Bibliography April 2001

  1. BARLOW JH, SHAW KL, WRIGHT CC: Development and preliminary validation of a children's arthritis self-efficacy scale. Arthritis Rheum. 2001, 45:159-166.
    Organism:Psychosocial Research Centre, Chronic Conditions & Disability, Child & Family Health Group, Coventry University, UK
    Abstract:     OBJECTIVE: To develop a valid and reliable measure of arthritis self-efficacy for use with school-age children with juvenile idiopathic arthritis (JIA). METHODS: Construction of the 11-item Children's Arthritis Self-Efficacy Scale (CASE) was based on an existing body of knowledge and the results of focus groups with children, their parents, and health professionals. Data for validation of the CASE were collected by self-administered questionnaires completed by 89 children and 151 caregivers. RESULTS: Analyses revealed a 3-factor structure relating to self-efficacy for managing symptoms, emotional consequences, and activities, explaining 76.5% of the total variance. The CASE demonstrated high internal consistency, concurrent validity, and construct validity. CONCLUSION: Preliminary findings suggest that the CASE is worthy of further psychometric testing and may have the potential to help delineate variations in adjustment among children with JIA


    Internet : PM:11324780

  2. BOWDEN AP, BARRETT JH, FALLOW W, SILMAN AJ: Women with inflammatory polyarthritis have babies of lower birth weight. Rinsho Ganka 2001, 28:355-359.
    Organism:ARC Epidemiology Unit, University of Manchester, Oxford Road, Stopford Building, Manchester, M13 9PT: alan.silman@man.ac.uk UK
    Abstract:     Objective. To assess the effect on fetal outcome, and development of the child over the first 8 months of life, of rheumatoid arthritis (RA) during pregnancy. Methods. Women with RA or undifferentiated inflammatory polyarthritis (IP) were recruited from throughout the UK and followed prospectively from late pregnancy to 8 months postpartum. Matched controls were obtained from general practitioners. The babies' health at birth and development at 8 months were monitored by the weight, head circumference, and length. Potential confounding variables were noted. Results. One hundred thirty-three women with RA or undifferentiated IP took part in the study. There were 5 (4%) admissions for hypertension during pregnancy and no cases of preeclampsia. Cesarean section was common (23%). Matched controls were found for 103 (77%) subjects. There were no significant differences between groups in head circumference or length at birth. Babies born to women with arthritis had lower mean birth weight than controls (3.3 kg (standard deviation 0.5) compared to 3.5 kg (0.4); p = 0.004), even after adjustment for potential confounding factors. Within the patient group those whose arthritis was in remission had significantly heavier babies than those with active disease (mean 3.5 kg (0.5) compared with 3.3 kg (0.5); p = 0.04). This trend was still apparent at 8 months, but differences were no longer statistically significant. Conclusion. This is the first relatively large prospective study of the effects on mother and baby of RA during pregnancy. The results suggest that, although disease improves in most women during pregnancy, it is still sufficiently active to have a modest negative effect on birth weight

  3. BROOKS CD: Sulfasalazine for the management of juvenile rheumatoid arthritis. Rinsho Ganka 2001, 28:845-853.
    Organism:Dr. C.D. Brooks, Department of Pediatrics, MSU/KCMS, 1000 Oakland Drive, Kalamazoo, MI 49008
    Abstract:     Objective. Sulfasalazine (SSZ) has regulatory approval for treatment of inflammatory bowel disease in children and adults, and for use as a slow acting agent in adult rheumatoid arthritis (RA). This report surveys the literature for experience with SSZ in juvenile RA. Methods. Medline, Excerpta Medica, and Derwent were searched under the terms juvenile, rheumatoid, arthritis, and sulfasalazine. Results. The search found reports of experience in 550 patients, of whom about half had pauciarticular and nearly one-third polyarticular disease. The studies generally reported at least some drug associated benefit in all subtypes. Some identified late onset pauciarticular disease as most responsive, but others reported poly- and pauciarticular response rates about the same. Systemic onset disease responded poorly and showed a substantial incidence of intolerance in the form of serum sickness. Most studies showed useful disease control in spondylitis. Overall, the patterns of toxicity and intolerance were close to those seen in adult SSZ recipients, with the possible exception of the serum sickness-like response. Conclusion. SSZ has demonstrated useful antirheumatic activity and can contribute to the care of selected patients

