Bibliography March 2001

  1. AGARWAL PK, MISRA M, SARKARI NB, GUPTA AK, AGARWAL P: Usefulness of echocardiography in detection of subclinical carditis in acute rheumatic polyarthritis and rheumatic chorea. J.Assoc.Physicians India 1998, 46:937-938.
    Organism:Dept of Medicine, BRD Medical College, Gorakhpur
    Abstract:     Detailed echocardiographic analysis was performed in 10 children with first episode of acute rheumatic fever who presented with acute rheumatic polyarthritis or rheumatic chorea and had no clinically detectable evidence of active carditis. Significant changes were observed in the form of mitral valve prolapse with regurgitation in 3, aortic valve prolapse with regurgitation in 1 and mitral valve billowing without regurgitation in 1 patient each. A significant (p < 0.001) anterior mitral chordal elongation was observed in both the groups--rheumatic polyarthritis and chorea when compared with age and sex matched control subjects. Mitral annular diameter was found to be increased (p „ 0.001) in patients presenting with polyarthritis alone. These observations of clinically silent but echocardiographically detectable element of carditis forms the basis of how patients of acute rheumatic fever develop permanent valvular deformities in their latter lives without revealing any cardiac affection earlier


    Internet : PM:11229218

  2. CAKMAKCI H, KOVANLIKAYA A, UNSAL E: Short-term follow-up of the juvenile rheumatoid knee with fat-saturated 3D MRI. Pediatr.Radiol. 2001, 31:189-195.
    Organism:H. Cakmakci, Department of Radiology, Dokuz Eylul Univ. Sch. Med., Inciralti Izmir
    Abstract:     Objective. To determine the correlation between clinical status and 3D, fat-saturated contrast-enhanced MRI findings in assessing the response to treatment in patients with knee-joint involvement from juvenile rheumatoid arthritis (JRA). Materials and methods. Synovial hypertrophy, effusion, cartilage and epiphyseal status were scored using spin-echo (SE) T1-weighted, SE T2-weighted and contrast-enhanced, fat-suppressed 3D MRI in 42 knees of 21 patients. MRI findings were evaluated by scoring results and compared with the clinical scoring results. Progression, improvement and equivalence were analysed between 0-3 and 3-6 months, both clinically and by MRI. Results. Fat-suppression imaging generated high contrast between cartilage, synovium, effusion and bone. Correlation coefficients according to progression, improvement and equivalent findings of months 1-3 and months 3-6 comparison of clinical and MRI scores were found to be 0.50 and 0.70, respectively. Conclusion. Contrast-enhanced 3D MRI with fat suppression provides good discrimination between synovial hypertrophy and fluid. Fat-suppressed imaging offers better contrast between cartilage and synovium. Long-term MRI follow-up of JRA improves direct follow-up of pathological changes and helps in modifying treatment regimens


    Internet : cakmakh@egenet.com.tr

  3. CHIKANZA IC, KUIS W, HEIJNEN CJ: The influence of the hormonal system on pediatric rheumatic diseases. Rheumatic Disease Clinics of North America 2000, 26:911-925.
    Organism:Bone and Joint Research Unit, St Bartholomew and Royal London Hospital School of Medicine and Dentistry New Science Building, Charterhouse Square, London, EC1M 6BQ: i.c.chikanza@mds.qmw.uk UK

  4. CUNNINGHAM ET, Jr.: Uveitis in children. Ocular Immunology and Inflammation 2000, 8:251-261.
    Organism:Dr. E.T. Cunningham Jr., Uveitis Service, Pearl/SJ Kimura Ocular Immunol. Lab., Francis I. Proctor Foundation, San Francisco, CA 94143-0944
    Abstract:     Purpose: To summarize the prevalence and patterns of uveitis in children. Methods: Pertinent articles were reviewed. Results: Children constitute 5-1O% of the patients with uveitis seen at tertiary referral centers, and girls appear to develop uveitis slightly more frequently than boys. Among all children with intraocular inflammation, anterior uveitis accounts for 30-40%, posterior uveitis accounts for 40-50%, intermediate uveitis accounts for 10-20%, and diffuse uveitis accounts for 5-10%. The most common cause of anterior uveitis is juvenile idiopathic arthritis (JIA), whereas the most frequent type of posterior uveitis is toxoplasmic retinochoroiditis. Most cases of intermediate and diffuse uveitis are bilateral, chronic, and idiopathic. The most common causes of vision loss in children with uveitis are cataract, band keratopathy, glaucoma, and cystoid macular edema. Up to one-third of the children with uveitis are left with severely impaired vision as a result of these complications. Conclusions: Uveitis is an important cause of ocular morbidity in children. Prompt diagnosis and treatment is essential to minimize the risk of long-term vision loss


