Bibliography June 2002

 
  1. AL MATAR M, CABRAL DA, PETTY RE: Drs. Al-Matar, et al reply. Rinsho Ganka 2002, 29:860
    Organism:Department of Pediatrics, University of British Columbia, Vancouver, BC Canada

  2. AVCIN T, CIMAZ R, FALCINI F, ZULIAN F, MARTINI G, SIMONINI G, PORENTA-BESIC V, CECCHINI G, BORGHI MO, MERONI PL: Prevalence and clinical significance of anti-cyclic citrullinated peptide antibodies in juvenile idiopathic arthritis. Ann.Rheum.Dis. 2002, 61:608-611.
    Organism:Department of Paediatrics, University of Ljubljana, Slovenia, Italy
    Abstract:     BACKGROUND: Antibodies against cyclic citrullinated peptide (anti-CCP) are considered to be specific for rheumatoid arthritis (RA). OBJECTIVE: To assess the clinical significance of anti-CCP in a cohort of patients with juvenile idiopathic arthritis (JIA). METHODS: Anti-CCP were tested by an enzyme linked immunosorbent assay (ELISA) in serum samples from 109 patients with JIA (30 boys, 79 girls), with a mean age of 8.7 years (range 0.6-20.3) and mean disease duration of 3.6 years (range 3 months to 15.6 years). As control groups, anti-CCP were also tested in sera of 30 healthy children, 25 patients with juvenile onset systemic lupus erythematosus (SLE), and 50 adult patients (30 with RA, 20 with SLE). RESULTS: Positive anti-CCP values were found in sera of two patients with JIA (2%), one with polyarthritis, and one with oligoarthritis. Statistical analysis showed that anti-CCP were not associated with the presence of antinuclear antibodies, raised erythrocyte sedimentation rate, or erosions. In the control groups, none of the patients with juvenile onset SLE and only one of 20 adults with SLE were positive for anti-CCP, but 19/30 (63%) adults with RA showed anti-CCP positivity. CONCLUSIONS: Anti-CCP can be detected in children with JIA, but are less frequently present than in adults with RA
    Internet : PM:12079901

  3. DOLEZALOVA P, TELEKESOVA P, NEMCOVA D, HOZA J: Soluble adhesion molecules ICAM-1 and E-selectin in juvenile arthritis: clinical and laboratory correlations. Clin.Exp.Rheumatol. 2002, 20:249-254.
    Organism:Department of Paediatrics and Adolescent Medicine, Charles University in Prague, 1st Medical Faculty, Czech Republic dolezalovapavla@vfncz
    Abstract:     OBJECTIVE: To determine serum and synovial fluid (SF) concentrations of soluble intercellular adhesion molecule-1 (ICAM-1) and E-selectin (E-sel) in patients with active juvenile idiopathic arthritis (JIA) and in paediatric controls and correlate them with clinical and laboratory variables. METHODS: Total of'30 JIA patients were evaluated: 15 with polyarticular disease course (JIA-poly) and 15 with oligoarthritis (JIA-oligo). Paediatric age-matched control groups consisted of 11 Henoch-Schonlein purpura (HSP) and 10 febrile patients (FC) and 28 healthy children (HC). Current medication, the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and full blood count (FBC) were recorded. Soluble ICAM-1 and E-sel in serum and SF were measured by a sandwich ELISA kit. RESULTS: In the JIA-poly group the concentration of ICAM-1 was significantly higher than in healthy (p < 0.01), but notfebrile controls. Both ICAM-1 and E-selectin correlated with the active joint count (p < 0.01). In 13 JIA patients no correlanon was found between SF ICAM-1 and E-sel levels and the SF leucocyte counts. No significant differences were seen in the disease control and JIA-oligo groups compared to HC. A significant negative correlation with age was observed for the group as a whole (ICAM-1: p < 0.05, E-sel: p < 0.01); E-sel correlated with the leucocyte and thrombocyte counts (p < 0.01), and both molecules with CRP (p < 0.05) and with each other (p < 0.01). CONCLUSION: A high concentration of soluble ICAM-1 in JIA patients with polyarthritis is reported here for the first time. None of the patients showed signs of injection or vasculitis, where generalised endothelial activation could be its main source. Our finding of correlations between both ICAM-1 and E-sel levels and joint counts supports the hypothesis of their synovial origin
    Internet : PM:12051408

  4. HAAPASAARI J, SOINI I, KAUPPI M: MRI diagnosis and successful treatment of upper cervical spine synovitis in a patient with juvenile chronic arthritis. Clin.Exp.Rheumatol. 2002, 20:256-257.
    Internet : PM:12051411