  4. CHIAPCO OR, RIVAS-CHACON RF: Malignant large cell lymphoma presenting as musculoskeletal syndrome. International Pediatrics 2001, 16:21-23.
    Organism:Dr. O.R. Chiapco, 3411 Wayne Avenue, Bronx, NY 10467
    Abstract:     This is a report of a previously healthy 17-year-old female who initially presented with fever of unknown origin, nonspecific arthropathy, weight loss, generalized malaise and persistent anemia. Her signs and symptoms persisted for several months and initially were felt to represent an autoimmune process, possibly systemic juvenile rheumatoid arthritis (JRA) versus systemic lupus erythematosus (SLE). She was treated with oral steroid and anti-inflammatory agents. Her initial work-up for possible malignancy yielded negative results. Her anemia, however, became progressively worse and eventually required hospitalization and multiple transfusions. Her work-up though had been generally unremarkable. About 4 months after her initial presentation, she presented with fever, jaundice and pancytopenia. Liver biopsy was highly suspicious of lymphoma. Awaiting final pathologic diagnosis from bone marrow biopsy, she developed marked thrombocytopenia and hemoptysis. She subsequently required mechanical ventilation. Empiric chemotherapy pending final histologic report was started. She, however, developed uncontrolled pulmonary hemorrhage and later expired. The final pathology report was malignant lymphoma CD30 (+), large cell type. The association between connective tissue disease and malignancy is reviewed


    Internet : oliverchiapco@prodigy.net

  5. DONN RP, BARRETT JH, FARHAN A, STOPFORD A, PEPPER L, SHELLEY E, DAVIES N, OLLIER WE, THOMSON W: Cytokine gene polymorphisms and susceptibility to juvenile idiopathic arthritis. British Paediatric Rheumatology Study Group. Arthritis Rheum. 2001, 44:802-810.
    Organism:Arthritis Research Campaign Epidemiology Unit, Manchester, UK
    Abstract:     OBJECTIVE: To investigate the involvement of candidate cytokine genes in the pathogenesis of juvenile idiopathic arthritis (JIA). METHODS: Single nucleotide polymorphisms and intragenic microsatellite markers within 8 candidate cytokine genes (interleukin-1alpha [IL-1alpha], IL-2, IL-4, IL-6, IL-10, interferon-alpha1 [IFNA1], interferon-gamma [IFNG], and interferon regulatory factor 1 [IRF-1]) were investigated in 417 Caucasian patients with clinically characterized JIA and a panel of 276 unrelated, healthy Caucasian controls, all from the United Kingdom. RESULTS: A novel 3'-untranslated region (3'UTR) polymorphism in IRF-1 was found to be associated with susceptibility to JIA (corrected P = 0.002). No significant association with IL-1alpha, IL-2, IL-4, IL-6, IL-10, IFNA1, or IFNG was observed. CONCLUSION: An association between JIA and a previously unreported 3'UTR polymorphism of IRF-1 was observed. This association was not found to be specific to any particular JIA subgroup. This suggests that IRF-1 may contribute to a common pathogenesis shared by all JIA patients, regardless of clinical phenotype. This is most likely to be a genetic contribution to the chronic inflammatory process that underlies JIA pathology


    Internet : PM:11315919

  6. HEDENGREN E, KNUTSON LM, HAGLUND-AKERLIND Y, HAGELBERG S: Lower extremity isometric joint torque in children with juvenile chronic arthritis. Scand.J.Rheumatol. 2001, 30:69-76.
    Organism:Department of Woman and Child Health, Karolinska Institute, Stockholm, Sweden
    Abstract:     OBJECTIVE: To determine the intratester reliability of joint torque testing with a hand-held dynamometer (HHD) during contractions of four major lower extremity muscles in children with juvenile chronic arthritis (JCA) and to compare results for children with JCA to results for children without disability. METHODS: Eleven children with JCA and 14 children with normal musculoskeletal function were tested with a HHD using isometric muscle contractions of the right quadriceps, hamstrings, tibialis anterior and triceps surae. RESULTS: Intratester reliability values exceeded the 0.92 level, regardless of the number of trials, for all motions tested. Statistically lower joint torque values were found in a subgroup of children with JCA for contractions of the tibialis anterior (p=0.003) and triceps surae (p=0.05) muscles. CONCLUSIONS: HHD offers a reliable means of testing the joint torque generated with contraction of these lower extremity muscles in children with JCA. Findings in children with JCA compared to children without disability agree with previous reports concerning quadriceps muscle function, but also point to concerns for muscles associated with generating ankle joint torque


