Bibliography June 2001

  1. Anonymous[In Process Citation]. Klin.Med.(Mosk) 2001, 79:26-29.
    Abstract:     Preparations of intravenous immunoglobulin (sandoglobulin, pentaglobin, intraglobin F, octagam) were given daily or each other day in a course dose 0.3-1 g/kg to 43 patients aged 4 to 15 years. Eight of them had allergosepsis, 22--allergoseptic variant of juvenile rheumatoid arthritis (JRA) and 13--systemic JRA and generalized joint syndrome. The treatment induced remission in patients with allergosepsis, prednisolone was discontinued. JRA patients coped with fever, eruption, polyserositis, infection symptoms. Leukocyte count normalized. Preparations of intravenous immunoglobulin in low doses can be therapy of choice in patients with rheumatic-like diseases. In JRA patients it can be effectively used against fever, eruption, polyserositis, carditis, leukocytosis, intercurrent infection before or in the course of immunosuppressive therapy


    Internet : PM:11419080

  2. AJITSARIA R, DALE R, FERGUSON V, MAYOU S, CAVANAGH N: Psoriasis, psoriatic arthropathy and relapsing orbital myositis Clinical dermatology. Clin.Exp.Dermatol. 2001, 26:274-275.
    Organism:Department of Paediatric Neurology, Chelsea and Westminster Hospital, Department of Ophthalmology, Western Eye Hospital, and Department of Dermatology, Chelsea and Westminster Hospital, London, UK
    Abstract:     Orbital myositis is an inflammatory disorder of the orbital muscles causing orbital pain and restriction of eye movements. Although rare in children, it is most frequently seen after orbital trauma or as a post-infectious process. We describe a child with chronic relapsing psoriasis, juvenile psoriatic arthritis and relapsing bilateral orbital myositis


    Internet : PM:11422174

  3. AKAR S, SOYLEV M, ONEN F, ADA E, BIRLIK M, AKKOC N: Acquired Brown's syndrome with juvenile idiopathic arthritis: resolution with early steroid treatment. Clin.Exp.Rheumatol. 2001, 19:354
    Internet : PM:11407097

  4. BECKER-COHEN R, FRISHBERG Y: Severe reversible renal failure due to naproxen-associated acute interstitial nephritis. Eur.J.Pediatr. 2001, 160:293-295.
    Organism:Division of Paediatric Nephrology, Shaare Zedek Medical Centre, Jerusalem, Israel
    Abstract:     Acute interstitial nephritis is uncommon in children and has very rarely been described with naproxen treatment. We report the occurrence of severe acute renal failure in a 10-year-old girl with juvenile rheumatoid arthritis after 1 month of naproxen therapy. Renal biopsy showed severe acute interstitial nephritis. The patient recovered completely after discontinuation of naproxen and administration of methylprednisolone. A review of the literature regarding non-steroidal anti-inflammatory drug-associated acute interstitial nephritis is provided. CONCLUSION: In an era of increasing popularity of non-steroidal anti-inflammatory drugs for use in children, paediatricians should be aware of the potential renal complications of this class of drugs


    Internet : PM:11388597

  5. CARNAHAN MC, WIROSTKO WJ, PERKINS SL, KIM JE, CONNOR TB, HAN DP: The vitreoretinal use of perfluorocarbon liquid in the pediatric population. IOVS 2001, 42:S430
    Organism:Eye Institute, Medical College of Wisconsin, Milwaukee, WI, 53226 USAAnnual Meeting of the Association for Research in Vision and Ophthalmology
    Fort Lauderdale, Florida, USA
    April 29-May 04, 2001