  5. JAROS c, GATTEROVA J, NE c, VAVR c, BREJCHOVA I, LAD V, MINXOVA L, NE c, ZVAROVA J, KYLOUS c, CIMLEROVA P: Analysis of clinical and laboratory data in a group of patients with juvenile idiopathic arthritis (JIA) in the framework of the national register. Ceska Revmatologie 2002, 10:65-70.
    Organism:Dr. K. Jaros(caron)ova, Revmatologicky Ustav, Na Slupi 4, 128 50 Praha 2
    Abstract:     Objective. The objective of the presented work was to analyze data from the nationwide register of inflamatory rheumatic diseases which comprises also a group with juvenile idiopathic arthritis. Method. The authors evaluated data from a total of 407 patients with JIA. The whole group of patients was divided into subgroups according to the last classification (Durban, 1997). In the whole group and in individual subgroups they evaluated clinical data (type of articular affection, systemic symptoms, opthalmological and skin manifestations, functional affections), some laboratory parameters and X-ray changes. Contemporary treatment was elaborated in greater detail, i. e. corticosteroid therapy as well as treatment with drugs modifying the disease. Results. The results confirmed the great heterogeneity of the disease. Serious functional affections at the time of registration were observed in 44 patients (10.8%, functional class c+d). After classification of patients into subgroups the most severe functional affection was observed in systemic arthritis, where functional class c was recorded in 12 (30.0%) patients. Advanced X-ray changes were present in 109 (26.8%) patients, most frequently in seropositive polyarthritis (23; 63.9%). Uveitis was diagnosed in 41 (10.1%) patients, in 28 (6.9%) chronic uveitis and in 13 (3.2%) acute uveitis. Complications, such as synechiae, zonular keratopathies and cataract or glaucoma were present in 18 (4.4%) of the patients with JIA. Contemporary treatment with oral corticosteroids was recorded in 186 (45.7%) patients with JIA, in particular in systemic arthritis (35; 87.5%) and seropositive polyarthritis (19; 52.8%). As to disease modifying druha, methotrexate was administered most frequently on half of the patients with JIA (200; 50.6%), and sulfasalazine (128; 31.5%). As to orthopaedic operations total endoprostheses were implanted in 22 (5.4%) and synovectomies in 57 (14.1%) JIA. Conclusion. The first analysis of data from the nationwide register indicates that JIA is a serious disease and that in a great proportion of patients it leads to functional affection and advanced X-ray changes

  6. JOHNSON K, WITTKOP B, HAIGH F, RYDER C, GARDNER-MEDWIN JM: The early magnetic resonance imaging features of the knee in juvenile idiopathic arthritis. Clin.Radiol. 2002, 57:466-471.
    Organism:Department of Clinical Radiology, Birmingham Children's Hospital, Birmingham, UK
    Abstract:     AIMS: Early diagnosis of juvenile idiopathic arthritis (JIA) facilitates earlier more aggressive therapy, and improved outcome. Recognition of the features of early, untreated JIA on magnetic resonance imaging (MRI) will improve disease detection and expedite treatment. This study aims to highlight the relevant MRI features. METHODS: MRI examinations of the knee joint were performed on 11 children with clinically confirmed, early, untreated JIA. The MRI images were obtained at a mean of 2 months after symptom onset and independently evaluated by two consultant paediatric radiologists. RESULTS: Abnormalities were found on all MRI examinations. Synovial hypertrophy, joint effusions, popliteal lymph nodes and soft tissue swelling were present in all patients. Gadolinium DTPA enhancement improved the detection of synovial hyperplasia. Metaphyseal splaying and condylar overgrowth were seen in five cases (41%), oedema of the lateral collateral ligament in two cases (18%) and superficial cartilage thinning in one case. Bony erosions and deep cartilage destruction were not demonstrated. CONCLUSION: MRI of the knee joint identifies early joint changes which are distinct from those in later disease. The presence of these features should alert the radiologist to the possible diagnosis of JIA and post gadolinium DTPA sequences should be performed. Gadolinium DPTA enhancement increases the sensitivity for the detection of inflammatory changes in JIA. Johnson, K.et al. (2002). Clinical Radiology57, 466-471
    Internet : PM:12069461

