with its typical attacks, or as an isolated finding in a member of an FMF family. Its presence was investigated by looking for proteinuria among the asymptomatic relatives of patients with FMF complicated by amyloidosis and among the asymptomatic relatives of patients with juvenile chronic arthritis (JCA) complicated by amyloidosis, used as controls. Methods - The relatives of the index patients (13 with FMF and amyloidosis) and controls (6 with JCA and amyloidosis) were screened for proteinuria. Rectal biopsies were performed when proteinuria was significant (>=300 mg/d). Results - 461 relatives were screened in the FMF group and 269 among the controls. Two of the FMF relatives and one JCA relative had no symptoms of FMF but had significant proteinuria. Rectal biopsy for amyloidosis was negative in all instances of significant proteinuria. Conclusion - Phenotype II is uncommon among the relatives of patients with FMF and amyloidosis
    Internet : ozdogan@attglobal.net

     

25. MICHELS H: What is low-dose corticosteroid therapy in juvenile idiopathic arthritis? A worldwide, questionnaire-based survey. Zeitschrift Fur Rheumatologie 2000, 59:II127-II130
    Organism:Dr. H. Michels, FKH, Abt. F. Kinder-/Jugendrheumatologie, Im Spitzerfeld 25, 69151 Neckargemund
    Abstract: Objective: To determine pediatric rheumatologists' personal definitions of systemic low-dose, long-term (> 4 weeks) corticosteroid therapy of juvenile idiopathic arthritis (JIA). Methods: Pediatric rheumatologists from America, the Near East (Israel), Australia and Europe were asked for their personal definition of a low-dose long-term corticosteroid therapy of JIA with the aid a standardized questionnaire. Results: Of 99 questionnaires returned, 92 were evaluable. The dosage still considered low turned out to be 0.26 +/- 0.14 mg prednisolone/kgBW/ day (min-max = 0.04-0.50 mg, n = 92). Higher dosages were indicated from Northern Europe (0.29 +/- 0.12, n = 9), Western Europe (0.42 +/- 0.14, n = 7), Southern Europe (0.30 +/- 0.14, n = 9), Eastern Europe (0.25 +/- 0.14, n = 6) and North America (0.33 +/- 0.17, n = 16) than from Central Europe (0.19 +/- 0.09, n = 43). Conclusion: Pediatric rheumatologists' personal definitions of low-dose, long-term corticosteroid therapy vary within a wide range. The reason for these differences and the impact on patients should be investigated. In addition, a generally accepted definition for lowdose, long-term corticosteroid therapy should be developed and subsequently examined in studies

     

26. MILLER ML, KRESS AM, BERRY CA: Decreased physical function in juvenile rheumatoid arthritis [In Process Citation]. Arthritis Care Res 1999, 12:309-313.
    Organism:Department of Pediatrics, Northwestern University Medical School, Chicago, Illinois, USA
    Abstract: OBJECTIVE: To assess the extent of physical disability in juvenile rheumatoid arthritis (JRA), classified according to subtype, and whether synovitis or flexion contractures are present on examination. METHODS: This retrospective study included 88 JRA patients and 50 controls without musculoskeletal disease. The outcome measure was the disability index (DI) derived from the Childhood Health Assessment Questionnaire (CHAQ). RESULTS: DI scores for JRA patients with synovitis (mean 0.49, range 0-1.88) and without synovitis (mean 0.37, range 0-1.75) were significantly higher (P < 0.001 for both groups) than for controls (mean 0.06, range 0-0.75, P < 0.001), but not significantly different from one another. Similarly, DI scores for JRA patients with and without any flexion contractures were higher than for controls, but not significantly different from one another. DI scores for JRA patients with both synovitis and flexion contractures were significantly higher than DI scores for JRA patients with neither, but were not distinguishable from JRA patients with synovitis only or flexion contractures only. Likewise, DI scores for JRA patients lacking synovitis and flexion contractures were not significantly different than those for JRA patients with one or the other. DI scores for systemic and polyarticular patients were higher than for pauciarticular patients, and DI scores for all 3 subtypes were higher than for controls. CONCLUSION: Our findings suggest that many JRA patients, including those with pauciarticular JRA, have problems with physical function, even when synovitis and flexion contractures are not present. Further attention and research is needed to elucidate the causes or origins of disability in JRA patients with seemingly well-controlled disease. We recommend that health status instruments like the CHAQ be more widely used for JRA patients to complement other assessments, especially in planning occupational and physical therapy
    Internet : PM:0011080999