  6. DOBRZYNIECKA B: Diagnosis of the cardiovascular system lesions in course of juvenile idiopathic arthritis
    <ORIGINAL> Diagnostyka zmian w ukladzie krazenia w przebiegu mlodzienczego idiopatycznego zapalenia stawow    . Reumatologia (Warsaw) 2001, 39:15-28.
    Organism:Oddzial Pediatrii, Wojewodzki Szpital Zespolony, pl. 1 Maja 8, 50 - 043, Wroclaw Poland
    Abstract:     The aim of the paper was assessment of the cardiovascular system using noninvasive techniques in children with diagnosis of connective tissue disorders and comparison to the control group. The study covered 81 patients with juvenile idiopathic arthritis (JIA) and 30 healthy children - the control group. Apart from physical examination, the following were analyzed: routine ECG and X-rays, 24 h ECG recording by Holter method, 24 h blood pressure monitoring and echosonography results. The 24 h ECG recording did not reveal hemo-dynamically significant arrhythmias and conduction disorders. There was significant reduction in the indices of the heart beat changes in time in JIA patients. The 24 h blood pressure monitoring revealed significant reduction of blood pressure in JIA. The nocturnal decrease in blood pressure in all groups of children with connective tissue disorders was lower than in healthy subjects. Echosonography of the heart indicated reduced contractility of the left ventricle, there was also thickening of the interventricular septum and back wall of the left ventricle observed. In 41.2% of children with generalized disease there was a thickening of the pericardium and presence of pericardial effusions. In all groups of children with connective tissue disorders there was significant increase in heart beat, both during the day and night. The analysis carried out confirms necessity of constant monitoring of the cardiovascular system in children with JIA and confirms the suitability of non-invasive methods, especially echosonography. The monitoring of blood pressure allows for assessment of the disease progression and of iatrogenic influence of the treatments employed. The analysis of the arrhythmias in Holter recording can be a valuable indicator of the central nervous system involvement and development of disautonomy

  7. EL MIEDANY YM, HOUSNY IH, MANSOUR HM, MOURAD HG, MEHANNA AM, MEGEED MA: Ultrasound versus MRI in the evaluation of juvenile idiopathic arthritis of the knee. Joint Bone Spine 2001, 68:222-230.
    Organism:Rheumatology and Rehabilitation Department, Ain Shams University, Cairo, Egypt miedanycrd@hotmailcom
    Abstract:     OBJECTIVE: To examine the role of ultrasound versus magnetic resonance imaging (MRI) in assessing joint inflammation in patients with juvenile idiopathic arthritis (JIA) of the knee. METHODS: This study was conducted on 38 patients with juvenile idiopathic arthritis (25 girls and 13 boys), whose ages ranged between 2-17 years (mean 8 years), presenting with joint swelling, tenderness, pain on motion and/or limitation of movement. Plain radiography, high-resolution ultrasound and MRI examinations of the knee (before and after contrast administration) were made on all patients. A control group of ten subjects was also examined. RESULTS: Compared to the control group, sonographic examination was found to be of great value as regards the joint effusion, popliteal cysts, lymph nodes and to a lesser extent, the degree of affection of the articular cartilage. MRI was superior in evaluating the extent of synovial proliferation (pannus), thinning out and erosions of articular cartilage, loculated effusions as well as hypoplastic menisci and ligaments, especially after contrast enhancement. CONCLUSION: Ultrasound is a simple, inexpensive and valuable tool in evaluating the initial stages of JIA. In more advanced stages of JIA and also for monitoring the progression of the disease process and response to therapy, MRI examination following gadolinium proved to be superior in evaluation of the joint affection


    Internet : PM:11394622

  8. FLEDELIUS H, ZAK M, PEDERSEN FK: Refraction in juvenile chronic arthritis: a long-term follow-up study, with emphasis on myopia. Acta Ophthalmol.Scand. 2001, 79:237-239.
    Organism:University Ophthalmology Clinic and University Clinic of Paediatrics, Rigshospitalet, Copenhagen, Denmark
    Abstract:     OBJECTIVE: Assessment of refraction anomalies in juvenile chronic arthritis (JCA) on a long-term follow-up basis. MATERIAL AND METHODS: Sixty-five adults, 52 females and 13 males, with a history of active JCA had a complete ophthalmic evaluation including subjective refractioning on average 26.4 years after JCA onset. The age range was 22-49 years. RESULTS: The refraction ranged from -8.12 D to +6.5 D with a mean (SD) of -0.64 (2.16) D. The mean refraction in the JCA group was significantly more towards myopia than that of a coeval adult hospital-based sample used as controls (p=0.008). Twenty-eight out of the 65 (43%) had a negative refractive value of at least 0.37 D. Myopia onset age ranged from 8 to 31 years. In those able to specify their myopia onset by first purchase of spectacles (n=25) the JCA onset had preceded the myopia, with a mean (SD) interval of 10.1 (5.4) years. CONCLUSION: The elevated myopia figure of 43% among JCA patients suggests an association between myopia and JCA. In lack of more precise indicators and in accordance with older literature, an explanation might be a weakening effect of chronic inflammation on scleral connective tissue