  7. KOLAR c, OLEJAROVA M, DOSTAL C, BEC c, DEJMKOVA H, JAROS c, MACHAC c, EDOVA L, TOLFA J, TEGZOVA D, VENCOVSKY J, KYLOUS c, HANZLIC c, ZVAROVA J, PAVELKA K: Analysis of social and occupational background of patients in the national register of rheumatic diseases. Ceska Revmatologie 2002, 10:58-64.
    Organism:Dr. P. Kolar(caron)ova, Revmatologicky Ustav, Na Slupi 4, 128 50 Praha 2
    Abstract:     Introduction. Rheumatic diseases are among the most frequent causes of morbidity and invalidity. Data on social conditions, education and occupation of patients with rheumatic diseases in the Czech Republic are not known so far. Objectives of project. The objective of the present study was to analyze family conditions, education and occupation of patients from the national register of rheumatic diseases which comprises patients with eight basic rheumatic diseases: rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), reactive arthritis (ReA), psoriatic arthritis (PsA), systemic lupus erythematodes (SLE), systemic scleroderma (SSc), polymyositis, dermatomyositis (PM/DM), mixed connective tissue disease (MCTD). Patients and methods. Basic demographic and socioeconomic data of patients with the above diagnoses were assembled by means of questionaires in the out-patient surgeries of the Rheumatological Institute and in the surgeries of 30 field rheumatologists from the entire Czech Republic. In different diagnoses the family status, maximum achieved education, social status and occupation were recorded. The different parameters were evaluated in absolute and relative number. Before the analysis was started the register comprised a total of 1178 patients. Results. Patients with rheumatic diseases are (except JIA) usually married (range 53.2-78.0%), the ratio of working people is 12.8% (JIA) to 70.2% (ReA), the ratio of partial invalidities is 0% (SSc) to 9.1% (MCTD), the ratio of invalidities is 2.1% (ReA) to 36.4% (MCTD). The ratio of unemployed in the group was 0-4.3% (PM/DM). The proportion of different professions could not be reliably evaluated due to the small numbers in different categories
    Internet : petra.kolarova@post.cz

  8. KOLAROV Z, VARBANOVA B, POPOVA D: Changes of T-cell subpopulations from the peripheral blood of patients with rheumatoid arthritis and juvenile chronic arthritis. Rheumatology 2002, 10:44-48.
    Organism:Dr. Z. Kolarov, Clinic of Rheumatology, Medical University, 13, Urvich Str., Bg - 1612 Sofia
    Abstract:     T-cell abnormalities have been established to play a key role in the pathogenesis of the rheumatoid inflammation. The aim of this study is to analyze the changes of T-cells from the peripheral blood of patients with rheumatoid arthritis (RA) and juvenile chronic/idiopathic arthritis (JCA/JIA), as compared to the healthy persons and between both diseases. We studied 49 patients with RA and 35 children with pauciarticular and polyarticular JCA/JIA. T-lymphocyte subpopulations were determined by means of flowcytometric analysis. The results showed significant increase of T-lymphocytes with suppressor characteristics and an activation of the suppressor/cytotoxic subpopulation in both diseases. In JCA/JIA significant elevation of helper/inducer subpopulation was found, as compared to the healthy controls. Total T-cells, helper subpopulation and the IL-2 dependant activation in JCA/JIA showed age-related decrease in comparison to RA

  9. LEAK AM: Treatment of juvenile idiopathic arthritis. CPD Rheumatology 2002, 3:3-7.
    Organism:Dr. A.M. Leak, Queen Elizabeth Queen Mother Hosp., St. Peter's Road, Margate CT9 4AN
    Abstract:     The management of juvenile idiopathic arthritis (JLA) must be rigorous, aiming for disease control. The long-term outlook is often good, but factors leading to a poor functional outcome include the severity of arthritis score at onset and the cumulative duration of active disease. Early use of methotrexate is now included in the British Paediatric Rheumatology Group algorithms for treatment. Whereas methotrexate, and other disease modifying and immuno-suppressive drugs are frequently employed, either alone or in combination, many of these drugs are neither licensed for use in children, nor have been subjected to randomised controlled trials. Despite all efforts systemic disease may remain refractory to even high dose drug regimes; anti-TNF alpha therapy and autologous stem cell transplantation are now being evaluated
    Internet : alison.leak@ekh-tr.sthames.nhs.uk

