Bibliography January 2001- AL MATAR MJ, CABRAL DA, PETTY RE: Isolated tuberculous monoarthritis mimicking oligoarticular juvenile rheumatoid arthritis. J.Rheumatol. 2001, 28:204-206.
Organism:Department of Pediatrics, University of British Columbia, Vancouver, Canada
Abstract: Isolated monoarthritis caused by Mycobacterium tuberculosis in the absence of clinical pulmonary disease is extremely rare in North America. After decades of consistent declines in incidence, a remarkable resurgence of tuberculosis (TB) is occurring in North America. It must always be considered in the differential diagnosis of chronic monoarthritis if devastating sequelae are to be avoided. We describe 2 cases of tuberculous arthritis in young children presenting with monoarthritis of the knee. The presumptive diagnosis in each case was oligoarticular onset juvenile rheumatoid arthritis (JRA). Each had an atypical course for JRA, with lack of response to intraarticular corticosteroid. The diagnosis of TB arthritis was made only with synovial biopsy
Internet : PM:11196526 - ARSLAN D, KUYUCU T, KENDIRCI M, KURTOGLU S: Celiac disease and Turner's syndrome: Patient report. Journal of Pediatric Endocrinology and Metabolism 2000, 13:1629-1631.
Organism:D. Arslan, Erciyes University, Faculty of Medicine, Department of Pediatrics, Talas Yolu, 38039 Kayseri
Abstract: Turner's syndrome is a chromosomal disease frequently associated with autoimmune disorders including thyroid disease, inflammatory bowel disease, diabetes mellitus and juvenile rheumatoid arthritis. Recent reports have described an association of celiac disease with Turner's syndrome. We present an additional patient with Turner's syndrome associated with celiac disease. A girl aged 15-7/12 yr was seen for the complaints of delayed growth and puberty, abdominal pain and chronic diarrhea. She was diagnosed as having celiac disease and a glutenfree diet was initiated. Despite one year of strict diet no signs of puberty were observed. She was then evaluated again for absence of puberty, and 45,XO karyotype Turner's syndrome was diagnosed
Internet : duranarslan@yahoo.com - DE SILVA B, BANNEY L, UTTLEY W, LUQMANI R, SCHOFIELD O: Pseudoporphyria and nonsteroidal antiinflammatory agents in children with juvenile idiopathic arthritis. Pediatric Dermatology 2000, 17:480-483.
Organism:B. De Silva, 17 Grove Place, London NW3 1JP
Abstract: Pseudoporphyria is characterized by erythema, blistering, and scarring on sun-exposed skin. Nonsteroidal antiinflammatory drugs (NSAIDs) are implicated in the etiology of this condition. In a 1-year prospective study of children attending the pediatric rheumatology clinic in Edinburgh we found a prevalence of pseudoporphyria of 10.9% in children taking NSAIDs for juvenile idiopathic arthritis. Naproxen was the most commonly implicated NSAID, independent of dosage. Blue/gray eye color was an independent risk factor for the development of pseudoporphyria. We would advise caution in prescribing naproxen in these children to prevent disfiguring facial scarring - DIAZ CJ: The psychosomatic family model: A study in families of children with juvenile rheumatoid arthritis. Psiquis 2000, 21:25-32.
Organism:Dr. J. Diaz Curiel, C/ Herrnosilla, 84-3 E, E-28001 Madrid
Abstract: We review the psychological features of juvenile rheumatoid arthritis (JRA) and choose the influence that disease perfome over the parents of patients. We have analysed the family characteristic of patients suffering from chronic medical or psychosomatic diseases and specially those with JRA and the influence of this disese in parents and brothers
Internet : jdiazcum@correo.cop.es - FALKENBACH A: Speleotherapeutic radon exposure of a child suffering from juvenile chronic arthritis. Journal of Alternative and Complementary Medicine 2000, 6:551-552.
Organism:Dr. A. Falkenbach, Gasteiner Heilstollen Hospital, A-5645 Bad Gastein-Bockstein
Abstract: Objective: Should a child be exposed to radon for therapeutic purposes? Case Report: We report on a 7-year-old boy with juvenile chronic arthritis who experienced good pain relief after therapeutic radon exposure. Discussion: Controversy exists whether children should be exposed to radon for therapeutic purposes. Benefit and risk of therapeutic radon exposure should be discussed more objectively and not emotionally - HII CS, MARIN LA, HALLIDAY D, ROBERTON DM, MURRAY AW, FERRANTE A: Regulation of human neutrophil-mediated cartilage proteoglycan degradation by phosphatidylinositol-3-kinase. Immunology 2001, 102:59-66.