    Internet : emmett@itsa.ucsf.edu

  5. FANTINI F: Classification of chronic arthritides of childhood (juvenile idiopathic arthritis): Criticisms and suggestions to improve the efficacy of the Santiago-Durban criteria [3]. Rinsho Ganka 2001, 28:456-459.
    Organism:Dr. F. Fantini, Gaetano Pini Institute, University of Milan, Milano

  6. FRENCH AR, MASON T, NELSON AM, O'FALLON WM, GABRIEL SE: Increased mortality in adults with a history of juvenile rheumatoid arthritis: a population-based study. Arthritis Rheum. 2001, 44:523-527.
    Organism:Mayo Clinic, Rochester, Minnesota, USA
    Abstract:     OBJECTIVE: To assess mortality in a population-based cohort of adults with a history of juvenile rheumatoid arthritis (JRA). METHODS: The Rochester Epidemiology Project database was used to identify all cases of JRA diagnosed among Rochester, Minnesota residents under the age of 16 between January 1, 1960 and December 31, 1993. Fifty-seven patients in this cohort are now adults (ages 18-53 years, mean age 34.3 years), and this subgroup was contacted for a long-term followup study. The average length of followup from the time of diagnosis was 25.6 years. RESULTS: Four deaths occurred in this cohort of 57 adults with a history of JRA. All 4 deceased patients had other autoimmune illnesses and died of complications of these diseases. The observed frequency of 4 deaths was significantly greater (P < 0.0026 by one-sample log-rank test) than the 1 death that would be expected among Minnesota whites of similar age and sex, and corresponds to a mortality rate of 0.27 deaths per 100 years of patient followup compared with an expected mortality rate of 0.068 deaths per 100 years of followup in the general population. CONCLUSION: The results indicate a significant, unexpected increase in mortality in this population-based cohort of adults with a history of JRA in comparison with the rate in the general population. The deaths in this group were all associated with other autoimmune disorders, suggesting that special emphasis should be given to the diagnosis and treatment of other autoimmune diseases, including immunodeficiencies, in JRA patients. The frequency of deaths in this cohort suggests that JRA patients are at substantial risk for mortality, and highlights the need for longitudinal followup and care into adulthood


    Internet : PM:11263765

  7. GARCIA-CONSUEGRA MJ, TAPIA MR, ABELAIRAS GJ, PERALTA CJ, MERINO MR: [Uveitis and juvenile idiopathic arthritis]. An.Esp.Pediatr. 2001, 54:255-259.
    Organism:Unidad de Reumatologia PediatricaHospital Universitario La Paz Madrid reumped@hulpes
    Abstract:     OBJECTIVE: Anterior uveitis is one of the most important extra-articular manifestations of juvenile idiopathic arthritis (JIA). The objective was to analyze the frequency of uveitis in patients with JIA and to describe its clinical and evolutive characteristics. PATIENTS AND METHOD: Among the 234 children diagnosed with JIA in our hospital, those presenting uveitis were studied. RESULTS: Seventeen children, 16 girls and 1 boy, presented uveitis in 28 eyes, representing a prevalence of 7.3%. Among patients with p


    Internet : PM:11262254

  8. HUEMER C, HUEMER M, FALGER J: JIA-Juvenile idiopathic arthritis: On the care of children and young people with chronic arthritis in Austria. Paediatrie & Paedologie 2000, 35:11-15.
    Organism:Univ.-Klinik fur Kinder- und Jugendheilkunde, Wien Austria