     

27. NEIMAN AR, LEE LA, WESTON WL, BUYON JP: Cutaneous manifestations of neonatal lupus without heart block: Characteristics of mothers and children enrolled in a national registry. J Pediatr. 2000, 137:674-680.
    Organism:Department of Rheumatology and Medicine, Hospital for Joint Diseases, New York University School of Medicine, New York, New York; Departments of Dermatology, Medicine, and Pediatrics, University of Colorado Health Sciences Center, Denver; and Dermatology Service, Department of Medicine, Denver Health Medical Center, Colorado
    Abstract: OBJECTIVE: To extend the information base on cutaneous manifestations of neonatal lupus erythematosus (NLE) with regard to maternal disease, sex of child, onset, localization, influence of UV light, prognosis, and recurrence rates in subsequent pregnancies. METHODS: Review of records from the Research Registry for Neonatal Lupus. RESULTS: The cohort includes 47 mothers (83% white) whose sera contain anti-SSA/Ro, anti-SSB/La, and/or anti-U1-ribonucleoprotein antibodies and their 57 infants (20 boys and 37 girls) diagnosed with cutaneous NLE (absent heart disease) between 1981 and 1997. At detection of the child's rash, 13 mothers were asymptomatic, 11 had an undifferentiated autoimmune syndrome (UAS), 9 had systemic lupus erythematosus (SLE), 7 Sjogren's syndrome (SS), 6 SLE/SS, and 1 rheumatoid arthritis/SS; 20 reported photosensitivity. Within 5 years, 7 asymptomatic mothers experienced disease progression: 1 developed photosensitivity, 2 SLE, 3 SS, 1 SLE/SS; in 2 mothers UAS progressed to SLE; and 2 mothers with SS developed SLE. The infant's rash often followed UV light exposure; mean age at detection was 6 weeks, and mean duration was 17 weeks. All had facial involvement (periorbital region most common) followed by the scalp, trunk, extremities, neck, and intertriginous areas. In 37, the rash resolved without sequelae, 43% of which were untreated. A quarter had residual sequelae that included telangiectasia and dyspigmentation. One child developed Hashimoto's thyroiditis, and 2 developed systemic-onset juvenile rheumatoid arthritis. Of 20 subsequent births, 7 children were healthy, 2 had congenital heart block (CHB) only, 4 CHB and skin rash, and 7 skin rash only. CONCLUSIONS: Future pregnancies should be monitored by serial echocardiograms, given the substantial risk for heart block. Affected children should be observed for later development of a rheumatic disease
    Internet : PM:0011060534

     

28. NJEH CF, SHAW N, GARDNER-MEDWIN JM, BOIVIN CM, SOUTHWOOD TR: Use of quantitative ultrasound to assess bone status in children with juvenile idiopathic arthritis: A pilot study [In Process Citation]. J Clin.Densitom. 2000, 3:251-260.
    Organism:Department of Nuclear Medicine, Queen Elizabeth Hospital, Birmingham, UK
    Abstract: Periarticular osteoporosis around inflammed joints and generalized osteoporosis have been shown to be markers of disease activity and severity in children with juvenile idiopathic arthritis (JIA). Bone mineral density (BMD) in adults can be assessed precisely by dual X-ray absorptiometry (DXA), but this technique has not been used widely in children. Quantitative ultrasound (QUS) may provide an alternative method for assessment of bone status. The aim of this pilot study was to compare QUS to DXA in assessing generalized osteoporosis in a cohort of patients JIA. Twenty-two Caucasian children (15 females, 7 males) with JIA of duration 19-142 months (mean 71 mo) and age 7-17 yr were recruited. Total body and lumbar spine BMD and bone mineral content (BMC) were measured by DXA using standard procedures on a Lunar DPX-L scanner. QUS was performed using Myriad SoundScan 2000. Speed of sound (SOS) was measured at the right midtibia. The DXA results were compared to QUS using linear regression analysis. Spine and total body BMD measured by DXA correlated significantly with tibia SOS (spine: r = 0.57, p < 0.007; total body: r = 0.68, p < 0.001). Spine BMC was similarly related to SOS as BMD (r = 0.58, p < 0.007). Individual patient weight and height were strong predictors of BMD, but only moderate predictors of SOS. The mean spine BMD was lower in the JIA patients compared to the normal ranges (mean Z-score of -1.19). BMD Z-scores were negatively associated with disease duration. Patients taking steroids were associated with lower Z-scores. In conclusion, SOS shows a significant correlation with BMD as measured by DXA, albeit with wide 95% confidence intervals in this small pilot study. QUS was also well tolerated and was technically easy to perform in these children. With the added advantage that it is free from radiation risk, further assessment of this potentially valuable tool for measuring bone status in children is warranted
    Internet : PM:0011090232