Organism:Department of Immunopathology, Women's and Children's Hospital, 72 King William Road, North Adelaide, South Australia 5006, Australia
Abstract: The ability of neutrophils to degrade cartilage proteoglycan suggests that the neutrophils that accumulate in the joints of rheumatoid arthritis patients are mediators of tissue damage. The regulatory mechanisms which are relevant to the proteoglycan-degrading activity of neutrophils are poorly understood. Since phosphatidylinositol 3-kinase (PI3-K), protein kinase C (PKC), the extracellular signal-regulated protein kinase (ERK)1/ERK2 and cyclic adenosine monophosphate (cAMP) have been reported to regulate neutrophil respiratory burst and/or degranulation, a role for these signalling molecules in regulating proteoglycan degradation was investigated. Preincubation of human neutrophils with GF109203X (an inhibitor of PKC), PD98059 (an inhibitor of MEK, the upstream regulator of ERK1/ERK2) or with forskolin or dibutyryl cAMP, failed to suppress proteoglycan degradation of opsonized bovine cartilage. In contrast, preincubation of neutrophils with wortmannin or LY294002, specific inhibitors of PI3-K, inhibited proteoglycan degradation. Incubation of neutrophils with cartilage resulted in the activation of PI3-K in neutrophils, consistent with a role for PI3-K in proteoglycan degradation. Activation of PI3-K and proteoglycan degradation was enhanced by tumour necrosis factor-alpha. Degradation caused by neutrophils from the synovial fluid of rheumatoid arthritis patients was also inhibited by wortmannin. These data demonstrate that the proteoglycan degradative activity of neutrophils required PI3-K but not PKC or the ERK1/ERK2/ERK5 cascades and was insensitive to increases in intracellular cAMP concentrations
Internet : PM:11168638 - KRISTENSEN K, NIELSEN S, PEDERSEN FK, ZAK M: Erythrocyte-methotrexate and disease activity in children treated with oral methotrexate for juvenile chronic arthritis. Scandinavian Journal Of Rheumatology 2000, 29:187-189.
Organism:K. Kristensen, Paediatric Clinic 2, Juliane Marie Centre, Natl. Univ. Hospital Rigshospitalet, Blegdams-vej 9, DK-2100 Copenhagen O
Abstract: The concentration of methotrexate (MTX) in erythrocytes (E-MTX) was measured twice with three months interval in 21 children suffering from juvenile chronic arthritis (JCA). At the same time joint score, visual analogue scale (VAS), and laboratory parameters (CRP, WBC, PMNs, and ALAT) were obtained. There was only a weak insignificant correlation between the dose of MTX/mSUP2 and E-MTX (r=0.24, p=0.11). No significant relations between the clinical or laboratory parameters and E-MTX was found. However, ALAT above normal range was associated with a lower dose of MTX (p=0.02) and lower VAS (p=0.02), indicating that toxicity may be associated with less articular discomfort. At present we consider routine determination of E-MTX in children with JCA of limited value - LOVELL DJ, PASSO M, GIANNINI E, BRUNNER H: Systemic onset juvenile idiopathic arthritis: a retrospective study of 80 consecutive patients followed for 10 years. J.Rheumatol. 2001, 28:220
Internet : PM:11196535 - PAIKOS P, FOTOPOULOU M, PAPATHANASSIOU M, CHOREFTAKI P, SPYROPOULOS G: Cataract surgery in children with uveitis. J.Pediatr.Ophthalmol.Strabismus 2001, 38:16-20.
Organism:Ophthalmology Department, Agia Sofia Children's Hospital, Athens, Greece
Abstract: PURPOSE: To report the technique and postoperative results of cataract surgery in children with uveitis. METHOD: Between 1988 and 1998, nine children (age range: 2.5-11 years) who developed secondary uveitic cataract and underwent cataract extraction were studied retrospectively. Seven children had juvenile rheumatoid arthritis and two had chronic anterior uveitis of unknown etiology. The surgical technique was lensectomy and wide anterior vitrectomy with limbal approach, lysis of anterior synechiae and in some cases, peripheral iridectomy. Postoperative aphakia was corrected with soft contact lenses in all patients. Follow-up ranged from 6 months to 6 years. RESULTS: Postoperatively, visual acuity in all patients improved and final visual acuity ranged from 20/70 to 20/25. Significant intraoperative complications did not occcur in any patient. One boy with juvenile rheumatoid arthritis developed cystoid macular edema 1 month postoperatively, which was successfully managed. He also developed hypertonia 1 year later, which was also successfully managed. Seven of the nine children had fewer and milder relapses of uveitis after surgery. CONCLUSION: Cataract surgery, using the lensectomy-vitrectomy technique in children with uveitis, is a safe technique with a relatively small percentage of postoperative complications and good functional results
Internet : PM:11201912 - PAY S, DINC A, SIMSEK I, CAN C, ERDEM H: Sulfasalazine-induced angioimmunoblastic lymphadenopathy developing in a patient with juvenile chronic arthritis. Rheumatol.Int. Berlin 2000, 20:25-27.