    Internet : PM:11401630

  9. HOSHINO K-I, 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. Journal of Bone and Mineral Metabolism 2001, 19:76-83.
    Organism:T. Hanyu, Department of Orthopedic Surgery, Niigata Univ. School of Medicine, 1 Asahimachi-dori, Niigata 951-8510
    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

  10. JAIN V, SINGH S, SHARMA A: Keratonconjunctivitis sicca is not uncommon in children with juvenile rheumatoid arthritis. Rheumatol.Int. 2001, 20:159-162.
    Organism:Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
    Abstract:     Keratoconjunctivitis sicca (KCS), characterised by aqueous tear deficiency, is the most common ocular complication in adult rheumatoid arthritis (RA). In juvenile rheumatoid arthritis (JRA), however, it remains under-reported. For this prospective study, 50 children with JRA were examined clinically and underwent tests for KCS (Schirmer's I and rose bengal tests, fluorescein staining, and tear film breakup time). Six children (12%) with two or more abnormal tests were diagnosed as having definite KCS, while one child with only one abnormal test was labelled with probable KCS. Five of the six (83.3%) with definite KCS were males, and three (50%) had a pauciarticular form of the disease. Two children (33.3%) with definite KCS had no ocular symptoms, five were receiving only nonsteroidal anti-inflammatory drugs, and one was additionally on methotrexate. Keratoconjunctivitis sicca appears to be a common ocular complication and all children with JRA should be screened for it with a comprehensive battery of tests


    Internet : PM:11411961

  11. LAIHO K, HANNULA S, SAVOLAINEN A, KAUTIAINEN H, KAUPPI M: Cervical spine in patients with juvenile chronic arthritis and amyloidosis. Clin.Exp.Rheumatol. 2001, 19:345-348.
    Organism:Rheumatism Foundation Hospital, 18120 Heinola, Finland
    Abstract:     OBJECTIVE: To describe cervical spine abnormalities in a group of adult patients with refractory juvenile chronic arthritis (JCA) complicated by secondary amyloidosis (SA). METHODS: The series consists of 49 patients who fulfilled the diagnostic criteria of the European League Against Rheumatism for JCA, here complicated by secondary amyloidosis (SA). We evaluated their clinical records and most recent cervical spine radiographs taken in adult age (> 18 years) at or after the diagnosis of SA. RESULTS: Forty-two (86%) patients evinced inflammatory changes in the cervical spine. Apophyseal joint ankylosis was seen in 31 (63%) and atlantoaxial impaction (AAI) in 28 (57%) patients; anterior atlantoaxial subluxation (aAAS) was noted in 17 (35%) patients, and 19 (39%) had the combination of AAI and apophyseal joint ankylosis. The size of the 4th vertebral body was small or narrow in 14 (29%) patients with JCA onset at a median of 3 years of age (range 1-12). CONCLUSION: Inflammatory cervical spine disorders are common and may be detected along the entire length of the cervical spine in patients with severe refractory JCA. The disorders tend to ankylose the apophyseal joints and destroy the atlantoaxial joints, resulting in aAAS or impaction. These changes will restrict rotatory and bending movements in the cervical spine. A peculiarly small or narrow cervical vertebral body was seen mainly in patients with early onset disease. The present findings shed light on the characteristics and course of the inflammatory changes in the cervical spine in patients with refractory JCA


    Internet : PM:11407093

  12. LEMANEK KL, KAMPS J, CHUNG NB: Empirically supported treatments in pediatric psychology: regimen adherence. J.Pediatr.Psychol. 2001, 26:253-275.
    Organism:Ohio Sate University College of Medicine University of Kansas University of Washington School of Medicine
    Abstract:     OBJECTIVE: To review empirical studies of psychological interventions for nonadherence to medical regimens for three chronic illnesses: asthma, juvenile rheumatoid arthritis (JRA), and type 1 diabetes. METHODS: The Chambless criteria for "promising," "probably efficacious," or "well-established" were applied to 8 intervention studies on asthma, 4 on JRA, and 11 on type 1 diabetes. RESULTS: For asthma, organizational strategies appear probably efficacious in promoting adherence, whereas educational and behavioral strategies appear promising. For JRA, behavioral strategies appear probably efficacious in improving adherence. For type 1 diabetes, multicomponent packages and operant learning procedures appear probably efficacious, whereas cognitive-behavioral strategies appear promising. No interventions were identified as "well-established." CONCLUSIONS: Future studies will need to develop adequate definitions of adherence, accurate methods of assessing adherence, and appropriate designs to evaluate multicomponent treatment programs to advance interventions to the "well-established" category


