Bibliography July 2002- ACCORINTI M, LA CAVA M, SPERANZA S, PIVETTI-PEZZI P: Uveitis in Turner's syndrome. Graefes Arch.Clin.Exp.Ophthalmol. 2002, 240:529-532.
Organism:Servizio Speciale di Immunovirologia Oculare, Istituto di Oftalmologia, Universita di Roma La Sapienza, Viale del Policlinico, Italy massimoaccorinti@tiscalinetit
Abstract: BACKGROUND: Turner's syndrome is a chromosomal abnormality where phenotypic females have either a missing X chromosome or a structural aberration of the X chromosome. Several ocular diseases have been associated with Turner's syndrome in the past, including one case only of proven iridocyclitis. METHODS: In this study we report the clinical findings of three females with Turner's syndrome and uveitis followed up for a mean period of 12.6 months. Two were observed in childhood or adolescence (10 and 16 years old). RESULTS: All the patients showed iridocyclitis, in one case complicated by the onset of papilledema and cystoid macular edema. Associated systemic diseases (psoriasis and juvenile seronegative arthritis) were diagnosed in two cases. The third patient showed positive antinuclear antibody and HLA-DR11, without any clinical or radiologic signs of arthritis. The iridocyclitis tended to become chronic with time, and this may be partially due to the endocrinologic contraindications to the use of systemic steroids. Nevertheless, the final visual acuity was > or =8/10 in all three cases. CONCLUSIONS: Iridocyclitis should be included in the list of ocular manifestations in Turner's syndrome. It may tend to become chronic and may be found especially in those patients presenting other associated autoimmune systemic disease
Internet : PM:12136281 - ALAKULPPI N, SAILA H, SAVOLAINEN A, TUOMILEHTO-WOLF E, TUOMILEHTO J: HLA haplotype (A,C,B,DRB1,DQB1) sharing in Finnish families with multiple siblings affected by juvenile idiopathic arthritis. Tissue Antigens 2002, 59:55
Organism:National Public Health Institute, Helsinki Finland - AMANO K, TAKEUCHI T: Parvovirus B19 infection in adults. Internal Medicine (Tokyo) 2002, 41:247-248.
Organism:Second Department of Internal Medicine, Saitama Medical Center, Saitama Medical School, Kawagoe, 350-8550 Japan - AVC c, CIMAZ R, FALCINI F, ZULIAN F, MARTINI G, SIMONINI G, PORENTA-BES c, CECCHINI G, BORGHI MO, MERONI PL: Prevalence and clinical significance of anti-cyclic citrullinated peptide antibodies in juvenile idiopathic arthritis. Annals of the Rheumatic Diseases 2002, 61:608-611.
Organism:Dr. R. Cimaz, Department of Paediatrics, Istituti Clinici di Perfezionamento, University of Milan, Via Commenda 9, 20122 Milan
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 : Rolando.Cimaz@unimi.it - BALL SD, KERTESZ D, DING Y, MOYER-MILEUR LJ: Dietary supplement use in children with a chronic illness. Pediatric Research 2002, 51:27A
Organism:Pediatrics, Center for Pediatric Nutrition Research, University of Utah, Salt Lake City, UT USA - BLOOM BJ, TOYODA M, PETROSYAN A, ALARIO AJ, JORDAN SM: Anti-endothelial cell antibodies are prevalent in juvenile idiopathic arthritis and may induce endothelial activation. Pediatric Research 2002, 51:12A
Organism:Pediatric Rheumatology Program, Hasbro Children's Hospital/Brown U., Providence, RI USA - BROWN GT, WALLEN M: Functional assessment tools for paediatric clients with juvenile chronic arthritis: An update and review for occupational therapists. Scandinavian Journal of Occupational Therapy 2002, 9:23-34.