Organism:S. Pay, GATA Romatoloji Bilim Dah, Etlik, 06010 Ankara
Abstract: We describe a patient with juvenile chronic arthritis who developed reactive angioimmunoblastic lymphadenopathy, induced by sulfasalazine. Development of angioimmunoblastic lymphadenopathy although rare, is a very serious side effect of sulfasalazine treatment, and patients treated with this drug should be watched carefully
Internet : isimsekl@yahoo.com - RAUZ S, MURRAY PI, SOUTHWOOD TR: Juvenile idiopathic arthritis and uveitis: The classification conundrum. Eye 2000, 14:817-820.
Organism:S. Rauz, Academic Unit of Ophthalmology, Birmingham and Midland Eye Centre, City Hospital NHS Trust, Dudley Road, Birmingham B18 7QU
Internet : S.Rauz@bham.ac.uk - SANDERS BM, WEST KW, GINGALEWSKI C, ENGUM S, DAVIS M, GROSFELD JL: Inflammatory pseudotumor of the alimentary tract: Clinical and surgical experience. Journal of Pediatric Surgery 2001, 36:169-173.
Organism:Dr. K.W. West, J.W. Riley Hospital for Children, 702 Barnhill Dr, Indianapolis, IN 46202
Abstract: Background/Purpose: Initially described in 1937, inflammatory pseudotumor (IPT) inflammatory myofibroblastic tumor (IMT) or plasma cell granulomas are synonymous for an inflammatory solid tumor that contains spindle cells, myofibroblasts, plasma cells, and histocytes. Common sites of presentation include lung, mesentary, liver, and spleen; intestinal presentations are rare, and the etiology remains obscure. This report details the clinical and surgical experiences in 4 children with alimentary tract IPT at a single institution. Methods: A retrospective chart review was conducted of pediatric patients with the pathologic diagnosis of IPT. Results: Between 1990 and 1999, 4 patients (4 girls, ages 5 to 15 years) were identified with gastrointestinal tract origins of IPT. Symptoms at presentation included anemia (n = 4), intermittent abdominal pain (n = 3), fever (n = 3), weight loss (n = 2), diarrhea (n = 2), dysphagia (n = 1). Two patients had comorbid conditions of juvenile rheumatoid arthritis and mature B cell lymphoma. Three of 4 patients had elevated sedimentation rates. The sites of origin were the gastro-esophageal junction, the colon, the rectum, and the appendix, with the referral diagnosis achalasia, perforated appendix, inflammatory bowel disease, and recurrent lymphoma, respectively. All were treated with aggressive surgical resection, and 3 girls have had no recurrences since the initial surgery. One patient had 3 recurrences within 8 months of presentation; she remains disease free 8 years later. Conclusions: IPT, although rare in the gastrointestinal tract, mimics more common problems. Successful surgical management is possible even in cases of multiple recurrences. Copyright (c) 2001 by W.B. Saunders Company - SANDERS BM, WEST KW, GINGALEWSKI C, ENGUM S, DAVIS M, GROSFELD JL: Inflammatory pseudotumor of the alimentary tract: clinical and surgical experience. J.Pediatr.Surg. 2001, 36:169-173.