    Internet : PM:11390568

  13. MARTIGNETTI JA, AQEEL AA, SEWAIRI WA, BOUMAH CE, KAMBOURIS M, MAYOUF SA, SHETH KV, EID WA, DOWLING O, HARRIS J, GLUCKSMAN MJ, BAHABRI S, MEYER BF, DESNICK RJ: Mutation of the matrix metalloproteinase 2 gene (MMP2) causes a multicentric osteolysis and arthritis syndrome. Nat.Genet. 2001, 28:261-265.
    Organism:[1] Department of Human Genetics, Mount Sinai School of Medicine, Box 1498, Fifth Avenue at 100th Street, New York, New York, USA [2] Department of Pediatrics, Mount Sinai School of Medicine, Box 1498, Fifth Avenue at 100th Street, New York, New York, USA
    Abstract:     The inherited osteolyses or 'vanishing bone' syndromes are a group of rare disorders of unknown etiology characterized by destruction and resorption of affected bones. The multicentric osteolyses are notable for interphalangeal joint erosions that mimic severe juvenile rheumatoid arthritis (OMIMs 166300, 259600, 259610 and 277950). We recently described an autosomal recessive form of multicentric osteolysis with carpal and tarsal resorption, crippling arthritic changes, marked osteoporosis, palmar and plantar subcutaneous nodules and distinctive facies in a number of consanguineous Saudi Arabian families. We localized the disease gene to 16q12-21 by using members of these families for a genome-wide search for homozygous-by-descent microsatellite markers. Haplotype analysis narrowed the critical region to a 1.2-cM region that spans the gene encoding MMP-2 (gelatinase A, collagenase type IV; (ref. 3). We detected no MMP2 enzymatic activity in the serum or fibroblasts of affected family members. We identified two family-specific homoallelic MMP2 mutations: R101H and Y244X. The nonsense mutation effects a deletion of the substrate-binding and catalytic sites and the fibronectin type II-like and hemopexin/TIMP2 binding domains. Based on molecular modeling, the missense mutation disrupts hydrogen bond formation within the highly conserved prodomain adjacent to the catalytic zinc ion


    Internet : PM:11431697

  14. MOORE TB, SHERRY D, DEODHAR A, TILFORD DL, JOHNSON FL, JONES GR, NICHOLSON HS, THOMAS GA, WOLFF LJ, BRADY K: Stem cell transplantation for severe juvenile rheumatoid arthritis. Blood 2000, 96:373b
    Organism:Pediatric Hematology/Oncology, Oregon Health Sciences University, Portland, OR USA
    Abstract:     Autologous stem cell transplantation offers potential as a treatment for refractory juvenile rheumatoid arthritis (JRA). We report our experience in the treatment of a ten year old girl with an eight year history of severe systemic JRA using high dose cytotoxic/immunosuppressive therapy and autologous CD34+ selected stem cell support. Initially diagnosed at 2 years of age, her JRA was completely refractory to conventional therapy including corticosteroids, methotrexate and low dose cyclophosphamide. Pain reduction including narcotics was ineffective. She required biannual corticosteroid injections of as many as 24 joints at a time. Peripheral blood stem cells were collected after 5 days of 10 mcg/kg/d of G-CSF. There was no exacerbation of arthritis during the G-CSF administration. Four collections and CD34+ selection were performed yielding a final product of 2 X 10e6 CD34+ cells/kg and less than 10e5 CD3+ cells/kg. Conditioning prior to stem cell infusion consisted of ATG 20 mg/kg, cyclophosphamide 200 mg/kg and TBI 400 cGy. She achieved neutrophil engraftment by day 17 and platelet transfusion independence by day 18. Serologic markers of her JRA including C-reactive protein became normal. She was readily weaned off all pain medications by 4 months and tapered off prednisone rapidly over the first month to 5 mg/d, and by 7 months following transplant was off all immunosuppressive drugs. She is currently pain-free and off all medications. The affected joint count dropped from greater than 11 (pre-transplant) to zero. The Karnoffsky score is currently 100. By 6 months post-transplant, she had normal IgG, IgM, and IgA levels, and normal B cell number. There was a normal proliferative response to mitogens PHA, CON-A, and PWM. T cells show a persistent inversion of the helper-suppresser ratio with a follow up of 8 months