  10. NEIDEL J, BOEHNKE M, KUSTER RM: The efficacy and safety of intraarticular corticosteroid therapy for coxitis in juvenile rheumatoid arthritis. Arthritis And Rheumatism 2002, 46:1620-1628.
    Organism:Dr. J. Neidel, Department of Orthopaedics, Charite University Hospital, Schumannstrasse 20/21, D-10117 Berlin
    Abstract:     Objective. To study the efficacy and safety of intraarticular triamcinolone hexacetonide (IATH) for the treatment of coxitis in patients with juvenile rheumatoid arthritis (JRA). Methods. Fifty consecutive patients with JRA and coxitis were studied prospectively. Forty-eight children received IATH in 67 arthritic hips. The remaining 2 children exhibited 3 cases of femoral head necrosis (FHN) at the initial assessment and were only followed up; both were receiving long-term systemic steroids. After a minimum of 2 years, the study was concluded with a final evaluation that included magnetic resonance imaging. Results. In 39 of 67 hip joints (58%), remission of the coxitis for a period of 2 years was obtained through a single administration of IATH, while another 12 hip joints showed remission of coxitis after repeated TH injections (total remission rate 76%). We observed 2 patients with FHN following IATH. Both of these children were receiving long-term systemic steroids. During the period between onset of JRA and screening assessment for this study, the children exhibited 2.4 cases of FHN per 100 patient-years, while 1.5 cases of FHN per 100 patient-years were observed between IATH treatment and final followup. All 5 observed cases of FHN occurred among the 20 children who received long-term systemic steroids, while no necrosis occurred in the 30 children who did not receive systemic corticosteroids (P = 0.009 by Fisher's exact test). Conclusion. IATH for juvenile rheumatoid coxitis was an effective treatment that did not increase the rate of FHN. Systemic steroids, however (or their covariable, severity of JRA), may increase the risk of FHN in JRA
    Internet : jasper.neidel@charite.de

  11. NORWEGIAN SOCIETY fR: Annual Meeting of the Norwegian Society for Rheumatology, Oslo, Norway, November 28, 2001. Scandinavian Journal Of Rheumatology 2002, 31:50-53.
    Abstract:     This meeting contains abstracts of 14 papers, written either in English or Norwegian, covering juvenile idiopathic arthritis, genetics, osteoarthritis, rheumatoid arthritis, Wegener's granulomatosis, and systemic lupus erythematosus

  12. OPENSHAW H, NASH RA, MCSWEENEY PA: High-dose immunosuppression and hematopoietic stem cell transplantation in autoimmune disease: Clinical review. Biology of Blood and Marrow Transplantation 2002, 8:233-248.
    Organism:Dr. H. Openshaw, City of Hope National Medical Center, 1500 East Duarte Rd., Duarte, CA 91010
    Abstract:     Since 1996, a number of investigators have carried out phase I-II studies of high-dose immunosuppression with autologous hematopoietic stem cell transplantation (HSCT) in autoimmune diseases. Most of this activity has been in studies of multiple sclerosis (MS), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and juvenile idiopathic arthritis (JIA). Supported by animal models of antigen-induced autoimmunity, the rationale of HSCT is to time-shift the clinical autoimmunity to an earlier period, restoring self-tolerance. Even with the considerable experience of more than 200 transplantations since 1996, it is difficult to judge the optimal approach. This difficulty is in part because of the multiplicity of centers and protocols and the variability in patient eligibility and assessment, the extent of T-cell depletion, and the intensity of the preparatory regimens used. Other than that found in RA, treatment-related mortality has been higher than expected: 17% in SSc (with an additional 10% mortality from progressive disease), 13% in SLE, 13% in JIA, and 8% in MS. Protocol changes to improve safety have been instituted. These changes include the avoidance of high-dose rabbit antithymocyte serum in patients who received T-cell-depleted grafts, use of corticosteroids with granulocyte colony-stimulating factor during stem cell mobilization and as prophylaxis for the engraftment syndrome in MS, lung radiation shielding in SSc, and multiple precautions against the macrophage activation syndrome in JIA. Responses to primary and secondary endpoints have been seen, and there is a consensus among investigators and regulatory bodies that the time has come for randomized phase II-III studies. Each disease presents distinct difficulties: in MS, restriction of eligibility to patients with active inflammatory disease; in SSc, formulation of cardiopulmonary eligibility criteria to decrease risk; in SLE, judgment of whether HSCT adds any advantage to high-dose nonmyeloablative immunosuppressive treatment alone; and in RA, enhancement of response durability. All prospective randomized studies in these diseases must address problems in selection of the comparison nontransplantation treatment and appropriate stopping rules, particularly with treatment arms of unequal risk. Parallel trials in Europe and in the United States are in the late stages of design
    Internet : hopenshaw@coh.org

  13. OZEN S, BESBAS N, BAKKALOGLU A, YILMAZ E: Pyrin Q148 mutation and familial Mediterranean fever. Qjm 2002, 95:332-333.
    Organism:Department of Paediatric Nephrology and Rheumatology, Hacettepe University Faculty of Medicine, Ankara Turkey^E-Mail: sozen@gen.hun.edu.tr