Organism:Section of Pediatric Surgery and Pediatric Pathology, Indiana University School of Medicine and JW Riley Hospital for Children, Indianapolis, IN
Abstract: BACKGROUND/PURPOSE: Initially described in 1937, inflammatory pseudotumor (IPT) inflammatory myofibroblastic tumor (IMT) or plasma cell granulomas are synonymous for an inflammatory solid tumor that contains spindle cells, myofibroblasts, plasma cells, and histocytes. Common sites of presentation include lung, mesentary, liver, and spleen; intestinal presentations are rare, and the etiology remains obscure. This report details the clinical and surgical experiences in 4 children with alimentary tract IPT at a single institution. METHODS: A retrospective chart review was conducted of pediatric patients with the pathologic diagnosis of IPT. RESULTS: Between 1990 and 1999, 4 patients (4 girls, ages 5 to 15 years) were identified with gastrointestinal tract origins of IPT. Symptoms at presentation included anemia (n = 4), intermittent abdominal pain (n = 3), fever (n = 3), weight loss (n = 2), diarrhea (n = 2), dysphagia (n = 1). Two patients had comorbid conditions of juvenile rheumatoid arthritis and mature B cell lymphoma. Three of 4 patients had elevated sedimentation rates. The sites of origin were the gastroesophageal junction, the colon, the rectum, and the appendix, with the referral diagnosis achalasia, perforated appendix, inflammatory bowel disease, and recurrent lymphoma, respectively. All were treated with aggressive surgical resection, and 3 girls have had no recurrences since the initial surgery. One patient had 3 recurrences within 8 months of presentation; she remains disease free 8 years later. CONCLUSIONS: IPT, although rare in the gastrointestinal tract, mimics more common problems. Successful surgical management is possible even in cases of multiple recurrences. J Pediatr Surg 36:169-173. Copyright 2001 by W.B. Saunders Company
Internet : PM:0011150459 - SAVOLAINEN A, SAILA H, KOTANIEMI K, KAIPIAINEN-SEPPANEN O, LEIRISALO-REPO M, AHO K: Magnitude of the genetic component in juvenile idiopathic arthritis [3]. Annals of the Rheumatic Diseases 2000, 59:1001
Organism:A. Savolainen, Rheumatism Foundation Hospital, 18120 Heinola - SIMONINI G, MATUCCI CM, CIMAZ R, ANICHINI M, CESARETTI S, ZOPPI M, GENERINI S, FALCINI F: Evidence for immune activation against oxidized lipoproteins in inactive phases of juvenile chronic arthritis. J.Rheumatol. 2001, 28:198-203.
Organism:Department of Pediatrics, University of Florence, Italy
Abstract: OBJECTIVE: Oxidative stress contributes to joint inflammation and damage in rheumatoid arthritis. In a mobile inflamed joint, exercise induced multiple cycles of hypoxia-reperfusion injury may lead to the creation of a redox environment in which oxido-reductase systems, by NADPH mechanisms, produce highly reactive chemical species (i.e., oxygen free radicals). We investigated 2 endproducts of lipid peroxidation, malonildialdehyde (MDA) and diene conjugates (DC), and the formation of antibodies against oxidized low density lipoproteins (Ab oxLDL) in juvenile chronic arthritis (JCA), and assessed the role of oxidative phenomena in different phases and subsets of this disease. METHODS: To assess the role of oxidative stress in JCA, we measured the endproducts of lipid peroxidation, MDA and DC, by the increase of absorbance at 586 nm and 234 nm, respectively, and the levels of Ab oxLDL by ELISA in the sera of 58 patients with JCA and 21 healthy controls. Due to crossreactivity between Ab oxLDL and anticardiolipin antibodies (aCL), the sera were also tested by a standard ELISA for IgG-aCL. The patients were divided into 3 subsets: 29 with pauciarticular (pauci), 15 with polyarticular (poly), and 14 with systemic (sys) onset disease, and then were subdivided, according to different variables appropriate to each subset, reflecting active and inactive disease, into 30 active (14 pauci, 8 poly, 8 sys) and 28 inactive (15 pauci, 7 poly, 6 sys). RESULTS: Levels of Ab oxLDL were significantly increased in the whole group of patients (566.6 +/- 263.0 vs 206.6 +/- 136.3 mU/ml; p < 0.001) and in each of the type of onset (pauci 660.8 +/- 272.1, p < 0.001; poly 341.3 +/- 134.7, p < 0.01; sys 497.8 +/- 114.8, p < 0.001) compared to controls. Ab oxLDL were higher in the inactive than in the active group (743.5 +/- 231.9 and 404.4 +/- 169.9; p < 0.001). MDA and DC levels were not increased significantly in patients' sera. No patient was positive for IgG-aCL. CONCLUSION: These findings suggest that MDA and DC cannot be considered major markers of oxidative stress in JCA and that the Ab oxLDL may represent a delayed sign of oxidative stress previously induced by the inflammatory process in patients with JCA
Internet : PM:11196525 - TSE S, LUBELSKY S, GORDON M, AL MAYOUF SM, BABYN PS, LAXER RM, SILVERMAN ED, SCHNEIDER R, FELDMAN BM: The arthritis of inflammatory childhood myositis syndromes. J.Rheumatol. 2001, 28:192-197.