Organism:G.T. Brown, Children's Hospital of Eastern Ont., 401 Smyth Road, Ottawa, Ont. K1N 8L1
Abstract: Juvenile chronic arthritis (JCA) is one cause of chronic illness and disability in childhood. Traditional clinical assessment of clients with JCA include objective measures of joint deformity, joint swelling, range of motion, duration of morning stiffness, pain, walking speed, running speed and muscle strength. In many instances, these traditional measures have little or no significance or relevance to paediatric clients and their parents whereas functional skills used in everyday living are more likely to be meaningful. Measures of physical, social, and psychological functioning ensure a comprehensive health assessment. Responsible occupational therapy assessment and management of paediatric clients diagnosed with JCA requires the use of reliable, valid and sensitive measures of function. Several instruments are now available which measure a child's or adolescent's functional abilities. In this paper, JCA and the impact of JCA on functional development are reviewed. As well, seven functional assessment tools designed for use with paediatric clients with JCA which occupational therapists can use in their clinical practice will be appraised. The various characteristics of these tools are discussed in order to assist practitioners and researchers in selecting the functional instrument which best meets their needs
Internet : brown@cheo.on.ca - CHEN C-C, LIN Y-T, YANG Y-H, CHIANG B-L: Sulfasalazine therapy for juvenile rheumatoid arthritis. J.Formos.Med.Assoc. 2002, 101:110-116.
Organism:Dr. B.-L. Chiang, Department of Pediatrics, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei
Abstract: Background and Purpose: Sulfasalazine (SSZ) has recently been shown to be effective for the management of juvenile rheumatoid arthritis (JRA). This study investigated the efficacy and adverse effects of SSZ therapy in children with JRA. Methods: Data from the medical records of 24 children with JRA who were treated with oral SSZ during the period from 1993 through 2000 were analyzed retrospectively. Disease onset was polyarticular in six children, oligoarticular in 11, and systemic in seven. All patients had received nonsteroidal anti-inflammatory drugs (NSAIDs) and 17 had received SSZ and azathioprine (AZA) concomitantly. The initial dose of SSZ averaged 21.6mg.kgSUP-1.dSUP-1. The mean duration of treatment was 13.3 months (range, 3-66 mo). The mean duration of follow-up was 16.6 months (range, 3-66 mo) from the start of SSZ therapy. Results: Twenty children (83%) showed clinical improvement and 18 children (75%) achieved clinical remission. Patients with systemic-onset JRA had lower response rates than did those with an oligoarticular onset (p < 0.05). SSZ was discontinued in seven patients following 7 months of clinical remission and 10 months of treatment. Relapse occurred in four patients (16.7%) following a mean of 17 months of clinical remission. All achieved remission again after restarting the regimen and increasing the SSZ dosage by one-third. Adverse effects related to SSZ were found in only three patients (12.5%): nausea and epigastralgia in two, skin rash in the other. Conclusions: SSZ in combination with other drugs (NSAIDs or disease-modifying antirheumatic drugs) is safe and appears to be an effective treatment for JRA, especially in patients with the oligoarticular- and polyarticular-onset disease - CHU S-H, SHYUR S-D, PENG Y-H, WU C-Y, CHANG C-L, LAI C-L, WU W-C: Juvenile idiopathic arthritis with pulmonary hemosiderosis: A case report. Journal of Microbiology, Immunology and Infection 2002, 35:133-135.
Organism:S.-D. Shyur, Department of Pediatrics, Mackay Memorial Hospital, 92, Section 2, Chung-Shan North Road, Taipei 104
Abstract: Pleuropulmonary disease is occasionally seen in association with juvenile idiopathic arthritis. There have been few case reports of pulmonary hemosiderosis associated with juvenile idiopathic arthritis. We describe a case of a 3-year-old girl with iron deficiency anemia, juvenile idiopathic arthritis, and pulmonary hemosiderosis. Arthralgia of the left knee was noted 2 weeks after the diagnosis of iron deficiency anemia, and juvenile idiopathic arthritis was diagnosed 9 months later. She was treated with naproxen and prednisolone. Her joint symptoms were well controlled after the treatment. Six months later, hemoptysis developed and pulmonary hemosiderosis was diagnosed. She was again treated with naproxen and prednisolone and no more pulmonary or joint symptoms developed during more than 1-year follow-up
Internet : abc1016@ms2.mmh.org.tw - CHUNG EK, YANG Y, LOKKI M, BLANCHONG CA, JONES KN, HIGGINS GC, RENNEBOHM RM, YU CY: Genetic sophistication of human complement C4A and C4B and RP-C4-CYP21-TNX modules in the major histocompatibility complex (MHC). Pediatric Research 2002, 51:12A
Organism:Pediatrics, Ohio State University and Children's Research Institute, Columbus, OH USA - ESENYEL M, CURRIE DM: A child with spina bifida, cerebral palsy and juvenile rheumatoid arthritis: Rehabilitation challenge. Disabil.Rehabil. 2002, 24:499-502.