  14. POKROVSKY V, I, MALEEV V, V, YEFREMENKO V, I, ZBOROVSKY AB, GONTAR IP, TYUMENTSEVA IS, AFANASYEV YN: Affine sorbents having magnetic properties in the clinical picture and diagnosis of communicable and noncommunicable diseases. Vestnik Rossiiskoi Akademii Meditsinskikh Nauk 2002, 3-6.
    Abstract:     Affine magnetic sorbents which have no analogs in the practice of our country have been for the first time developed for the rapid diagnosis of various life-threatening diseases (plague, cholera, anthrax, glanders, meliodosis, tularemia, leptospirosis, dysentery, viral hepatitis A) and for the identification of their causative agents. The efficacy of new magnet-controlling test systems has been repeatedly confirmed by their applications in epidemiological events and emergencies: in the epidemiological surveillance of viral hepatitis A in Stavropol and in the Caucasian Mineralnye Vody towns, Stavropol Territory (1994), in the identification of cholera patients, in the detection of transmission factors, when monitoring during large epidemic outbursts of cholera in Stavropol (1990), Daghestan (1994), as well as in the microbiological monitoring during military conflicts in the Chechen Republic (1995). The application of the sorbents has shown that their sensitivity is 4-5 times as much as that of conventional serological assays. In addition, biotechnologies for the production of polyacrylamide and composite aluminosilicate affine immunosorbents with magnetic properties have been developed. They have been used as the basis for designing immobilized granulated antigen reagents for the immunodiagnosis, differential diagnosis, evaluation of the time course and severity of a disease, the efficiency of therapy in patients with systemic scleroderma, proliferative arthritis, systemic lupus erythematosus, juvenile rheumatoid arthritis, osteochondrosis

  15. RAMANAN A, V, BAILDAM EM, WYNN RF: Macrophage activation syndrome is hemophagocytic lymphohistiocytosis: Need for the right terminology. Rinsho Ganka 2002, 29:1105
    Organism:Department of Paediatric Rheumatology, Royal Manchester Children's Hospital, Manchester UK

  16. RAPOFF MA: Assessing and enhancing adherence to medical regimens for juvenile rheumatoid arthritis. Pediatr.Ann. 2002, 31:373-379.
    Organism:Behavioral Sciences Division, Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160-7330, USA
    Internet : PM:12073741

  17. RAVELLI A, MARTINI A: Drs. Ravelli and Martini reply. Rinsho Ganka 2002, 29:1105
    Organism:Pediatria II, Istituto G. Gaslini, Universita di Genova, Genova Italy

  18. REIFF A, HAUBRUCK H, AMOS MD: Evaluation of a recombinant antigen enzyme-linked immunosorbent assay (ELISA) in the diagnostics of antinuclear antibodies (ANA) in children with rheumatic disorders. Journal of developmental and behavioral.pediatrics 2002, 21:103-107.
    Organism:Dr. A. Reiff, Childrens' Hospital Los Angeles, Keck School of Medicine, Univ. Southern California Sch. Med., 4650 Sunset Blvd., Los Angeles, CA 90027
    Abstract:     The reliability and accuracy of ELISAs for the detection of circulating ANA in children with rheumatic diseases has recently been questioned. In this study we evaluated an allegedly superior ELISA method using recombinant antigens in a paediatric population with various rheumatic conditions and compared it to a conventional Hep-2 IFA assay. Sera from 123 children (204 blood samples) were simultaneously tested by conventional ANA immunofluorescence on Hep-2 cells (ANA-IFA) and recombinant antigen ELISA (rELISA). There were 44 children with systemic lupus erythematosus (SLE), 29 with juvenile rheumatoid arthritis (JRA), eight with mixed connective tissue disease (MCTD), eight with reactive arthritis, five with juvenile fibromyalgia syndrome, three with dermatomyositis (JDMS) and 31 with other diagnoses. Thirty-five children (27%) had a positive Hep-2 result, which remained undetected by ELISA (P <0.002). Almost all of these children had significant IFA titres above 1:160. The major discrepancies were observed in children with JRA and SLE. There was no titre correlation between the two assays and the rELISA's OD readings were not linear. The ELISA using recombinant antigens was not useful for the detection of serum ANA in children with rheumatic diseases due to a high rate of false negative results. These data concur with recent reports about the lack of reliability of ELISAs using non-recombinant antigens
    Internet : reiff@hsc.usc.edu