     

29. PICCO P, BUONCOMPAGNI A: An update about the treatment of the rheumatic disorders in childhood. Gaslini 2000, 32:171-183.
    Organism:P. Picco, Divisione Pediatria 2, Istituto Giannina Gaslini, l.go G Gaslini 5, 16148 Genova
    Abstract: The improved knowledges about the basis of the immunopathology and immunogenetics of the rheumatic disorders have led to achieve an actual amelioration of their prognosis. It is worth noting that only the strict cooperation between the paediatric-rheumatologist with other specialists such as physiatrics, physiokinotherapists, orthopeadics, oculists, nephrologists, gastroenterologists may represent the basis for this task. The activities of these specialist is aimed to reduce the pain and the inflammation both articular and systemic. The organization of multicentre trials to assess the efficacy of the drugs used, leads the possibility to purpose non-conventional therapeutic strategies. As regards the oligoarticular-onset form of juvenile idiopathic arthritis (JIA), the intra-articular injection of longterm steroids has assumed a therapeutic pivotal role. This procedure was not frequently used in childhood until few years ago. Nowadays its therapeutic effectiveness and the employment of anhestetic cream or drugs inducing a pharmacological amnesia leads this procedure more easy to perform in children. In these latter years new non steroidal anti-inflammatory drugs (NSAID) with a selective action only on cyclooxigenase-2 (anti COX-2) are available. These drugs will decrease the NSAID side effects on gastro-intestinal system and kidney. Furthermore the use of steroids in these patients has been recently critically reviewed. As regard the systemic and the polyarthicular onset JIA, it is of note that: 1. selected NSAID are used in order to avoid the life threatening macrophage activation syndrome; 2. combinate treatment using 2 or more disease modificatory anti-rheumatic disease (DMARD) are employed; 3. new recumbinant molecules which are able to neutralize some cytokine involved into inflammatory synovial disease are purposed as a new way to treat poly-JIA; 4. some experimental model of genetic therapy are on assay; although few data are available in vivo, they represent a further possibility of treatment. A very intriguing field of research is the treatment of seronegative spondyloarthropathies (SpA) with gastrointestinal involvement using polymeric diet regimen. Lyme disease is due to the infection of Borrelia burgorferii. Only in these latter years a treatment with antibiotics has been validated: moreover it is available a recombinant vaccine to use in endemic regions for this disease. The treatment of thrombosis in patients affected with systemic lupus erytematosus (SLE) or antiphospholipid primary syndrome (APS) is based upon low molecular weight heparin and then, in chronic phase on warfarin. The treatment has to be prolonged up to 6 months. Steroids are poor effective and no validated studies are available about immunosuppressive drugs

     

30. PRAHALAD S, RYAN MH, SHEAR ES, THOMPSON SD, GLASS DN, GIANNINI EH: Twins concordant for juvenile rheumatoid arthritis [In Process Citation]. Arthritis Rheum 2000, 43:2611-2612.
    Organism:Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH, USA
    Internet : PM:0011083290

     

31. PRAHALAD S, RYAN MH, SHEAR ES, THOMPSON SD, GLASS DN, GIANNINI EH: Twins concordant for juvenile rheumatoid arthritis. Arthritis And Rheumatism 2000, 43:2611-2612.
    Organism:Dr. S. Prahalad, Children's Hospital Medical Center, Univ. of Cincinnati College of Med., Cincinnati, OH

     

32. RAPACKA E, OSTROWSKA-NAWARYCZ L, BASZCZYNSKI J, KUDZIN A, MAKOWSKI M, MAKOWSKA J, KUDZIN J, GORSKI P: [In Process Citation]. Pol.Merkuriusz.Lek. 2000, 9 Suppl 1:27-28.
    Organism:Katedry Pediatrii WAM w Lodzi
    Abstract: The aim of the study was to assess the frequency of renal complications and also evaluation of renal efficiency with regard to sex and age in children with inflammatory connective tissue diseases. The examination embraced 18 children out of 5657 hospitalised in 19991-1998 in Military University School of Medicine-Dpt of Pediatrics suffering from inflammatory connective tissue diseases, which constitutes 0.32%. They found the following number of isolated cases: 9 cases of juvenile chronic arthritis (JCA), 6 cases of rheumatic fever (RF), and 3 cases of systemic lupus erythematosus (SLE). There were 9 girls and 9 boys. The most frequent symptom of kidneys affection was erythrocyturia. Due to chronic course, reccurrence and the possibility of further complications, children with inflammatory connective tissue diseases, after discharging from hospital, should stay under the care of rheumatological outpatient clinic
    Internet : PM:0011081339