    Internet : PM:11324792

  7. HORNEFF G, FORSTER J, SEYBERTH HW, MICHELS H: Recommendations of the Study Group of Child and Youth-age Rheumatology on therapy with Etanercept (P75 TNF-alpha receptor-immunoglobulin fusion protein)
    <ORIGINAL> Empfehlungen der Arbeitsgemeinschaft Kinder- und Jugendrheumatologie zur Therapie mit Etanercept (P75 TNF-alpha-Rezeptor-Immunglobulinfusionsprotein): Kommission Pharmakotherapie    . Zeitschrift fuer Rheumatologie 2000, 59:365-369.
    Organism:Universitaetsklinik und Poliklinik fuer Kinder- und Jugendmedizin, Martin-Luther-Universitaet Halle-Wittenberg, 06120, Halle: gerd.horneff@medizin.uni-halle.de Germany

  8. HOSHINO K, HANYU T, ARAI K, TAKAHASHI HE: Mineral density and histomorphometric assessment of bone changes in the proximal tibia early after induction of type II collagen-induced arthritis in growing and mature rats. J.Bone Miner.Metab 2001, 19:76-83.
    Organism:Department of Orthopedic Surgery, Niigata University School of Medicine, Japan
    Abstract:     Bone changes in both actively growing (6-week-old) and mature (6-month-old) rats with collagen-induced arthritis (CIA) were investigated in order to clarify the mechanisms of osteoporosis near inflamed joints in patients with early rheumatoid arthritis (RA) and juvenile RA. In female Sprague-Dawley rats, the proximal tibiae from the CIA and control groups early after immunization, when any influence of immobilization due to joint pain and swelling is minimal, were studied using dual X-ray absorptiometry and histomorphometry after double-labeling with tetracycline. Arthritis developed within 10-14 days after immunization in both growing and mature rats. Physical activity, growth, and body weight continued to resemble that of the control group for at least 10 days. The bone mineral density in the proximal tibia did not differ significantly between the CIA and control groups. In growing rats, a highly significant increase in bone resorption, and decreases in bone formation and trabecular bone volume became evident histomorphometrically before visible signs of arthritis had developed. In mature rats, bone formation was markedly decreased without an increase in bone resorption. The differences in the reaction between growing and mature rats reflected a difference in the number of remodeling sites (units) and an uncoupling between osteoblasts and osteoclasts. We conclude that osteoporosis near inflamed joints results from an imbalance between bone resorption and formation caused by immune reactions in the CIA rats. Moreover, a decrease in bone formation may, in part, precede the clinical onset of arthritis


    Internet : PM:11281163

  9. JOHNSON CJ, REILLY KM, MURRAY KM: Etanercept in juvenile rheumatoid arthritis. Ann.Pharmacother. 2001, 35:464-471.
    Organism:Immunex Corporation, Professional Services Department, Seattle, WA 98101-2936, USA cjohnson@immunexcom
    Abstract:     OBJECTIVE: To review the classification, pathophysiology, safety, and efficacy of treatment options for juvenile rheumatoid arthritis (JRA). Etanercept, the agent most recently approved by the Food and Drug Administration for use in JRA, is featured. DATA SOURCES: Articles were identified from a search of the MEDLINE database (1966 to January 2000) and through secondary sources. Meeting abstracts and posters were also evaluated. STUDY SELECTION AND DATA EXTRACTION: Articles identified and retrieved from data sources were evaluated and, if determined to be relevant, were included in this review. DATA SYNTHESIS: JRA represents a major cause of functional disability in children. In contrast to traditional therapeutic agents for JRA, which act through generalized antiinflammatory activity or generalized immunosuppression, new therapeutic modalities have been developed that target specific molecules involved in the pathophysiology of JRA. Etanercept inhibits the activity of tumor necrosis factor and lymphotoxin-alpha. In a clinical trial of patients with polyarticular-course JRA, etanercept-treated patients experienced less pain and swelling in their joints, decreased incidence of disease activity, less frequent flare, and a longer time to flare than patients receiving placebo. Treatment with etanercept was generally well-tolerated. CONCLUSIONS: Etanercept represents an exciting new therapeutic option for the treatment of JRA. The positioning of etanercept among other therapeutic options for JRA will be more clearly established as additional safety and efficacy data are made available


    Internet : PM:11302411

  10. KAMPHUIS SSM, VAN BILSEN JHM, HAVERKAMP M, GORDON G, KUIS W, WAUBEN MHM, PRAKKEN BJ: Identification of joint inflammation-specific T cell responses in juvenile idiopathic arthritis: Potential targets for immunotherapy. Immunobiology 2000, 203:358-359.
    Organism:Department of Pediatric Immunology, Wilhelmina Children's Hospital, UMC Utrecht, Utrecht NetherlandsJoint Annual Meeting of the German and Dutch Societies of Immunology
    Duseldorf, Germany
    November 29-December 02, 2000