Organism:M. Esenyel, SSK Vakif Gureba Teaching Hospital, Dept. of Physical Medicine/Rehab., Istanbul
Abstract: Purpose: A child with spina bifida, cerebral palsy and juvenile rheumatoid arthritis is presented, and strategies to approach a patient with multiple paediatric onset disabling conditions with possible overlaps are discussed. Conclusion: The value of multidisciplinary team approach including physiatrist, physical therapist, occupational therapist, rehabilitation nurse, prosthetist-orthotist, psychologist, speech-language pathologist, paediatric rheumatologist, social worker, kinesiotherapist, dietitian, recreation therapist, dentist and other disciplines as required is emphasized
Internet : meltemesenyel@yahoo.com - FAIRBURN PS, PANAGAMUWA B, FALKONAKIS A, OSBORNE S, PALMER R, JOHNSON B, SOUTHWOOD TR: The use of multidisciplinary assessment and scientific measurement in advanced juvenile idiopathic arthritis can categorise gait deviations to guide treatment. Arch.Dis.Child 2002, 87:160-165.
Organism:Clinical Measurements Laboratory, West Midlands Rehabilitation Centre, UK
Abstract: BACKGROUND: It is difficult to identify the range of gait deviations associated with juvenile idiopathic arthritis (JIA) using simple clinical observations. AIMS: To use objective gait analysis to accurately describe biomechanical gait abnormalities in JIA and to search for common patterns, which may subsequently serve as a basis for therapeutic intervention. METHODS: Children with persistent polyarticular arthritis and symmetrical joint involvement were referred to the Gait Analysis Laboratory and independently assessed by a multidisciplinary team. Gait analysis was performed using an in-house Visual Vector System and the Novel PEDAR in-shoe plantar pressure measurement system. Clinical groupings were based on the extent of joint restriction: minimal (group A), and moderate-severe (with supinatory foot deformity (group B), or with pronatory foot deformity (group C)). Gait analysis enabled classification of each subject into one of four gait patterns: either near normal (pattern I) or one of three adaptive patterns defined by the predominant abnormality--lower limb pain (pattern II), lower limb deformity (pattern III), or a combination of pain and deformity of the lower limb (pattern IV). RESULTS: Of the 15 subjects assessed as part of this study, seven were placed into clinical group A, six into group B, and two into group C. All the subjects with gait patterns I and II were found in clinical group A. Both subjects from clinical group C exhibited gait pattern III. All subjects from clinical group B and the remainder from group A exhibited a mixture of gait patterns III and IV. CONCLUSION: Despite the initial clinical observations it was not always possible to predict the resultant gait pattern. Scientific gait analysis allowed a clear distinction to be made between primary and secondary gait deviations, and accurate targeting of physiotherapy and orthotic interventions to suit each individual. Prospective quantitative analysis in a larger sample is under way to support the clinical effectiveness of these findings
Internet : PM:12138073 - FORRE O, SMERDEL A: Genetic epidemiology of juvenile idiopathic arthritis. Scandinavian Journal Of Rheumatology 2002, 31:123-128.
Organism:O. Forre, Center for Rheumatic Diseases, Rikshospitalet University Hospital, Sognsvannsveien 20, NO-0027 Oslo
Abstract: Juvenile idiopathic arthritis (JLA) is a heterogeneous group of disorders. Although the pathogenesis is not completely understood, many studies point to a genetic component in the susceptibility for this disease with environmental factors also contributing to the pathogenesis. The genetic component of JIA is complex, involving the effects of multiple genes at various points in the disease pathology. The best documented association is with the genes within the Human Leukocyte Antigen (HLA) complex, encoding the classical peptide-presenting molecules. JIA is associated with particular alleles at, at least, three different HLA loci: HLA-A (HLA-A*0201), -DR/DQ (DRB1*08, DRB1*11, DRB1*13) and -DP (DPB1*0201. DPB1*0301), with marked differences between the disease subtypes. Non-HLA genes may also contribute to the disease. Many of these genes encode cytokines and probably regulate their production. Examples of such cytokines involved in JIA are interleukin-1alpha (IL-1alpha), interleukin-1 receptor antagonist (IL-1Ra), interleukin-6 (IL-6), interleukin-10 (IL-10), macrophage inhibitory factor (MIF), interferon regulatory transcription factor (IFN1). Accumulated data suggest that interactions between the genes are necessary for the development of the disease. Knowledge of the genes involved would help to understand the molecular mechanisms involved in the pathogenesis of JIA and may have implications for prognosis and therapy
Internet : oystein.forre@rikshospitalet.no - GARAVITO G, MIDDLETON D, IGLESIAS A, EGEA EE, CABALLERO C, V, EGEA E: Absence of EO-JRA in a north Colombian afrocaribbean subpopulation: Associated HLA-class I DNA polymorphism. Tissue Antigens 2002, 59:138
Organism:Universidad del Norte, Barranquilla Colombia - GOTIA S, POPOVICI I, HERMEZIU B: Antioxidant enzymes levels in children with juvenile rheumatoid arthritis. Rev.Med.Chir Soc.Med.Nat.Iasi 2001, 105:499-503.