  9. KIETZ DA, PEPMUELLER PH, MOORE TL: Clinical response to etanercept in polyarticular course juvenile rheumatoid arthritis. J.Rheumatol. 2001, 28:360-362.
    Organism:Department of Internal Medicine, Saint Louis University Health Sciences Center, St Louis, Missouri 63104, USA
    Abstract:     OBJECTIVE: To evaluate safety and clinical response to treatment with etanercept in the polyarticular course of patients with juvenile rheumatoid arthritis (JRA). METHODS: Ten patients were studied (8 female, 2 male; 6 polyarticular JRA, 4 systemic onset; mean age 13.3 yrs; mean duration of disease 6.6 yrs). Patients received 0.4 mg/kg etanercept subcutaneously twice weekly in addition to their existing therapeutic regimen. Observed duration of treatment ranged between 4 and 12 months. RESULTS: Patients tolerated treatment with etanercept well. No serious adverse events were noted. Treatment response showed considerable improvement of morning stiffness (mean reduction of 96 min approximately equal to -93%) and joint counts including swollen joints (delta -8.2 approximately equal to -40%), tender joints (delta -9.2 approximately equal to -88%), and total joints (delta -9.8 approximately equal to -37%). Laboratory results included decreases in ESR (delta -46 mm/h approximately equal to -53%) and improvement of anemia. CONCLUSION: Our results confirm etanercept is a powerful adjunct in the therapy of polyarticular JRA resistant to conventional treatment regimens


    Internet : PM:11246677

  10. KIETZ DA, PEPMUELLER PH, MOORE TL: Clinical response to etanercept in polyarticular course juvenile rheumatoid arthritis. Rinsho Ganka 2001, 28:360-362.
    Organism:Dr. T.L. Moore, Division of Rheumatology, Doisy Hall, St. Louis Univ. Health Sciences Ctr., 1402 S. Grand Blvd., Saint Louis, MO 63104
    Abstract:     Objective. To evaluate safety and clinical response to treatment with etanercept in the polyarticular course of patients with juvenile rheumatoid arthritis (JRA). Methods. Ten patients were studied (8 female, 2 male; 6 polyarticular JRA, 4 systemic onset; mean age 13.3 yrs; mean duration of disease 6.6 yrs). Patients received 0.4 mg/kg etanercept subcutaneously twice weekly in addition to their existing therapeutic regimen. Observed duration of treatment ranged between 4 and 12 months. Results. Patients tolerated treatment with etanercept well. No serious adverse events were noted. Treatment response showed considerable improvement of morning stiffness (mean reduction of 96 min (congruent) -93%) and joint counts including swollen joints (DELTA-8.2 (congruent) -40%), tender joints (DELTA-9.2 (congruent) -88%), and total joints (DELTA-9.8 (congruent) -37%). Laboratory results included decreases in ESR (DELTA-46 mm/h (congruent) -53%) and improvement of anemia. Conclusion. Our results confirm etanercept is a powerful adjunct in the therapy of polyarticular JRA resistant to conventional treatment regimens

  11. KOTANIEMI K, AHO K, KOTANIEMI A: Uveitis as a cause of visual loss in arthritides and comparable conditions. Rinsho Ganka 2001, 28:309-312.
    Organism:Dr. K. Kotaniemi, Rheumatism Foundation Hospital, FIN-18120 Heinola
    Abstract:     Objective. To examine the role of inflammatory rheumatic diseases and comparable conditions in the etiology of severe uveitis leading to visual impairment and blindness. Methods. A retrospective study based on the Finnish Register of Visual Impairment. At the end of 1996, the Finnish Register of Visual Impairment included 296 uveitis patients in whom uveitis was the main cause of visual impairment. The patient records were examined retrospectively to investigate the etiology of severe uveitis. Due to the incompleteness of data obtained of the patients blinded a long time ago, we included only 174 uveitis patients whose visual handicap (best corrected visual acuity in the better eye < 20/60 or severe visual field loss) was stated during 1980-1996. Results. A total of 174 uveitis patients were found, 72 male and 102 female. A diagnosed or presumed inflammatory rheumatic disease or comparable condition was found in 38/174 (22%) patients: juvenile rheumatoid arthritis in 14 (8%), spondyloarthropathy (ankylosing spondylitis or reactive arthritis) in 10 (6%), sarcoidosis in 5 (3%), seronegative rheumatoid arthritis in 4 (2%); Behc(cedil)et's disease was diagnosed in 2 (1%), 1 patient had polymyositis, 1 polyarteritis nodosa, and 1 juvenile systemic lupus erythematosus. In addition to the above, 10 (6%) patients had chronic back pain and 5 (3%) patients various noninflammatory joint problems. Diverse other ophthalmologic or systemic disease was detected in 38 (22%) cases. Trauma or surgery caused uveitis in 9 (5%) patients. For 74/174 (43%) uveitis patients no specific associating condition could be shown. Legal blindness was documented in 65/174 (37%) patients, including 8 totally blind persons. Conclusion. This study provides first data on the relative importance of inflammatory rheumatic diseases and comparable conditions in the etiology of severe uveitis leading to visual handicap and blindness