    42nd Annual Meeting of the American Society of Hematology
    San Francisco, California, USA
    December 01-05, 2000
    American Society of Hematology_

  15. ORLIN M, STETSON K, SKOWRONSKI J, PIERRYNOWSKI M: Foot pressure distribution: methodology and clinical application for children with ankle rheumatoid arthritis. Clin.Biomech.(Bristol., Avon.) 1997, 12:S17
    Abstract:     INTRODUCTION:: Foot pressure measurements furnish information about distribution of pressures, forces, time and contact areas under the foot during standing and walking. Foot pressure measurement has been used in a number of rehabilitation and athletic applications in adults, however, little has been published regarding the clinical usefulness of this technology for children with disabilities. Children with juvenile rheumatoid arthritis (JRA) are reported to have various foot deformities and gait deviations and clinicians report that the children may have foot pain such as metatarsalgia. These may be treated with specially fitted shoes, shoe modifications or ankle foot orthoses. The purpose of this preliminary study was to describe the methodology used to quantify foot pressure distribution patterns and, further, to describe the patterns seen in individual children with JRA compared to aged matched typical children without JRA. METHODS:: Pressure, area and force were measured using the EMED-F system including a platform with 2048 capacitive pressure sensors and a computerized data collection and analysis system. Children were asked to walk comfortably and normally across the platform while time, pressure and area measurements were automatically taken. Other data collected were height and weight, observational gait analysis and lower extremity range of motion measurements. Data are reported for the entire foot, as well as particular areas of the foot that are of interest. For this study, eight discrete areas or masks were identified (medial and lateral heel, medial and lateral midfoot, first metatarsal, lateral four metatarsals, great toes and four lateral toes) for description. Information reported for each area and the total foot included force, peak pressure, total area, pressure time integral and force time integral. Data from three pairs of children were analysed and differences were described. RESULTS:: Several differences in the descriptive data were noted and will be highlighted. Children with JRA had striking asymmetries in several variables, higher peak pressures and in increased total foot pressure time integrals and force time integrals. This information is presented to improve our understanding of the patterns under the foot so that (1) appropriate treatment strategies for foot impairments may be better prescribed for children with JRA and (2) to assist in planning for treatment of gait abnormalities. This preliminary work will also form the basis for determining the clinically meaningful variables to consider in a larger study and statistical analysis


    Internet : PM:11415720

  16. PEACE TA, GOODCHILD LR, VASCONCELOS DY: What's your diagnosis? Fever and leukocytosis in a young beagle. Canine juvenile polyarteritis syndrome (beagle pain syndrome). Lab Anim (NY) 2001, 30:23-26.
    Organism:Battelle Memorial Institute, Columbus, OH, USA
    Internet : PM:11385730

  17. PIGNATTI P, MASSA M, TRAVAGLINO P, MEAZZA C, MARTINI A, DE BENEDETTI F: Activation-induced cell death and Fas-induced apoptosis in patients with systemic or pauciarticular juvenile idiopathic arthritis. Clin.Exp.Rheumatol. 2001, 19:339-344.
    Organism:Clinica Pediatrica, IRCCS Policlinico San Matteo, Pavia, Italy
    Abstract:     OBJECTIVE: To investigate the functionality of the Fas-induced apoptotic pathway in peripheral blood mononuclear cells (PBMC) from patients with systemic or pauciarticular juvenile idiopathic arthritis (JIA). METHODS: PBMC from 12 patients with systemic and 6 with pauciarticular JIA were activated with anti-CD3 and rhIL-2 and then incubated in the presence or absence of the anti-Fas MoAb CH11 inducing activation of the Fas apoptotic pathway. Apoptosis was evaluated by flow cytometry and fluorescence microscopy. RESULTS: The percentage of apoptotic cells following triggering of Fas did not differ between patients with systemic JIA (12.5 +/- 9.5%) or pauciarticular JIA (18.7 +/- 8.9%) and controls (16.1 +/- 6.8%). Evaluation of activation-induced cell death (AICD) in the absence of exogenous triggering of Fas showed that 44% (8/18) of the patients with JIA, compared to none of the controls (0/16), had a percentage of apoptotic cells higher than the mean + 2 SD of controls. The increased AICD was neutralized by the addition of an anti-TNF-alpha antibody. CONCLUSION: Patients with systemic or pauciarticular JIA do not show a defect in the Fas-dependent apoptotic pathway of T cells. The increased AICD present in some patients with JIA appears to be at least in part related to the inflammatory cytokine TNF-alpha