  19. SHAHIN AA, SHAKER OG, KAMAL N, HAFEZ HA, GABER W, SHAHIN HA: Circulating interleukin-6, soluble interleukin-2 receptors, tumor necrosis factor alpha, and interleukin-10 levels in juvenile chronic arthritis: Correlations with soft tissue vascularity assessed by power Doppler sonography. Rheumatol.Int. Berlin 2002, 22:84-88.
    Organism:A.A. Shahin, Faculty of Medicine, Cairo University, Cairo
    Abstract:     Nineteen patients with juvenile chronic arthritis (JCA), ten with systemic (s)-JCA, and nine with polyarticular-onset (p)-JCA were examined for interleukin (IL)-6, tumor necrosis factor (TNF)-alpha, IL-2R, and IL-10 levels. Power Doppler sonography (PDS) for the more affected knee was used in all of them to evaluate soft tissue vascularity. Serum levels of IL-6 were significantly higher in JCA patients than in controls (P<0.007). Patients with p-JCA showed higher levels of IL-6 than patients with s-JCA, and the difference was statistically nonsignificant. Serum IL-6 levels in all patients correlated significantly with the degree of vascularity detected by PDS (P<0.01). This correlation was more pronounced in p-JCA patients (P<0.01 in p-JCA vs P<0.05 in s-JCA). Serum levels of TNF-alpha were higher in patients with JCA than in controls (P<0.0001). Serum levels of TNF-alpha were significantly greater in patients with s-JCA than in p-JCA (P=0.008). Soluble IL-2R levels were higher in patients with JCA than controls (P<0.0002). Serum levels of IL-2R correlated significantly with pannus thickness in p-JCA (P<0.01) and inversely with methoxetrate (MTX) duration in s-JCA (P<0.05). Serum levels of IL-10 were significantly higher in JCA patients than in controls (P<0.0008). Serum IL-10 levels in all patients correlated significantly inversely with hemoglobin levels (r=-0.50, P<0.05), total leukocytic count (TLC) (r=-0.58, P<0.01), and intra-articular steroid injection (r=+0.56, P<0.01). In s-JCA, IL-10 levels correlated significantly with MTX weekly dose (P<0.05). In conclusion, a significant correlation of serum IL-6 levels with the degree of knee joint vascularity was found, and this correlation was more pronounced in p-JCA, which may stress the role of IL-6 as an inducer of neoangiogenesis in JCA
    Internet : rughe@rusys.eg.net

  20. SIMON D, FERNANDO C, CZERNICHOW P, PRIEUR A-M: Linear growth and final height in patients with systemic juvenile idiopathic arthritis treated with longterm glucocorticoids. Rinsho Ganka 2002, 29:1296-1300.
    Organism:Dr. D. Simon, Department of Endocrinology, Hopital Robert Debre, 48 boulevard Serurier, 75019 Paris
    Abstract:     Objective. To assess linear growth and final height in patients given glucocorticoids during childhood for systemic juvenile idiopathic arthritis (JIA). Methods. Heights throughout followup for JIA and final height were recorded in 24 patients. Height data were expressed as the height standard deviation score for chronological age (HSDS/CA). Final height was compared to reference values for the French population and to target height. Results. During glucocorticoid therapy, mean loss of HSDS/CA was -2.7 +/- 1.5 and was positively correlated with prednisone therapy duration (p < 0.01). After prednisone discontinuation, 17 patients (70%) had catch-up growth and 7 (30%) continued to experience slow linear growth. Mean final height was -2.0 +/- 1.8 HSDS and was correlated with mean height at prednisone discontinuation (p < 0.0001). Mean final height was significantly greater in the patients with catch-up growth at prednisone discontinuation (-1.5 +/- 1.6 vs -3.6 +/- 1.2 HSDS), and 87% of patients had a final height below their target height. Conclusion. These data suggest that chronic inflammation and prednisone therapy may adversely affect growth in patients with JIA, and that final height may be closely dependent both on the severity of growth retardation during the active phase of the disease and on linear growth after remission. Thus treatments like growth hormone presently under investigation to improve final height may be most effective when given early after disease onset and/or at remission

  21. SIMON D: Puberty in chronically diseased patients. Horm.Res. 2002, 57:53-56.
    Organism:Dr. D. Simon, Service Pr. Czernichow, Hopital Robert Debre, 48 boulevard Serurier, F-75019 Paris
    Abstract:     Delayed onset of puberty and a reduced pubertal growth spurt are often reported in patients suffering from chronic diseases. The basis of abnormal puberty in these patients is multifactorial. Nutritional deficiency may contribute to growth disorders and delayed puberty. Insufficient food supply and/or eating disorders and/or malabsorption of nutrients can be observed in these patients. Moreover, increased energy supplies are often needed in patients with chronic lung disease, infection or inflammation. More specific factors due to the disease itself may be involved in growth and puberty disorders. Abnormalities of the growth hormone (GH)-insulin-like growth factor (IGF)1 axis and gonadotrophin secretion have been described in patients with chronic renal failure, cystic fibrosis and Crohn's disease. More recently, it has been shown that cytokines produced during chronic diseases such as juvenile idiopathic arthritis may affect the GH-IGF1 axis. Finally, concomitant medication, namely corticosteroids, which are often given to these patients, may contribute to delayed puberty and poor pubertal growth. Copyright (c) 2002 S. Karger AG, Basel
    Internet : dominique.simon@rdb.ap-hop-paris.fr