  12. MAENO N, TAKEI S: [Juvenile rheumatoid arthritis]. Ryoikibetsu.Shokogun.Shirizu. 2000, 458-461.
    Organism:Department of Pediatrics, Faculty of Medicine, Kagoshima University
    Internet : PM:11269135

  13. NAKAGAWA R, KAWANO Y, YOSHIMURA E, SUZUYA H, WATANABE T, KANAMARU S, ONISHI T, NAKAYAMA H, NAKAGAWA R, MATSUOKA S, YAMASHITA K, KURODA Y: Intense immunosuppression followed by purified blood CD34SUP+ cell autografting in a patient with refractory juvenile rheumatoid arthritis. Bone Marrow Transplant. 2001, 27:333-336.
    Organism:Dr. R. Nakagawa, Department of Pediatrics, Univ. of Tokushima School of Med., 2-50-1 Kuramoto-cho, Tokushima 770-8503
    Abstract:     A 15-year-old boy with refractory juvenile rheumatoid arthritis (JRA) underwent intense immunosuppressive therapy followed by purified blood CD34SUP+ cell autografting. He had been taking prednisolone (PDN) daily or every other day combined with methotrexate once a week to control the disease for 7 years. He suffered from psychological complications and a very short stature due to the adverse effects of these drugs. CD34SUP+ cells were purified in bulk from G-CSF-mobilized PBSC using an Isolex 300. After the administration of cyclophosphamide (200 mg/kg) and anti-lymphocyte globulin (45 mg/kg), 3.6 x 10SUP6/kg purified CD34SUP+ cells were infused. His post-transplant course was uneventful except for herpes-zoster infection. He is now more than 1 year post transplant and has not taken any immunosuppressive medication. His rate of growth has increased (> 10 cm/year) due to the effects of the cessation of PDN and the administration of recombinant human growth hormone (rGH), in contrast to the gain of 2 cm in the preceding 3 years with rGH treatment. Although the durability of this remission is unknown, intense immunosuppressive therapy followed by purified blood CD34SUP+ cell autografting might be acceptable for adolescent patients with refractory JRA to achieve a drug-free period for physical and psychological maturation

  14. PIPITONE N, FIORAVANTI A, MARCOLONGO R, PITZALIS C: [Articular involvement in the course of primary hypogammaglobulinemia]. Recenti Prog.Med. 2001, 92:63-67.
    Organism:Istituto di Reumatologia, Universita, Siena
    Abstract:     The Authors describe the main features of the most common forms of primary hypogammaglobulinaemia (PH) focusing on the articular involvement. Patients with Bruton's agammaglobulinemia (BA) and common variable immune deficiency (CVID) are predisposed to develop septic arthritis (including arthritis due to atypical microorganisms such as mycoplasma), arthralgia and symmetrical (usually non-erosive) polyarthritis. In BA and CVID complicated by recurrent infections, amyloidosis, which may be itself a cause of arthropathy, can occur. In addition, patients with CVID and selective IgA deficiency show an increased prevalence of juvenile rheumatoid arthritis, systemic lupus erythematosus, Sjogren's syndrome and primary biliary cirrhosis, while patients with selective IgA deficiency are prone to developing seronegative spondylarthropathies, including ankylosing spondylitis. The mainstay of treatment for BA and CVID is replacement therapy with human immunoglobulins. Septic arthritis should be promptly treated with antibiotics, whereas other types of arthritis usually respond well to non-steroidal antiinflammatory medications. In contrast, the second line agents commonly used to treat rheumatoid arthritis do not appear to be beneficial in patients with PH-associated arthritis