Organism:2nd Clinic of Pediatrics, School of Medicine, University of Medicine and Pharmacy GrT Popa Iasi
Abstract: Pathogenic mechanism of chronic inflammation is associated with increased production of superoxide anion and hydrogen peroxide. In the neutralization process of that anions, superoxid dismutase (SOD), catalase (CAT), and glutation peroxidase (GPx) are key enzymes. Aim of study consists of establishing of some clinic-biological correlations in JRA chronic inflammation in childhood between clinical status and determination of lipoperoxidation products and antioxidative enzymes in the blood. MATERIAL AND METHODS: Blood samples were obtained from 20 patients admitted in 2nd Clinic of Pediatrics, 4-6 months after onset of disease, diagnosed with JRA, oligoarticular form (6 cases), poliarticular form (9 cases) and systemic form (5 cases), as compared to 10 control subjects. SOD, CAT, GPx were measured comparing with malonildialdehyde (MDA), seric glutation (GSH) and usual inflammatory tests (ESR, fibrinogen, CRP). Determinations were repeated after 6 weeks of treatment. RESULTS: In all our cases, level of antioxidant enzymes (CAT, GPx) was decreased at time of diagnosis, concomitant with increased MDA, SOD and inflammatory tests. In most of cases, after 6 weeks of correct anti-inflammatory treatment, levels of enzymatic antioxidant markers were still decreased, as compared to usual inflammatory tests that came back to normal. Persistent decreased antioxidant enzymatic activity was found in cases that need immunomodulatory activity (Methotrexat). CONCLUSIONS: Determination of antioxidant enzymes level can be considered an evolution marker in JRA. More studies are necessary to find if antioxidant potential of blood can be used as following marker for immunosuppressive therapy
Internet : PM:12092181 - HUEMER C, MALLESON PN, CABRAL DA, HUEMER M, FALGER J, ZIDEK T, PETTY RE: Patterns of joint involvement at onset differentiate oligoarticular juvenile psoriatic arthritis from pauciarticular juvenile rheumatoid arthritis. Rinsho Ganka 2002, 29:1531-1535.
Organism:Dr. C. Huemer, Eponastrasze 7, A-6900 Bregenz
Abstract: Objective. To compare the patterns of joint involvement of patients with oligoarticular onset juvenile psoriatic arthritis (Oligo-JPsA) and pauciarticular onset juvenile rheumatoid arthritis (Pauci-JRA) in order to estimate the predictive performance of specific patterns for the diagnosis of Oligo-JPsA. Methods. Twenty-three children who fulfilled the diagnostic criteria for JPsA (Vancouver criteria) and who had fewer than 5 joints involved in the first 6 months of disease (Oligo-JPsA), and 64 children with Pauci-JRA (ACR criteria) were enrolled. Patients were also classified with respect to the ILAR criteria for juvenile idiopathic arthritis (JIA). Patient characteristics and clinical features at onset and during followup were determined. Patterns of joint involvement at onset of disease and their ability to differentiate between Oligo-JPsA and Pauci- JRA/Oligo-JIA were evaluated. Results. Small joint disease (defined as involvement of any of the metatarsophalangeal or proximal or distal interphalangeal joints of the foot, or metacarpophalangeal or proximal or distal interphalangeal joints of the hand) was significantly more frequent in Oligo-JPsA than in Pauci-JRA at disease onset. The odds of patients with Oligo-JPsA having small joint disease or wrist disease within 6 months of disease onset were much higher than those with Pauci-JRA or Oligo-JIA (p < 0.05 or 0.001). Conclusion. Small joint disease and wrist disease are suggestive of Oligo-JPsA. The use of a criterion consisting of small joint disease and/or wrist disease and/or dactylitis instead of dactylitis alone may increase the ability to differentiate Oligo-JPsA from Pauci-JRA or Oligo-JIA - HUSNI ME, MAIER AL, MEASE PJ, OVERMAN SS, FRASER P, GRAVALLESE EM, WEINBLATT ME: Etanercept in the treatment of adult patients with Still's disease. Arthritis Rheum. 2002, 46:1171-1176.