     

33. REICHENBERGER C: [Care of chronically ill children, demonstrated on a case of chronic juvenile arthritis] [In Process Citation]. Kinderkrankenschwester. 2000, 19:311-313.
    Organism:Kinderkrankenschwester in der Kinderklinik und Rheumaklinik fur Kinder und Jugendliche, Garmisch-Partenkirchen
    Internet : PM:0011096828

     

34. RUPERTO N, MARTINI A: The importance of clinical trials for the paediatric rheumatic diseases: Organisation, methodological and ethical problems. Gaslini 2000, 32:165-170.
    Organism:A. Martini, IRCCS Policlinico S. Matteo, Clinica Pediatrica - PRINTO, p.le Golgi 2, 27100 Pavia
    Abstract: The paediatric rheumatic diseases are rare condition associated with important sequelae on the quality of life of these children. The research aimed at studying new therapeutic approaches is difficult because of organisation, methodological and ethical problems. To face these problems in May 1996 it was founded an international research network called 'Paediatric Rheumatology International Trials Organisation - PRINTO' with the goal to promote, facilitate and conduct high quality research in the paediatric rheumatic diseases. PRINTO is composed of 4 main vertical structures: the Advisory Council, the international co-ordinating centre located in Pavia, Italy, one national co-ordinator in each country, and 140 centres (hospitals and/or Universities) in 32 countries worldwide. PRINTO is now conducting the following studies all financed by the European Community: 1. Methotrexate in medium versus higher doses in juvenile chronic arthritis (JCA): a total of 340 patients have been enrolled in the screening phase with 42 patients randomised to higher dose of MTX. 2. Quality of life project in the JCA with the cross-cultural adaptation and validation of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ) with more than 4000 patients collected from 32 countries. 3. Core-set of outcome measures and definition of improvement for juvenile systemics lupus erythematosus and juvenile dermatomyositis. This international network represents a powerful tool to investigate future treatment in the paediatric rheumatic diseases
    Internet : amartini@smatteo.pv.it

     

35. SPENCER-GREEN G: Etanercept (Enbrel): Update on therapeutic use. Annals of the Rheumatic Diseases 2000, 59:i46-i49
    Organism:Dr. G. Spencer-Green, Immunex Corporation, 51 University Street, Seattle, WA 98101
    Abstract: Tumour necrosis factor (TNF) is an important inflammatory disease mediator in a wide spectrum of articular diseases, including adult and juvenile rheumatoid arthritis (RA, JRA). Etanercept (Enbrel), approved in the United States and in Europe for use in patients with RA and JRA, is an effective inhibitor of TNF that has been shown to provide rapid and sustained improvement in both of these diseases. Long term studies continue to show that etanercept controls signs and symptoms of RA and JRA with no change in rate or type of adverse event over time. To demonstrate that etanercept is effective as first line treatment for patients with early active RA who have not been previously treated with methotrexate, and to examine the effect of etanercept on radiographic progression, a double blind, placebo controlled study was recently conducted, comparing etanercept with methotrexate (median dose 20 mg per week). Both etanercept 25 mg twice weekly and rapidly escalated methotrexate were effective in reducing the signs and symptoms of RA, and etanercept was significantly better than methotrexate in slowing the rate of radiographic erosions. In patients with severe psoriatic arthritis (PsA), a double blind, placebo controlled study demonstrated that etanercept was also effective in reducing disease activity in PsA. Etanercept has been well tolerated in all of these clinical trials and offers an important new treatment option to patients with inflammatory articular diseases
    Internet : spencerg@immunex.com

     