    Internet : PM:11260975

  15. PRIEUR AM: A recently recognised chronic inflammatory disease of early onset characterised by the triad of rash, central nervous system involvement and arthropathy. Clin.Exp.Rheumatol. 2001, 19:103-106.
    Organism:Pediatric Immunology, Hematology and Rheumatology Unit, Hopital Necker-Enfants Malades, AP-HP, University Paris V, Rue de Sevres no 149, F-75743 Paris, France
    Abstract:     Chronic Infantile Neurological Cutaneous and Articular (CINCA) syndrome, also called Neonatal Onset Multisystemic Inflammatory Disease (NOMID) is characterised by the triad of cutaneous rash, chronic meningitis and arthropathy. It is a chronic inflammatory illness that starts most often at birth and persists for the whole lifespan of the patient. Attempts at therapy have been disappointing. The long-term prognosis is poor, with progressive deafness and visual impairment, and worsening of the central nervous system manifestations. Some cases of death have been reported secondary to infection, vasculitis and amyloidosis. Usually observed as sporadic cases, some familial association is recognised


    Internet : PM:11247311

  16. PUNNONEN K, KAIPIAINEN-SEPPANEN O, RIITTINEN L, TUOMISTO T, HONGISTO T, PENTTILA I: Evaluation of iron status in anemic patients with rheumatoid arthritis using an automated immunoturbidimetric assay for transferrin receptor. Clinical Chemistry and Laboratory Medicine 2000, 38:1297-1300.
    Organism:Department of Clinical Chemistry, Kuopio University Hospital, PL 1777, 70211, Kuopio: kari.punnonen@kuh.fi Finland
    Abstract:     We have evaluated a newly introduced immunoturbidimetric transferrin receptor assay (IdeA TfR-IT, Orion Diagnostica, Finland) in healthy subjects and in a study population consisting of patients with rheumatoid arthritis and juvenile chronic arthritis. The IdeA TfR-IT assay was found to provide reproducible results which were in good agreement with the ELISA assays from Orion Diagnostica (IDeA-ELISA, correlation R2=0.8, n=102) and R&D systems (Quantikine TfR ELISA assay, correlation R2=0.95, n=39). The analysis of the patient samples suggested that, on the basis of serum transferrin receptor and ferritin concentrations, in approximately one third of patients with rheumatoid arthritis anemia is due to the depletion of iron stores. Apparently, in all patients with rheumatoid arthritis iron deficiency must be considered as a potential cause of the anemia. Now, that assays which are suitable for automated analyzers have become available for the measurement of serum transferrin receptor, this analyte has the potential to become a part of the routine evaluation of iron status

  17. ROSSUM MARION AJ, FISELIER THEO JW, FRANSSEN MARCEL JAM, TEN CATE R, SUIJLEKOM-SMIT LISETTE WA, WULFFRAAT NM, LUIJK WILMA HJ, OOSTVEEN JOHANNA CM, KUIS W, DIJKMANS BEN AC, VAN SOESBERGEN RM: Effects of sulfasalazine treatment on serum immunoglobulin levels in children with juvenile chronic arthritis. Scandinavian Journal Of Rheumatology 2001, 30:25-30.
    Organism:Department of Paediatrics, Leiden University Medical Centre, 2300 RC, Leiden Netherlands
    Abstract:     This article describes the effects of sulfasalazine (SSZ) treatment on serum immunoglobulin (Ig) levels in 6 children with oligoarticular- or polyarticular onset juvenile chronic arthritis (JCA). None of the children who developed dysimmunoglobulinemia during treatment showed clinical symptoms of this adverse event, in particular none developed severe infections. All patients regained normal immunoglobulin levels after discontinuing SSZ treatment. One patient with a partial IgA deficiency at the start of SSZ treatment showed a slow increase in the IgA level during treatment. During follow-up (4-6 years), one patient spontaneously developed a dysimmunoglobulinemia and one patient developed diabetes mellitus. Based on these case reports and review of the literature we advocate monitoring of serum immunoglobulin levels while on SSZ treatment