Organism:Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA
Abstract: OBJECTIVE: To evaluate the safety and efficacy of etanercept in the treatment of adult patients with Still's disease. METHODS: Twelve adult patients who met criteria for Still's disease and had active arthritis were enrolled in a 6-month open-label trial of etanercept given in biweekly doses of 25 mg. The mean disease duration at study entry was 10.7 years. All patients had been treated unsuccessfully with other disease-modifying antirheumatic drugs. Efficacy was evaluated according to American College of Rheumatology (ACR) improvement criteria, and adverse events were recorded. RESULTS: Ten patients successfully completed the study; 2 withdrew due to disease flare. In 4 patients, the dosage of etanercept was increased from 25 mg biweekly to 25 mg 3 times per week. Seven patients met ACR 20% response criteria. Of these 7 responders, 4 met ACR 50% response criteria and 2 met ACR 70% response criteria. Among the 3 patients with systemic features of Still's disease (fever and rash), improvement in these features was seen in 1; the arthritis did not improve in any of these 3 patients. Except in the 2 patients who withdrew due to disease flare (rash, fever, and arthritis), no other significant adverse events occurred. CONCLUSION: In this initial study of etanercept therapy for Still's disease in the adult, this treatment resulted in improvement in the arthritis and was well tolerated. Additional trials should be performed to elucidate the effects of tumor necrosis factor inhibitors in Still's disease
Internet : PM:12115220 - JARVIS JN: Juvenile rheumatoid arthritis: A guide for pediatricians. Pediatric Annals 2002, 31:437-446.
Organism:Dr. J.N. Jarvis, Department of Pediatrics, OK University College of Medicine, Basic Sciences Bldg., #235A, Oklahoma City, OK 73104
Abstract: This article provides a guide to distinguishing children with juvenile rheumatoid arthritis (JRA) from those presenting with musculoskeletal complaints. The author discusses the limits of laboratory testing in making the diagnosis of JRA and reviews common complications and treatment - KOCH WC, BARNSTEIN B, SAULSBURY FT: Parvovirus B19 antibody prevalence in children with juvenile rheumatoid arthritis (JRA). Pediatric Research 2002, 51:14A
Organism:Pediatrics/Division of Infectious Diseases, Virginia Commonwealth University, Richmond, VA USA - LUTHI F, ZUFFEREY P, HOFER MF, SO AK: "Adolescent-onset Still's disease": characteristics and outcome in comparison with adult-onset Still's disease. Clin.Exp.Rheumatol. 2002, 20:427-430.
Organism:Service of Rheumatology, CHUV, Lausanne, Switzerland
Abstract: OBJECTIVES: To determine if adolescent onset systemic juvenile idiopathic arthritis (JIA) and adult onset Still's disease (AOSD) represent the same clinical continuum of disease. METHODS: Retrospective review of available clinical data on all pediatric and adult patients diagnosed with Still's disease within the last 10 years at a university hospital. Assessment of functional outcomes at last visit by clinical evaluation and HAQ or c-HAQ. RESULTS: Nine patients were identified as adolescent onset systemic JIA and were compared with 10 patients with AOSD (onset > 18 years old). No statistically significant differences were found between the two groups in terms of clinical presentation at onset and outcome at follow up. CONCLUSION: Adolescent patients presenting with systemic JIA have a disease onset and course undistinguishable from that of AOSD patients, suggesting that they represent a continuum of a single disease entity
Internet : PM:12102485 - MANNERS PJ, BOWER C: Worldwide prevalence of juvenile arthritis - Why does it vary so much? Rinsho Ganka 2002, 29:1520-1530.