    Internet : PM:11407092

  18. RAUZ S, SOUTHWOOD TR, MURRAY P, I: Uveitis and the International League of Associations of Rheumatologists classification of juvenile idiopathic arthritis. IOVS 2001, 42:S461
    Organism:Academic Unit of Ophthalmology, Division of Immunity and Infection, University of Birmingham, Birmingham UKAnnual Meeting of the Association for Research in Vision and Ophthalmology
    Fort Lauderdale, Florida, USA
    April 29-May 04, 2001

  19. REIFF A, TAKEI S, SADEGHI S, STOUT A, SHAHAM B, BERNSTEIN B, GALLAGHER K, STOUT T: Etanercept therapy in children with treatment-resistant uveitis. Arthritis Rheum. 2001, 44:1411-1415.
    Organism:Division of Rheumatology, Children's Hospital Los Angeles, California 90027, USA
    Abstract:     OBJECTIVE: To evaluate the safety and efficacy of the tumor necrosis factor fusion protein etanercept in children with treatment-resistant uveitis. METHODS: Ten children with chronic active uveitis (7 girls and 3 boys, mean age 7.5 years [range 3-12 years]) were enrolled in this prospective study. In 7 children, uveitis was associated with pauciarticular juvenile rheumatoid arthritis. Five children were antinuclear antibody positive. All patients had failed previous therapy with topical steroids and methotrexate and/or cyclosporine. All were treated with etanercept at a dosage of 0.4 mg/kg twice weekly for the first 3 months, and then, if eyes did not improve, with 25 mg twice weekly (mean 1.1 mg/kg) for at least 3 additional months. RESULTS: At the beginning of the trial, uveitis affected 18 eyes in the 10 children. Within 3 months, 10 of 16 affected eyes (63%; P = 0.017) showed a rapid decrease in anterior chamber cell density, including remission of uveitis in 4 eyes. In children with visual acuity of less than 20/25, 4 of 10 eyes (40%) improved. An exacerbation of uveitis during etanercept therapy occurred in only 1 child (1 of 14 eyes [7%]). Other ocular outcome parameters, such as intraocular pressure, synechia formation, and lens clarity, remained unchanged. Following a dosage increase to an average of 1.1 mg/kg after 3 months in 7 children, no further improvement was noted. CONCLUSION: Our data suggest that etanercept injected subcutaneously twice a week has a beneficial effect on treatment-resistant chronic uveitis in children. Further controlled studies with etanercept in systemic or topical form are necessary to confirm its efficacy and optimal mode of administration


    Internet : PM:11407702

  20. SMITH JR, LEVINSON RD, HOLLAND GN, JABS DA, ROBINSON MR, WHITCUP SM, ROSENBAUM JT: Differential efficacy of tumor necrosis factor inhibition in the management of inflammatory eye disease and associated rheumatic disease. Arthritis Rheum. 2001, 45:252-257.
    Organism:Casey Eye Institute, Oregon Health Sciences University, Portland 97201-4197, USA
    Abstract:     OBJECTIVE: To evaluate the clinical usefulness of tumor necrosis factor (TNF) inhibitors in patients with inflammatory eye disease that is resistant to conventional immunosuppressive therapies. METHODS: Sixteen patients (4 males and 12 females aged 7 to 78 years) who received etanercept (n = 14) or infliximab (n = 2) for either inflammatory eye disease or associated joint disease were studied retrospectively to determine the effect of these medications on their ocular inflammation. RESULTS: Nine cases of uveitis and 7 cases of scleritis were treated. Systemic diagnoses included rheumatoid arthritis (n = 8), juvenile rheumatoid arthritis (n = 3), ankylosing spondylitis (n = 1), and psoriatic spondylarthropathy (n = 1). Three patients had uveitis without associated systemic disease. Although 12 of 12 patients with active articular inflammation (100%) experienced improvement in joint disease, only 6 of 16 with ocular inflammation (38%) experienced improvement in eye disease. Five patients developed inflammatory eye disease for the first time while taking a TNF inhibitor. No patient discontinued treatment because of adverse drug effects. CONCLUSION: TNF inhibitors are well tolerated immunosuppressive medications that may benefit certain subgroups of patients with inflammatory eye disease, but they appear to be more effective in controlling associated inflammatory arthritis