  18. SAILA H, KOTANIEMI K, SAVOLAINEN A, KAUTIAINEN H, LEIRISALO-REPO M, AHO K: Uveitis in sibling pairs with juvenile idiopathic arthritis. Rheumatology (Oxford) 2001, 40:221-224.
    Organism:Rheumatism Foundation Hospital, Heinola, Finland
    Abstract:     OBJECTIVE: To ascertain the occurrence and characteristics of uveitis in sibling pairs affected with juvenile idiopathic arthritis (JIA). METHODS: The sibling series comprised 80 JIA patients from 37 families with two or three JIA children, seen at the paediatric department of the Rheumatism Foundation Hospital in Heinola, Finland. An ophthalmologist examined the children for uveitis two to four times a year and the course of the condition was recorded during the follow-up. RESULTS: Uveitis was diagnosed in 21 of the 80 patients (26%). Three pairs (3.4 pairs expected) were concordant for the presence of asymptomatic uveitis. Two patients with enthesitis-related arthritis had acute unilateral uveitis. Among the remaining cases, uveitis was chronic and continuously active at the end of follow-up in 13 instances, but in spite of this only one patient had impaired vision. HLA allele B27 occurred more frequently in patients with uveitis than in those without uveitis (52 vs 30%, P=0.073) and all six subjects in the pairs concordant for chronic uveitis carried this allele. CONCLUSIONS: The observed concordance rate for uveitis did not differ from that expected. Although the uveitis was chronic in most instances, its course was usually mild


    Internet : PM:11257162

  19. SCHMELING H, MATHONY K, JOHN V, KEYSSER G, BURDACH S, HORNEFF G: A combination of etanercept and methotrexate for the treatment of refractory juvenile idiopathic arthritis: a pilot study. Ann.Rheum.Dis. 2001, 60:410-412.
    Organism:Department of Paediatrics, Martin-Luther University Halle-Wittenberg, 06120 Halle, Germany
    Abstract:     OBJECTIVE: To study the efficacy of combination therapy with etanercept and methotrexate in patients with refractory juvenile idiopathic arthritis. METHODS: Seven children with active juvenile idiopathic arthritis refractory to at least combination therapy with methotrexate and sulfasalazine or cyclosporin A were studied. Concomitant treatment, consisting of non-steroidal drugs, corticosteroids, and methotrexate, remained unchanged. RESULTS: Six patients continued the treatment for at least 24 weeks. In the child with systemic arthritis, etanercept was stopped because of persisting spiking fever, joint pain, and rash. In the remaining children an immediate significant decrease in joint pain (p<0.05), disappearance of morning stiffness, and regression of joint swelling (p<0.05) were observed. Improvement was apparent after two injections. An immediate significant (p<0.05) decrease in erythrocyte sedimentation rate, C reactive protein, and interleukin 6 was observed. Side effects consisted of mild reactions at the injection site in two children. CONCLUSIONS: In this observational study, etanercept in combination with methotrexate was well tolerated and highly effective in treating juvenile polyarthritis but not in the patient with systemic arthritis. Combination treatment appears to be feasible in terms of toxicity and may enhance efficiency


    Internet : PM:11247875

  20. SIDIROPOULOU-CHATZIGIANNI S, PAPADOPOULOS MA, KOLOKITHAS G: Dentoskeletal morphology in children with juvenile idiopathic arthritis compared with healthy children. J.Orthod. 2001, 28:53-58.
    Organism:Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, Greece
    Abstract:     The aim of this study was to evaluate the dentoskeletal relationships in children with juvenile idiopathic arthritis (JIA) compared to healthy children without significant differences in relation to age and sex, by means of lateral cephalometric radiographs. Cephalometric, as well as dental panoramic radiographs were taken of 66 JIA children (27 males and 39 females; age range: 6-19 years; mean age: 11*9 years). The control group consisted of 37 healthy children unaffected by JIA seeking orthodontic treatment, with Class I occlusion (17 males and 20 females; age range: 7*5-17 years; mean age: 11*9 years). All cephalometric landmarks were identified and digitized, and calculations were performed by means of a computerized cephalometric system. The cephalometric findings indicated a tendency towards retrognathism with a short mandible. The lower facial height was increased and the growth pattern of the face was biased towards the vertical direction (clockwise, i.e. with a tendency to open bite) and the interincisal angle was less in the JIA children compared to the healthy children. These findings were in general more pronounced by the JIA children with polyarticular type of the disease as well as with affected condyles. Our study indicated that the dentoskeletal morphology in children with JIA presented some special characteristics when compared to healthy children, which could be attributed to the effects of the disease