36. SPIEGEL LR, SCHNEIDER R, LANG BA, BIRDI N, SILVERMAN ED, LAXER RM, STEPHENS D, FELDMAN BM: Early predictors of poor functional outcome in systemic-onset juvenile rheumatoid arthritis: a multicenter cohort study [In Process Citation]. Arthritis Rheum 2000, 43:2402-2409.
    Organism:The Hospital for Sick Children, University of Toronto, Ontario, Canada
    Abstract: OBJECTIVE: To examine the ability of a previously described set of criteria to predict poor functional outcome in a large, multicenter cohort of children with systemic-onset juvenile rheumatoid arthritis (JRA). METHODS: All children who were diagnosed with systemic-onset JRA since 1980 at the Hospital for Sick Children (Toronto), since 1983 at the Isaac Walton Killam Hospital for Children (Halifax), and since 1981 at the Children's Hospital of Eastern Ontario (Ottawa) were evaluated. Patients were included in the study if they had been evaluated clinically within 6 months of diagnosis and had been followed up for at least 2 years. Patients were divided into 4 cohorts according to their length of followup: 2-4 years, 4-7 years, 7-10 years, and >10 years. Using previously described criteria for destructive arthritis in children with systemic-onset JRA, the patients were classified as either high risk or low risk for poor functional outcome based on the data from their 6-month visit. High-risk patients had active systemic disease (persistent fever or corticosteroid requirement for control of systemic disease) and a platelet count > or =600 x 10(9)/liter. Poor outcome was defined as moderate or severe disability (defined as a score of > or =0.75 on the Childhood Health Assessment Questionnaire) or disease-associated death. RESULTS: Among 122 eligible patients with systemic-onset JRA, we were able to contact 111 (91%) for outcome data. The mean followup period was 7.7 years (SD 3.7). The mean age at outcome assessment was 13.5 years (SD 5.3). There were 51 boys and 60 girls. Twenty-four patients (22%) had moderate-to-severe disability and 2 patients died; these 26 patients were considered to have had a poor outcome. We could determine risk classification for 104 patients. Twenty-four patients (23%) met the criteria for high risk at the 6-month visit. Overall, the risk of a poor functional outcome was significantly higher in the high-risk group (relative risk 3.3, 95% confidence interval [95% CI] 1.73-6.43, P = 0.0004). This risk was most marked in the cohort with > 10 years of followup (relative risk 4.3, 95% CI 1.82-10.29, P = 0.006). CONCLUSION: The presence of active systemic disease at 6 months, as characterized by fever or the need for corticosteroids, and thrombocytosis strongly predicted the development of a poor functional outcome in these patients. This was especially apparent with longterm followup. Our study validates the previously developed prognostic criteria for systemic-onset JRA
    Internet : PM:0011083261

     

37. SVENSSON B, ADELL R, KOPP S: Temporomandibular disorders in juvenile chronic arthritis patients. A clinical study [In Process Citation]. Swed.Dent.J 2000, 24:83-92.
    Organism:Department of Oral & Maxillofacial Surgery, Orebro Medical Centre Hospital, Sweden
    Abstract: In a prospective study, 105 children with juvenile chronic arthritis (JCA) were clinically and radiographically examined. The aim was to investigate the distribution of symptoms and clinical signs of temporomandibular disorders and to study correlations with radiographic mandibular condylar lesions. The present material appeared to be a representative sample of Swedish JCA children with respect to the distribution of genders and JCA subtypes as well as the peak of onset of the disease. Symptoms from the masticatory system were common (26%) and pain at mandibular function and stiffness at mouth opening the most frequent ones. Restricted maximal voluntary mouth opening (MVM) was the most frequent clinical finding. Radiographic condylar lesions, frequently found in the present material (39%), were significantly correlated with postnormal occlusion, restricted MVM, anterior open bite and mandibular retrognathia. However, most of the JCA children with radiographic condylar lesions did not present with symptoms from the masticatory system, postnormal occlusion, restricted MVM, anterior open bite or mandibular retrognathia
    Internet : PM:0011061206

     

38. TAUBERT H, THAMM B, MEYE A, BARTEL F, ROST AK, HEIDENREICH D, JOHN V, BRANDT J, BACHE M, WURL P, SCHMIDT H, RIEMANN D: The p53 status in juvenile chronic arthritis and rheumatoid arthritis [In Process Citation]. Clin.Exp.Immunol 2000, 122:264-269.
    Organism:Institute of Pathology, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany helgetaubert@medizinuni-hallede
    Abstract: The aim of this study was to investigate the p53 status in two autoimmune diseases; juvenile chronic arthritis (JCA) and rheumatoid arthritis (RA). In a PCR-sequencing analysis of exons 4-9 of the p53 gene, no mutation was identified, except for the case of an RA synovectomy sample with two mutations of intron 7. p53 gene polymorphisms for codons 36, 47, and 213 were not detected. Codon 72 polymorphism showed an indication of an increased occurrence of the Pro/Pro allelotype in JCA. Expression of P53 protein was comparable for JCA and RA synovectomy samples. For all RA samples P53 protein was detectable, whereas one sample of a JCA patient failed to express P53 protein
    Internet : PM:0011091284