    Internet : PM:11409666

  21. TYNDALL A, PASSWEG J, GRATWOHL A: Haemopoietic stem cell transplantation in the treatment of severe autoimmune diseases 2000. Ann.Rheum.Dis. 2001, 60:702-707.
    Organism:Department of Rheumatology, University Hospital, Basel, Switzerland
    Abstract:     An international meeting took place in Basel, Switzerland from 5 to 7 October 2000 involving 180 participants from 30 countries, with the aim of assessing the existing data on autologous haemopoietic stem cell transplantation (HSCT) in the treatment of severe autoimmune disease, and to decide on future trial planning. Data on 390 patients were presented: 260 from the EBMT/EULAR Basel European/Asian database, 87 from North America (55 from the IBMTR), 39 from Australia, and 4 others. The major disease categories and number of patients receiving transplant were: multiple sclerosis (MS) 127, systemic sclerosis (SSc) 72, rheumatoid arthritis (RA) 70, juvenile idiopathic arthritis (JIA) 36, systemic lupus erythematosus (SLE) 34, dermatomyositis/polymyositis (DM/PM) 5, idiopathic thrombocytopenic purpura (ITP) 7. Single or several cases of other autoimmune diseases were reported. Clinically significant responses were seen in two thirds of all the cases and in all disease categories, with a more accentuated trend towards relapse in JIA and RA.Treatment was associated with a significant morbidity and mortality. In the EULAR/EBMT database (71 centres in 22 countries), a mobilisation associated mortality of 1.5% and an overall procedure related mortality (actuarially adjusted at 12 months) of 9% (confidence interval 6 to 12%) were found, with significant variation between diseases. The North American data showed similar results. Higher mortalities were seen in SSc and systemic JIA, with only one death reported in RA. After presentation of the data and workshop discussion a consensus was reached on several aspects: prospective randomised phase III trials are now appropriate in SSc, MS, and RA. A protocol is ready for SSc (ASTIS Trial), concepts are clear for MS and RA. Further phase I and II data are required in SLE, JIA, and vasculitis. The need for continuing collection of all cases after mobilisation by the standardised EBMT and IBMTR data forms was emphasised


    Internet : PM:11406528

  22. VARBANOVA B, BALEV B, TZONEV K: Clinical significance of arthrosonography in juvenile chronic arthritis. Rheumatology 2001, 9:32-37.
    Organism:Dr. B. Varbanova, Department of Pediatry, Medical University, 55, Marin Drinov Str., Bg - 9000 Varna
    Abstract:     The late and non-obligatory occurrence of cartilage and bone erosions, representing the major radiological features of the rheumatoid inflammation, leads to the necessity for additional imaging methods for assessment of articular damage in juvenile chronic arthritis (JCA). We studied the large peripheral joints of 34 paediatric patients with oligoarthritis, extended oligoarthritis and RF-negative polyarthritis in the age range from 2.6 to 13 years. All children fulfilled the EULAR criteria for JCA. Twenty-six children with other inflammatory arthropathies were used as a control group. The arthrosonography was applied using a frequency of 7.5 MHz by apparatus Aloka. The section directions were consistent with the anatomical structure of the investigated joints. The following indices were evaluated: 1) width of the joint space; 2) echogenicity of the synovial fluid; 3) thickness, structure and outline of the joint cartilage; 4) thickness and structure of the joint capsule; 5) size and density of the joint bursas; 6) signs of subchondral osteodegradation. Major differences between JCA and the control group were found in the following indices: 1) synovial hypertrophy (62% vs 25%, p = 0.047); 2) changes in the cartilage outline (73% vs 0%, p < 0,001); 3) echogenicity of the synovial fluid (82% vs. 0%, p < 0.001); 4) echogenicity of the joint cartilage (94% vs. 50%, p = 0.003). Those abnormalities predominated in children with active disease, more than 1-year duration of the disease and polyarticular course of the disease onset and progression. The arthrosonography is noninvasive and useful method for monitoring the indices for chronic inflammation and joint damage in JCA, inaccessible for the radiological investigation