  22. SMERDEL A, LIE BA, PLOSKI R, KOELEMAN BPC, FORRE O, THORSBY E, UNDLIEN DE: A gene in the telomeric HLA complex distinct from HLA-A is involved in predisposition to juvenile idiopathic arthritis. Arthritis And Rheumatism 2002, 46:1614-1619.
    Organism:A. Smerdel, Institute of Immunology, Rikshospitalet, N-0027 Oslo
    Abstract:     Objective. Juvenile idiopathic arthritis (JIA) is associated with particular alleles at 3 different HLA loci: HLA-A, HLA-DR/DQ, and HLA-DP. These associations are independent of each other (i.e., they cannot be explained by the known linkage disequilibrium between alleles at these loci). The purpose of this study was to look for additional JIA susceptibility genes in the HLA complex. Methods. One hundred two Norwegian JIA patients and 270 healthy individuals, all carrying the DQ4;DR8 haplotype, were investigated by scanning (similar)10 megabases of DNA covering the HLA complex with microsatellite polymorphisms. An expectation-maximization algorithm was used to estimate haplotype frequencies, and the distribution of microsatellite alleles on the high-risk DQ4;DR8 haplotype was compared between patients and controls, to exclude effects secondary to linkage disequilibrium with these susceptibility genes. Results. Allele 5 at the microsatellite locus D6S265 (D6S265*5), 100 kb centromeric of HLA-A, showed a strong positive association with the disease (odds ratio 4.7, corrected P < 10SUP-6). Haplotype analysis demonstrated that the D6S265*5 association was not caused by linkage disequilibrium to the gene encoding HLA-A*02, which has previously been reported to be associated with JIA. Instead, our data suggested that a gene in linkage disequilibrium with D6S265*5, but distinct from HLA-A*02, is involved in the predisposition to JIA. Conclusion. We found that D6S265*5 could be a marker for an additional susceptibility gene in JIA which is distinct from A*02, adding to the risk conferred by DQ4;DR8
    Internet : anna.smerdel@klinmed.uio.no

  23. VARBANOVA B, KOLAROV Z, BALEVA M: IgA-RF as a marker of progressing of rheumatoid arthritis and juvenile idiopathic arthritis. Rheumatology 2002, 10:49-53.
    Organism:Dr. B. Varbanova, Department of Pediatrics, Medical University, 55, Marin Drinov Str., Bg - 9002 Varna
    Abstract:     For the last decade several studies have demonstrated the link between IgA-RF and erosive arthritis both in seropositive and seronegative patients with rheumatoid arthritis (RA). The aim of this study is to investigate the presence of IgA-RF in patients with RA and juvenile chronic arthritis, to analyze the antibody's clinical associations and to look for a connection with criteria for progressing of both diseases. IgA-RF is detected by ELISA in 151 patients with RA, 78 children with pauciarticular and polyarticular forms of juvenile idiopathic arthritis (JIA), 36 healthy adults, 58 healthy children, 50 patients with osteoarthrosis and 67 children with autoimmune and rheumatic diseases. Our results reveal the presence of IgA-RF in about two thirds of the investigated patients with RA and in a quarter of the children with JIA. In patients with RA IgA-RF shows higher concentrations and it is a more frequent finding in seropositive and female patients. In children with JIA IgA-RF is associated with a polyarticular course of the disease (polyarticular and extended pauciarticular forms). In both diseases this immunological marker tends to grow up parallel with the activity and duration of the rheumatoid inflammation and correlates significantly with the development of more severe erosive disease