Organism:Dr. P.J. Manners, Department of Paediatrics, Prncs. Margaret Hosp. for Children, GPO Box D184, Perth, WA 6014
Abstract: Objective. To review epidemiological studies of childhood arthritis from 1966, and to identify possible reasons for the wide-ranging results for both prevalence and incidence of juvenile arthritis (JA). JA is the term used here collectively for juvenile rheumatoid arthritis, juvenile chronic arthritis, or juvenile idiopathic arthritis as defined in the respective published studies. Methods. A review of 34 epidemiological studies of JA since 1966 was undertaken. Results. Prevalence of JA is reported as 0.07 to 4.01 per 1000 children. Annual incidence is reported as 0.008 to 0.226 per 1000 children. The major factors contributing to differences in estimates include (1) factors due to diagnostic difficulties, to the development of new diagnostic criteria, and to the differing definitions of clinical cases; (2) differences in case ascertainment (community based versus clinical case studies, qualification and experience of study clinicians, definition of study population); (3) factors occurring with the passage of time, i.e., standard of living, health care resources, and increasing knowledge; and (4) small studies and hence more chance fluctuation. The major variation in reported prevalence was due to the difference between true community based studies involving children from within classrooms or homes (and not necessarily previously diagnosed with JA) compared with clinical case studies of children who (by definition) had been previously diagnosed. The highest prevalence was reported for true community based studies. Conclusion. Many factors contribute to the discrepancies between reported prevalence and incidence for JA. Studies based truly in the community reported the highest prevalence, as previously undiagnosed cases were included. Future studies involving standardized criteria and standardized case ascertainment done by fully trained clinicians should show greater consistency of results
Internet : pruem@paed.uwa.edu.au - MUSIEJ-NOWAKOWSKA E, WOJTECKA-LUKASIK E, MASLINSKI S: Polymorphonuclear leukocyte collagenase as an indicator of the juvenile idiopathic arthritis activity. Reumatologia (Warsaw) 2002, 40:5-13.
Organism:Pediatric Clinic, Institute of Rheumatology, Spartanska 1, 02-637, Warsaw Poland
Abstract: In 58 children with JIA and 23 age-matched healthy controls the blood leukocyte PMN collagenase was determined. A significant increase in the level of active collagenase was observed in systemic and pauciarticular forms of JIA and a close positive relation was found between the level of both (active and latent) leukocyte collagenase and joint effusion. It is concluded that PMN - leukocytes in systemic and pauciarticular form are already "partially" activated in the peripheral blood and that the level of active leukocyte collagenase may be a valuable index of disease activity, especially in the pauciarticular form of JIA - O'DONOGHUE NB, HIGGINS EM: Case 1: Naproxen-induced pseudoporphyria. Clin.Exp.Dermatol. 2002, 27:339-340.
Organism:Department of Dermatology, Kings College Hospital, London, UK nualaodonoghue@doctorsorguk
Internet : PM:12139696 - ODABAS AR, CETINKAYA R, SELCUK Y, ERMAN Z, BILEN H: Clinical and biochemical outcome of renal amyloidosis. Int.J.Clin.Pract. 2002, 56:342-344.
Organism:Department of Nephrology, Ataturk University, School of Medicine, Erzurum, Turkey
Abstract: AA amyloidosis is a relatively rare disease which complicates chronic inflammatory diseases, chronic infections, familial Mediterranean fever (FMF) and malignant diseases. Although amyloid deposition may be found in many organs, renal involvement dominates the clinical picture. We reviewed 63 patients with AA amyloidosis who presented to our nephrology department between 1995 and 2000. Prognostic markers, detailed history, physical examination and laboratory tests were evaluated. The causes of AA amyloidosis were as follows: FMF 42 (66.6%), pulmonary tuberculosis 9 (14.2%), chronic osteomyelitis 4 (6.3%), bronchiectasia 4 (6.3%), rheumatoid arthritis 1 (1.5%), juvenile idiopathic arthritis 1 (1.5%), inflammatory abdominal aortic aneurysm 1 (1.5 %), unknown aetiology 1 (1.5%). The diagnosis was made on renal biopsies in 63.4% of the patients, while the remaining 36.6% were diagnosed as a result of rectal biopsies. Sixteen patients died. A low serum albumin, high creatinine and high 24-hour urine albumin excretion were associated with high mortality
Internet : PM:12137441 - OMOLOJA AA, KEDDACHE M, FURLOW S, THOMPSON SD, GLASS DN: Interleukin 4 gene promoter polymorphism and juvenile rheumatoid arthritis. Pediatric Research 2002, 51:11A
Organism:Nephrology and Hypertension USA^Human Genetics^Rheumatology, Children's Hospital Medical Center, Cincinnati, OH - PETTY RE: Frequency of uncommon diseases: Is juvenile idiopathic arthritis underrecognized? Rinsho Ganka 2002, 29:1356-1357.