    Internet : PM:11254804

  21. SMITH KJ, SKELTON H: Common variable immunodeficiency treated with a recombinant human IgG, tumour necrosis factor-alpha receptor fusion protein. Br.J.Dermatol. 2001, 144:597-600.
    Organism:Department of Dermatology and Pathology, National Naval Medical Center, Bethesda, MD 20889-5600, USA Laboratory Corporation of America, Herndon, VA, USA
    Abstract:     Common variable immunodeficiency (CVI) is characterized by a failure in B-cell differentiation and impaired immunoglobulin secretion, but with a variable clinical presentation, including the development of sarcoidal granulomas and autoimmune diseases, as well as an increased incidence of malignancies. We present a 21-year-old white man who carried a diagnosis of juvenile rheumatoid arthritis and presented 6 years later with scarring alopecia showing sarcoidal granulomas. Further work confirmed the diagnosis of CVI, and with increasing systemic symptoms, it was elected to treat the patient with a tumour necrosis factor (TNF)-alpha antagonist, a TNF-alpha receptor IgG1 fusion protein. The patient showed improvement in his systemic symptoms and some hair regrowth after 3 months of therapy, and continued improvement in his systemic disease with only mild scalp hair thinning in the areas of prior involvement after almost 1 year of therapy. CVI and sarcoid may have overlapping clinical and immunological findings. Previous therapies for CVI, including intravenous immunoglobulin, have not altered the mortality of the disease. TNF-alpha is a primary cytokine and is elevated in CVI, and specific inhibition of TNF-alpha in this patient was effective in moderating his disease, including his skin disease


    Internet : PM:11260023

  22. TESSEL EM, VAN DER NJ, KUIS W, WULFFRAAT NM: Outcome status in children with sustained polyarticular and systemic juvenile idiopathic arthritis. Rheumatology (Oxford) 2001, 40:225-226.
    Internet : PM:11257163

  23. VAN ROSSUM MA, FISELIER TJ, FRANSSEN MJ, TEN CATE R, SUIJLEKOM-SMIT LW, WULFFRAAT NM, VAN LUIJK WH, OOSTVEEN JC, KUIS W, DIJKMANS BA, VAN SOESBERGEN RM: Effects of sulfasalazine treatment on serum immunoglobulin levels in children with juvenile chronic arthritis. Scand.J.Rheumatol. 2001, 30:25-30.
    Organism:Department of Paediatrics, Leiden University Medical Centre, The Netherlands
    Abstract:     This article describes the effects of sulfasalazine (SSZ) treatment on serum immunoglobulin (Ig) levels in 6 children with oligoartic


    Internet : PM:11252688

  24. VAN ROSSUM MAJ, FISELIER TJW, FRANSSEN MJAM, TEN CATE R, SUIJLEKOM-SMIT LWA, WULFFRAAT NM, VAN LUIJK WHJ, OOSTVEEN JCM, KUIS W, DIJKMANS BAC, VAN SOESBERGEN RM: Effects of sulfasalazine treatment on serum immunoglobulin levels in children with juvenile chronic arthritis. Scandinavian Journal Of Rheumatology 2001, 30:25-30.
    Organism:M.A.J. Van Rossum, Department of Paediatrics, Leiden University Medical Centre, Postbus 9600, 2300 RC Leiden
    Abstract:     This article describes the effects of sulfasalazine (SSZ) treatment on serum immunoglobulin (Ig) levels in 6 children with oligoarticular- or polyarticular onset juvenile chronic arthritis (JCA). None of the children who developed dysimmunoglobulinemia during treatment showed clinical symptoms of this adverse event, in particular none developed severe infections. All patients regained normal immunoglobulin levels after discontinuing SSZ treatment. One patient with a partial IgA deficiency at the start of SSZ treatment showed a slow increase in the IgA level during treatment. During follow-up (4-6 years), one patient spontaneously developed a dysimmunoglobulinemia and one patient developed diabetes mellitus. Based on these case reports and review of the literature we advocate monitoring of serum immunoglobulin levels while on SSZ treatment