  11. KENDIRLI SG, YILMAZ M, ALTINTAS D, BINGOL G: Serum cytokines levels of patients with juvenile rheumatoid arthritis. Journal of Allergy and Clinical Immunology 2001, 107:S84
    Organism:Faculty of Medicine, Cukurova University, Adana Turkey57th Annual Meeting of the American Academy of Allergy, Asthma and Immunology
    New Orleans, Louisiana, USA
    March 16-21, 2001

  12. MCELHATTON PR: A review of the reproductive toxicity of methotrexate in human pregnancy. Reproductive Toxicology 2000, 14:549
    Organism:National Teratology Information Service (NTIS), Newcastle upon Tyne, NE2 4HH UK28th Conference of European Teratology Society
    Ferrara, Italy
    September 11-14, 2000
    European Teratology Society_

  13. NAJAM F, FUCHS HA: Cardiac tamponade: A life-threatening complication of Still's disease. Journal of Clinical Rheumatology 2001, 7:97-101.
    Organism:Dr. H.A. Fuchs, Vanderbilt University, Nashville, TN 37232-2681
    Abstract:     Pericarditis, a common feature of adult-onset and juvenile-onset Still's disease, is rarely complicated by cardiac tamponade. We report one patient with juvenile-onset and another with adult-onset Still's disease presenting with pericardial tamponade. On the basis of our experience and analysis of literature, we suggest early identification of pericarditis and the life-threatening complication of tamponade, with institution of aggressive intervention with corticosteroids and, if necessary, pericardiocentesis and pericardial window formation. These cases remind physicians about the need to include Still's disease in the differential diagnosis of pericarditis and tamponade and to not neglect the potential of severe systemic inflammation to lead to fatal complications in this group of patients

  14. OHKI T, ADACHI O, KAMIYAMA H, KUMAZAWA H, NISHINARITA S, MATSUKAWA Y, KITAMURA N, HORIE T: Adult onset Still's disease: The diagnosis and clinical features of twelve cases. Nichidai Igaku Zasshi 2000, 59:417-421.
    Organism:Sixth Grade of Medical Students, Nihon University School of Medicine, Tokyo Japan
    Abstract:     We analyzed the clinical features of twelve cases with adult onset Still's disease (AOSD) visited to our department during past three and half years. High grade fever (higher than 39degreeC), skin rash and polyarthralgia were common in most patients with AOSD. These symptoms, however, did not always show typical features describrd as an evening spike fever or salmon pink skin rash, respectively. Furthermore, polyarthralgia sometimes appeared after a high fever and/or skin rash. Thus, it may be sometimes difficult to establish a diagnosis of AOSD in patients manifesting pyrexia of unknown origin. On physical examination, cervical lymphadenopathy and splenomegaly were observed in several patients. Laboratory examination revealed elevated white blood cell count mainly due to an increase in the neutrophil count, high serum level of CRP, marked accerelation of erythrocyte sedimentation rate in most cases, and mild elevations of serum transaminase levels snd LDH levels in some patients. The most important laboratory findings for the diagnosis of this disease was from the serum ferritin level, since all AOSD patients but one patient, the exception having undergone corticosteroid treatment showed marked elevation (range 2100 to 21000 ng/ml). Nine patients responded well to corticosteroid or methotrexate, but the remaining cases required high doses of corticosteroid with additional cytotoxic agents or antirheumatic agents to maintain clinical remission. None of our patients died of this disease during four-years observation. AOSD seemes to be a clinical entity that distinct from rheumatoid arthritis. However, the difference between AOSD and juvenile rheumatoid arthritis remains a problem to be determined

  15. PIPITONE N, FIORAVANTI A, MARCOLONGO R, PITZALIS C: Articular involvement in course of primary hypogammaglobulinaemia
    <ORIGINAL> Interessamento articolare in corso di ipogammaglobulinemia primaria    . Recenti Progressi in Medicina 2001, 92:63-67.
    Organism:Rheumatology Unit, School of Medicine and Dentistry, Guy's King's and St Thomas Hospital, Guy's Campus, London, SE1 9RT UK
    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

  16. RAVELLI A, CARIA MC, BURATTI S, MALATTIA C, TEMPORINI F, MARTINI A: Methotrexate as a possible trigger of macrophage activation syndrome in systemic juvenile idiopathic arthritis. Rinsho Ganka 2001, 28:865-867.
    Organism:Prof. A. Martini, Clinica Pediatrica dell'Universita, IRCCS Policlinico S. Matteo, P. le Golgi 2, 27100 Pavia
    Abstract:     Macrophage activation syndrome (MAS) is a potentially life threatening complication of chronic rheumatic diseases, particularly systemic juvenile idiopathic arthritis (JIA). A number of triggers have been related to the development of MAS, including viral infections, nonsteroidal antiinflammatory drug therapy, and gold salt injections. We describe a patient with systemic JIA who developed MAS shortly after receiving methotrexate, suggesting that this drug can be regarded as a potential trigger of MAS in children with JIA