Organism:Dr. R.E. Petty, Department of Pediatrics, University of British Columbia, Brit. Columbia's Children's Hospital, Vancouver, BC - PICCO P, GATTORNO M, SORMANI MP, VIGNOLA S, BUONCOMPAGNI A, BATTILANA N, PISTOIA V, RAVAZZOLO R: Involvement of the hypothalamic-pituitary-adrenal axis in children with oligoarticular-onset idiopathic arthritis. Ann.N.Y.Acad.Sci. 2002, 966:369-372.
Organism:Dr. P. Picco, Department of Pediatric Rheumatology, G. Gaslini, 5, 16148 Genova
Abstract: Adult patients with rheumatic arthritis and other rheumatic disorders show inappropriate cortisol secretion and peculiar CRH promoter gene polymorphisms. So far, no data are available about this topic in children with juvenile idiopathic arthritis (JIA). We have studied a series of 13 prepubertal patients (10 female, 3 male) affected with oligoarticular JIA (o-JIA) without clinical and biological signs of disease activity (ESR and IL-6). ACTH plasma concentrations were significantly increased at 8 A.M. in o-JIA patients, whereas no differences were found in cortisol plasma concentrations. The ACTH/cortisol ratio was significantly increased in o-JIA patients with respect to the normal population both at 8 A.M. and at noon. DHEAS and testosterone plasma concentration did not statistically differ in the two populations. The genetic study was aimed at defining the prevalence of polymorphisms A1 and A2 in o-JIA patients, but we failed to find allelic or genotypic differences. Our study suggests the presence of a partial resistance to ACTH with a dysregulated pattern of secretion also in inactive o-JIA patients. These preliminary data need further confirmation in larger pediatric studies
Internet : Paolopicco@ospedale-gaslini.ge.it - PRAHALAD S, SHEAR ES, THOMPSON SD, GIANNINI EH, GLASS DN: Increased prevalence of familial autoimmunity in simplex and multiplex families with juvenile rheumatoid arthritis. Arthritis And Rheumatism 2002, 46:1851-1856.
Organism:Dr. S. Prahalad, Division of Immunology, Department of Pediatrics, Univ. of Utah School of Medicine, 50 North Medical Drive, Salt Lake City, UT 84132
Abstract: Objective. To determine if the prevalence of autoimmunity among relatives of patients with juvenile rheumatoid arthritis (JRA) is greater than that among relatives of healthy volunteer control subjects. Methods. Interviews were used to obtain histories of the following disorders among living first- and second-degree relatives of 110 patients and 45 controls: alopecia areata, ankylosing spondylitis, dermatomyositis, Graves' disease, Hashimoto thyroiditis, insulin-dependent diabetes mellitus, inflammatory bowel disease, iritis, JRA, multiple sclerosis, psoriasis, RA, systemic lupus erythematosus, and vitiligo. Chisquares, odds ratios (ORs), and 95% confidence intervals (95% CIs) were calculated. Families of 23 JRA affected sibpairs were interviewed subsequently. Results. There were no significant differences between patients and controls with regard to age, sex, ethnicity, or family size. Patients had 1,228 relatives and controls had 496 relatives. Of all the relatives of the patients, 155 had at least 1 autoimmune disorder, compared with 20 relatives of the controls (12.6% versus 4.0%; OR 3.4 [95% CI 2.1-5.7], P < 0.000001). The prevalence of autoimmunity was increased in first-degree and in second-degree relatives of patients (16.1% and 10.6%, respectively). The prevalence of Hashimoto thyroiditis was significantly higher in the relatives of patients (OR 3.5 [95% CI 1.6-7.9], P = 0.0008). The prevalences of other disorders were not significantly different. JRA affected sibpair families had an increased prevalence of autoimmunity (15.0%). A history of arthritis was found significantly more frequently in the JRA affected sibpair families, but not in the simplex families. Conclusion. These data demonstrate that the prevalence of autoimmunity is significantly higher among first- and second-degree relatives of JRA patients. This suggests that clinically different autoimmune phenotypes may share common susceptibility genes, which may act as risk factors for autoimmunity
Internet : sampath.prahalad@hsc.utah.edu - RACKHAM OJ, SILLS JA, DAVIDSON JE: Immunoglobulin levels in methotrexate treated paediatric rheumatology patients. Arch.Dis.Child 2002, 87:147-148.