  25. WEISS KA, SCHIAFFINO KM, ILOWITE N: Predictors of sibling relationship characteristics in youth with juvenile chronic arthritis. Children's Health Care 2001, 30:67-77.
    Organism:K.M. Schiaffino, Psychology Department, Fordham University, 441 East Fordham Road, Bronx, NY 10458
    Abstract:     Relationships between 20 children with juvenile chronic arthritis (JCA) and their siblings were compared with relationships among 20 comparison sibling pairs. Participants ranging in age from 7 to 21 years were interviewed using the Sibling Relationships Questionnaire-Revised. Parents completed ratings of their families' and children's behavior and an illness activity rating scale. Siblings in the JCA and comparison groups did not differ in perceptions of their relationships or in their family structure. Age, sex, birth order, and age difference between siblings were associated with sibling relationship variables, whereas adaptive behavior was not a significant factor. Among JCA patients, severity of illness was positively associated with perceived conflict with siblings

  26. YILMAZ M, KENDIRLI SG, ALTINTAS D, BINGOL G, ANTMEN B: Cytokine levels in serum of patients with juvenile rheumatoid arthritis. Journal of developmental and behavioral.pediatrics 2001, 20:30-35.
    Organism:Dr. M. Yilmaz, Department of Pediatrics, C(cedil)ukurova Univ. Fac. Med., 01330 Adana
    Abstract:     We investigated serum levels of interleukin (IL)-1beta, IL-6, IL-8, IL-12 and tumour necrosis factor (TNF)-alpha in JRA patients during both active and inactive phases of the disease. The systemic JRA patients had the highest IL-1beta and IL-6 levels during both active and inactive periods. In the systemic group IL-1beta, IL-6 and IL-12 levels during the active period were elevated compared to the inactive period (p = 0.0173, p = 0.0359 and p = 0.0117, respectively). Levels of these cytokines during the inactive stage were still greater than those of controls. IL-8 and TNF-alpha levels during both active and inactive periods were comparable to controls. IL-1beta correlated strongly with CRP and ESR (p = 0.008 and p = 0.031, respectively). IL-6 correlated significantly with CRP (p = 0.002). IL-12 levels were found to be correlated with ESR and CRP (p = 0.03 and p = 0.04, respectively). In active polyarticular JRA patients, IL-6 levels were elevated compared to the inactive phase, and the control (p = 0.001) IL-12 levels decreased significantly with clinical remission (p = 0.018). There was a strong correlation between I1-12 levels and number of joint with limited motion (p = 0). In oligoarticular JRA patients, IL-12 levels during active period were greater than in the controls and there was a marked decrease in IL-12 levels when the patients entered the inactive phase (p = 0.001) In conclusion, IL-1beta, IL-6 and IL-12 may play an important role in JRA and may be used as a marker of disease activity


    Internet : Deraytek@pamuk.cu.edu.tr

  27. YILMAZ M, KENDIRLI SG, ALTINTAS D, BINGOL G, ANTMEN B: Cytokine levels in serum of patients with juvenile rheumatoid arthritis. Clin.Rheumatol. 2001, 20:30-35.
    Organism:Department of Pediatrics, Cukurova University Faculty of Medicine, Adana, Turkey Deraytek@pamukcuedutr
    Abstract:     We investigated serum levels of interleukin (IL)-1beta, IL-6, IL-8, IL-12 and tumour necrosis factor (TNF)-alpha in JRA patients during both active and inactive phases of the disease. The systemic JRA patients had the highest IL-1beta and IL-6 levels during both active and inactive periods. In the systemic group IL-1beta, IL-6 and IL-12 levels during the active period were elevated compared to the inactive period (p = 0.0173, p = 0.0359 and p = 0.0117, respectively). Levels of these cytokines during the inactive stage were still greater than those of controls. IL-8 and TNF-alpha levels during both active and inactive periods were comparable to controls. IL-1beta correlated strongly with CRP and ESR (p = 0.008 and p = 0.031, respectively). IL-6 correlated significantly with CRP (p = 0.002). IL-12 levels were found to be correlated with ESR and CRP (p = 0.03 and p = 0.04, respectively). In active polyarticular JRA patients, IL-6 levels were elevated compared to the inactive phase, and the control (p = 0.001) IL-12 levels decreased significantly with clinical remission (p = 0.018). There was a strong correlation between 11-12 levels and number of joint with limited motion (p = 0). In oligoarticular JRA patients, IL-12 levels during active period were greater than in the controls and there was a marked decrease in IL-12 levels when the patients entered the inactive phase (p = 0.001) In conclusion, IL-1beta, IL-6 and IL-12 may play an important role in JRA and may be used as a marker of disease activity


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