  24. VARGOVA V, VESELY R, ELBERTOVA A, PODRACKA L: [Characteristics of the cytokine response in patients with various forms of juvenile idiopathic arthritis]. Cas.Lek.Cesk. 2002, 141:248-250.
    Organism:Klinika deti a dorastu LF UPJS a FNsP, Kosice vargova@centralmedicupjssk
    Abstract:     BACKGROUND: Impairment of the dynamic balance between the first and second type of cytokine response with the prevalence of cytokines of the first type plays and important role in the pathogenesis of several autoimmune diseases, including the juvenile idiopathic arthritis (JIA). The aim of our work was to analyse cytokine profile in lymphocytes in the peripheral blood of patients with JIA, and to evaluate the mutual ration between T lymphocytes producing cytokines of the first and second type in different forms of the disease. METHODS AND RESULTS: We studied a group of 42 children aged 6 to 16 years, 32 of them were patients with JIA, 10 children with non-autoimmune diseases represented the control group. Expression of intracellular cytokines INF-gamma and IL-4 were assayed in activated T lymphocytes using recommended protocol (FastImmune Cytokine system, BD). For the sample analysis, flow cytometer FACScan (BD) was used. No differences in incidence of CD3+INF-gamma + Ly was found between patients with oligoarticular and polyarticular form of JIA (19.3 +/- 8.65 vs. 19.2 +/- 9.7%), and values were equal to that of the control group (19.5 +/- 5.85%). Similarly, no difference was found in incidence of CD3+INF4+ Ly between the JIA patients and controls (2.4 +/- 0.9 vs. 2.8 +/- 0.45%). Patients with polyarticular form of disease had statistically lower incidence of CD3+INF4+ Ly than it was among the control group (1.8 +/- 0.9 vs. 2.8 +/- 0.45%, p < 0.05). CONCLUSIONS: In the studied group of 32 patients with different forms of JIA, lower activity of cytokine response of the type 2 was found in children with polyarticular form of the disease
    Internet : PM:12038074

  25. VIGNOLA S, PICCO P, FALCINI F, SABATINI F, BUONCOMPAGNI A, GATTORNO M: Serum and synovial fluid concentration of vascular endothelial growth factor in juvenile idiopathic arthritides. Rheumatology 2002, 41:691-696.
    Organism:M. Gattorno, Second Div. Paediat. Rheumatol. Unit, G. Gaslini Scientific Inst. Children, Largo G. Gaslini 5, 16147 Genoa
    Abstract:     Objective. To evaluate the role of vascular endothelial growth factor (VEGF) in the pathogenesis of local joint inflammation in juvenile idiopathic arthritis (JIA). Methods. Sera from 50 patients affected with JIA and 10 age-matched healthy controls were tested with a commercial ELISA for VEGF. Corresponding synovial fluid (SF) concentrations of VEGF and p75 soluble tumour necrosis factor receptor (sTNFR) were evaluated in 20 active JIA patients. Results. Serum concentrations of VEGF were significantly higher in patients with active polyarticular disease than in patients with active and inactive oligoarticular disease and healthy controls. In JIA patients, serum concentrations of VEGF displayed a significant correlation with a number of clinical and laboratory parameters of disease activity. VEGF concentrations in SF were significantly higher than those detected in corresponding sera. Moreover, a clear correlation was found between corresponding SF and serum VEGF concentrations. In SF, VEGF showed a strong positive correlation with p75 sTNFR. Conclusions. Concentrations of VEGF in SF in patients with JIA are higher than corresponding serum concentrations, suggesting that this pro-angiogenic factor may have a major role in the outgrowth of hyperplastic pannus and tissue damage at the site of tissue inflammation

  26. ZAKE LN, CIMDINA I, RUMBA I, DABADGHAO P, SANJEEVI CB: Major histocompatibility complex class I chain related (MIC) a gene, TNFa microsatellite alleles and TNFB alleles in juvenile idiopathic arthritis patients from Latvia. Human Immunology 2002, 63:418-423.
    Organism:Dr. C.B. Sanjeevi, Karolinska Institutet, Karolinska Hospital, CMM, S-17176 Stockholm
    Abstract:     In order to analyze involvement of major histocompatibility complex class I chain-related gene A (MICA) and tumor necrosis factor a (TNFa) microsatellite polymorphisms as well as TNFB gene in juvenile idiopathic arthritis (JIA), we studied 128 patients divided into groups according to clinical features [monoarthritis (n = 14), oligoarthritis (n = 58), polyarthritis (n = 50), and systemic (n = 6)], and 114 age- and sex-matched healthy controls from Latvia. DNA samples were amplified with specific primers and used for genotyping of MICA and TNFa microsatellite. Typing for a biallelic NcoI polymerase chain reaction RFLP polymorphism located at the first intron of TNFB gene was done as follows: restriction digests generated fragments of 555bp and 185bp for TNFB*1 allele, and 740bp for TNFB*2 allele. The results were compared between cases and controls. We found significant increase of MICA allele A4 (p = 0.009; odds ratio [OR] = 2,3) and allele TNFa2 (p = 0.0001; OR = 4.4) in patients compared with controls. The frequency of allele TNFa9 was significantly decreased (p = 0.0001; OR = 0.1) in patients with JIA. No significant differences of TNFB allele frequency were found. Our data suggest that MICA and TNFa microsatellite polymorphisms may be used as markers for determination of susceptibility and protection from JIA. (c) American Society for Histocompatibility and Immunogenetics, 2002. Published by Elsevier Science Inc
    Internet : sanjeevi.carani@molmed.ki.se