    Internet : amartini@smatteo.pv.it

  17. SAVAGE M: Complications with reformulated one-alpha vitamin D. BMJ 2001, 322:799
    Internet : PM:11303536

  18. SCOLA MP, IMAGAWA T, BOIVIN GP, GIANNINI EH, GLASS DN, HIRSCH R, GROM AA: Expression of angiogenic factors in juvenile rheumatoid arthritis: correlation with revascularization of human synovium engrafted into SCID mice. Arthritis Rheum. 2001, 44:794-801.
    Organism:Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA
    Abstract:     OBJECTIVE: Although increased vascularity was noted in early histopathologic studies of juvenile rheumatoid arthritis (JRA) synovium, the available data on angiogenesis in JRA are very limited. The main purposes of this study were to assess expression of the key angiogenic factors in JRA synovium, and to evaluate a SCID mouse model of JRA as an approach to study in vivo regulation of the expression of these factors in JRA. METHODS: RNase protection assay was used to assess the expression of the key angiogenic factors in fresh JRA synovium and in JRA synovial tissue fragments that had been minced and then implanted into SCID mice. Vascularity of the samples was assessed by immunohistochemical staining for von Willebrand factor. Synovial specimens obtained from patients with osteoarthritis (OA) or other noninflammatory arthropathies were used as controls. RESULTS: Detectable levels of messenger RNA for vascular endothelial growth factor and angiopoietin 1 and their respective receptors, as well as endoglin and thrombin receptors, were present in all JRA tissue specimens studied. The levels of expression of these factors in JRA tissues were significantly higher than those in tissues obtained from patients with OA or other noninflammatory arthropathies. Furthermore, increased expression of the key angiogenic factors in the fresh JRA tissues correlated with the exuberant revascularization of JRA minced tissue fragments implanted into SCID mice. This was in sharp contrast to the poor revascularization of implanted OA tissues. CONCLUSION: JRA synovium is characterized by high angiogenic activity. SCID mouse-human JRA synovium chimeras may provide a good approach to study the in vivo regulation of angiogenesis in JRA


    Internet : PM:11315918

  19. SIKORA A, BROZIK H, CHLEBNA-SOKOL D, KARDAS-SOBANTKA D, BIERNACKA M, SMOLEWSKA E, POLAKOWSKA E: Vaccination against hepatitis B in children with connective tissue diseases. Part II: Efficacy of vaccination against virus hepatitis B in children with chronic juvenile arthritis and other connective tissue diseases. Przeglad Pediatryczny 2001, 31:60-63.
    Organism:A. Sikora, Klinika Propedeutyki Pediatrii, Instytutu Pediat. AM w Lodzi, ul. Sporna 36/50, 91-738 Lodz
    Abstract:     The aim of the study was evaluation of the efficacy of vaccination against virus hepatitis B with Engerix-B vaccine in children with chronic juvenile arthritis (34 cases) and other connective tissue diseases (4 cases). The study comprised 38 patients (29 girls and 9 boys) aged between 3 and 20 years at various stages of activity of the inflammatory process. Vaccination was conducted according to the scheme 0-1-6. Control examinations of antibodies anti-HBs level after vaccination were done after the second and third doses of vaccine. Mean level of anti-HBs antibodies after the second dose of vaccine was 54,2 IU/I, and after the third dose, 200 IU/I. Very low level (no antibodies, values below 10 IU/I) was seen in 10 children (26,3%), who necessitated the administration of a double dose at the third vaccination. The results of the study show that vaccination against active viral hepatitis B in this group of patients was effective

  20. TAKKEN T, VAN DER NJ, HELDERS PJ: Do junvenile idiopathic arthritis patients benefit from an exercise program? A pilot study. Arthritis Rheum. 2001, 45:81-85.
    Organism:Department of Pediatric Physical Therapy, University Hospital for Children and Youth, Het Wilhelmina Kinderziekenhuis, University Medical Center Utrecht, The Netherlands
    Internet : PM:11308067

  21. YABUKI K, INOKO H, OHNO S: HLA testing in patients with uveitis. International Ophthalmology Clinics 2000, 40:19-35.
    Organism:Department of Ophthalmology, Yokohama city University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Kanagawa, Yokohama, 236-0004 Japan