Organism:Department of Pediatrics, Medicine, Immunology, Diagnostic Imaging, and Public Health Sciences, Hospital for Sick Children, University of Toronto, Ontario, Canada
Abstract: OBJECTIVE: Arthritis has been an associated finding in juvenile dermatomyositis (JDM), but its prevalence, course, and response to therapy has not been well described. We investigated the frequency, course, and clinical and radiographic features in a large cohort of patients with JDM. METHODS: The charts of 94 patients with idiopathic myositis (1984-99) were reviewed: 80 JDM, 3 juvenile polymyositis (JPM), 5 amyopathic JDM, and 6 overlap myositis syndromes. Compiled data included demographics, clinical features, a detailed description of the arthritis, investigations (radiographs, autoantibodies), course, and response to therapy. All radiographs were independently reviewed by a single radiologist. RESULTS: Sixty-one percent (95% CI 50-72%) of patients with JDM had arthritis. The arthritis was reported a median 4.5 mo (range -73.6 to 76.6 mo) after the JDM onset. When compared to patients with no arthritis, the occurrence of arthritis was not significantly related to sex, race, positive antinuclear antibody or rheumatoid factor, calcinosis, nodules, vasculitis, or Raynaud's phenomenon. The initial involvement was pauciarticular in 67% and polyarticular in 33%. In the pauci group, asymptomatic knee effusions were the predominant finding (n = 19, 58%), and in 18 patients may have been the result of steroid therapy. Two patients evolved from a pauci onset to a polyarticular course. All responded to therapy (corticosteroids; 47 were taking other medications) with remission of the arthritis within a median of 2.0 mo (range 0.1-64.5 mo). However, the arthritis recurred in 39% as the corticosteroids were tapered. Four patients with JDM eventually required corticosteroid wrist injections, with resolution of the arthritis. The arthritis was nonerosive in all cases. No patient with JPM had arthritis. Three of 5 patients with amyopathic JDM and 4 of 6 with overlap myositis syndrome had a nonerosive polyarthritis. CONCLUSION: Nonerosive arthritis involving the knees, wrists, elbows, and fingers is a frequent manifestation of JDM and other idiopathic childhood myositis. The arthritis is seen early in the course of JDM and often responds to treatment. However, the arthritis may recur with tapering of corticosteroids despite remission of the JDM. In a significant proportion of JDM cases, arthritis is the major sequela and may warrant further medical therapy or intraarticular corticosteroid injections
Internet : PM:11196524 - UHL M, KRAUSS M, KERN S, HERGET G, HAUER MP, ALTEHOEFER C, DARGE K, BERNER R, LANGER M: The knee joint in early juvenile idiopathic arthritis. An ROC study for evaluating the diagnostic accuracy of contrast-enhanced MR imaging. Acta Radiol. 2001, 42:6-9.
Organism:Department of Diagnostic Radiology, University Hospital, Freiburg, Germany
Abstract: PURPOSE: Diagnosis of juvenile idiopathic arthritis (JIA) remains difficult due to unspecific clinical and laboratory findings, especially in early stages of the disease. The purpose of our study was to determine the sensitivity and specificity of MR imaging in diagnosing JIA of the knee joints. MATERIAL AND METHODS: Forty children (3-17 years old) clinically diagnosed with JIA (follow-up > 1 year) of a knee joint and a control group of 40 children with painful knee joints (MR diagnosis: bone bruise of the knee (n = 7), normal knee joint (n = 12), osteomyelitis (n = 6), septic arthritis (n = 2), bone tumor (n = 7) and miscellaneous bone lesions (n = 6)) were examined using a 1.5 T MR unit. T1-weighted spin-echo (SE), T2-weighted fast SE, contrast-enhanced T1-weighted SE and 2D gradient echo sequences were performed. The receiver operating characteristic (ROC) curves evaluation was conducted by 5 independent radiologists. RESULTS: The positive criteria for diagnosing JIA were joint effusions (n = 40), contrast-enhancing synovitis (n = 39), cartilage lesions (n = 15), subchondral erosions and bony destruction (n = 1). Sensitivity and specificity were 93.5% and 92.5%, respectively. Both cases of septic arthritis were misdiagnosed as JIA by all radiologists. CONCLUSION: Contrast-enhanced MR imaging seems to be a highly sensitive tool in establishing the diagnosis of JIA
Internet : PM:11167323