     

39. TYNDALL A, GRATWOHL A: Immune ablation and stem-cell therapy in autoimmune disease: Clinical experience. Arthritis Res 2000, 2:276-280.
    Organism:University of Basel, Basel, Switzerland alantyndall@fps-baselch
    Abstract: In the past 5 years, around 350 patients have received haematopoietic stem cell (HSC) transplantation for an autoimmune disease, with 275 of these registered in an international data base in Basel under the auspices of the European League Against Rheumatism (EULAR) and the European Group for Blood and Marrow Transplantation(EBMT). Most patients had either a progressive form of multiple sclerosis (MS; n = 88) or scleroderma (now called systemic sclerosis; n = 55). Other diseases were rheumatoid arthritis (Ra n = 40), juvenile idiopathic arthritis (JIA; n = 30), systemic lupus erythematosus (SLE; n = 20), idiopathic thrombocytopenic purpura (ITP; n = 7) and others. The procedure-related mortality was around 9%, with between-disease differences, being higher in systemic sclerosis and JIA and lower in RA (one death only). Benefit has been seen in around two-thirds of cases. No one regimen was clearly superior to another, with a trend toward more infectious complications with more intense regimens. Prospective, controlled randomized trials are indicated and being planned
    Internet : PM:0011094441

     

40. VARBANOVA B: Clinical associations of class-specific rheumatoid factors in children with pauciarticular and polyarticular form of juvenile chronic arthritis. Rheumatology 2000, 8:43-48.
    Organism:Dr. B. Varbanova, Department of Pediatrics, Medical University, 55, Marin Drinov Str., Bg - 9002 Varna
    Abstract: The objective of this study was to establish clinical associations of the class-specific rheumatoid factors (IgG-, IgA- and IgM-RF) detected in children with pauciarticular and polyarticular form of juvenile chronic arthritis (JCA). We studied 79 patients with JCA in the age range from 1.5 to 18 years and the disease duration range from 4 months to 17 years. Thirty-one children had polyarticular form and 48 - pauciarticular form of the disease. Four patients had positive Waaler-Rose agglutination test. The class-specific rheumatoid factors have been tested by ELISA. We used the following clinical indices: disease form, duration, activity, age at onset, radiological progression and the patient's age. Our results showed insignificant prevalence of IgG-RF in JCA with no significant clinical associations. IgA-RF was significantly elevated in the polyarticular form (p = 0.0028), polyarticular course of the disease (p = 0.0074) and erosive arthritis (p = 0.046). IgM-RF was significantly associated with polyarticular form (p = 0.02), polyarticular course (p < 0.007) and erosive arthritis (p = 0.007). No significant associations with the disease duration, activity, age at onset and patients' age have been found

     

41. VERROTTI A, CIERI F, PELLICCIA P, MORGESE G, CHIARELLI F: Lack of association between antiphospholipid antibodies and migraine in children. International Journal of Clinical & Laboratory Research 2000, 30:109-111.
    Organism:Department of Pediatrics, University of Chieti, Chieti Italy
    Abstract: Anticardiolipin antibodies are found frequently in those suffering from migraine, but it is not clear if this association is real or coincidental. Moreover, there are no data on the prevalence of anticardiolipin antibodies in children. In this study, 40 patients were divided into two groups according to the type of migraine: group I included 22 cases (15 females and 7 males, mean age+-SD 13.7+-8.9 years) suffering from migraine with and without aura; group II consisted of 18 children (10 females and 8 males, age 14.7+-6.9 years) having migraine with prolonged aura or migrainous infarction, also called complicated migraine. We studied two groups of children as controls: a group of 35 children (25 females and 10 males, mean age 13.9+-7.1 years) with juvenile chronic arthritis (group III) and a group of 40 healthy sex- and age-matched children who did not suffer from migraine or any other neurological disease (group IV). No statistically significant differences in levels of anticardiolipin antibodies were found between group I and II and controls. Our data demonstrate that, in children with migraine, anticardiolipin antibodies are not more frequent than in healthy controls, and suggest that anticardiolipin antibodies are not implicated in the pathogenesis of migraine