Organism:Department of Rheumatology, Alder Hey Children's Hospital, Eaton Road, Liverpool, UK ojrackham@talk21com
Abstract: Retrospective review of serum immunoglobulin levels in 78 methotrexate treated paediatric rheumatology patients showed that IgG, IgA, and IgM levels fell significantly by 26%, 21%, and 17% respectively while on methotrexate. Six patients with systemic disease showed a fall in IgG to below the normal range
Internet : PM:12138068 - SHIGEMORI M, TAKEI S, IMANAKA H, MAENO N, HOKONOHARA M, MIYATA K: Diagnostic significance of increased serum hyaluronic acid in juvenile rheumatoid arthritis. Pediatr.Int. 2002, 44:394-399.
Organism:Departments of Pediatrics and Nursing School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima University, Japan
Abstract: Background: We have previously reported that serum levels of hyaluronic acid (HA) objectively reflect the severity of arthritis in juvenile rheumatoid arthritis (JRA). However, clear diagnostic standards do not exist for JRA; it is difficult to evaluate arthritis in children, particularly in small children and the diagnostic criteria for JRA requires an exclusion of several diseases. Therefore, if a specific test finding associated with JRA could be established, it would enable general pediatricians to make an objective diagnosis. Methods: We measured the serum HA levels in children with joint symptoms as a chief complaint. The total number of subjects were 197 children; of these 89 had JRA, 39 had rheumatic diseases other than JRA, and 69 had non-rheumatic diseases (including systemic 31, polyarticular 40 and pauci-articular in 17), rheumatic diseases other than JRA in 39 subjects, and non-rheumatic diseases in 69 subjects. Sandwich enzyme-linked immunosorbent assay measured HA by using the HA binding protein. Results: The serum level of HA was significantly higher in systemic and polyarticular JRA patients than in patients with pauci-articular JRA, with rheumatic diseases other than JRA, and non-rheumatic patients. With a cut-off value of 100 ng/mL, a diagnostic value of HA in all JRA patients was 48.3% sensitivity and 98.1% specificity. Conclusions: In children presenting with joint symptoms, serum HA measurement is useful for diagnosing systemic and polyarticular JRA
Internet : PM:12139564 - TAUBERT H, RIEMANN D, KEHLEN A, MEYE A, BARTEL F, JOHN V, BRANDT J, BACHE M, WURL P, SCHMIDT H, WEBER E: Expression of cathepsin B, D and L protein in juvenile idiopathic arthritis. Autoimmunity 2002, 35:221-224.
Organism:H. Taubert, Institute of Pathology, Faculty of Medicine, Martin Luther Univ. Halle-Wittenberg, Magdeburger Strasse 14, Halle/Saale D-06097
Abstract: Juvenile idiopathic arthritis (JIA) is the most common childhood autoimmune rheumatic disease and like rheumatoid arthritis (RA), it is characterized by inflammation and the progressive destruction of joints. In RA, cathepsins as proteinases play a major role in destroying synovial tissue and cartilage matrix. So far no data on cathepsin expression in pannus tissue of JIA patients exist. The aim of this study was to characterize the expression levels of cathepsins B, D, H, and L in JIA and to compare them with those in RA. Synovectomy tissue from 16 JIA and 12 RA patients was investigated for cathepsin expression levels by Western blot analysis. Expression of cathepsins B, D and L was on comparable levels in the synovectomy tissue of JIA and RA patients. The following graduation of expression was determined: cathepsin D > cathepsin L > cathepsin B. Cathepsin H was neither found to be expressed in JIA nor in RA patients. The expression levels of cathepsins in pannus tissue showed no clear difference between patients with systemic JIA and patients with monoarticular JIA. In summary, the comparable expression of cathepsins B, D and L in RA and JIA synovectomy tissue suggests that they may play a similarly important role in destroying synovial tissue and cartilage matrix in the course of JIA and RA
Internet : helge.taubert@medizin.uni-halle.de - TOTH E: Localised and generalised osteoporosis in autoimmune polyarthritis. Lege Artis Medicine 2002, 12:149-152.
Organism:Dr. E. Toth, Reumatologiai Osztaly, Flor Ferenc Korhaz, Semmelweis ter 1, H-2143 Kistarcsa
Abstract: In this article, recent data are summarised on the osteoporosis occurring in autoimmune polyarthritis. Involvement of the bone in patients with autoimmune diseases occurs in two forms: localised (around inflamed joints) and generalised. Paraarticular osteoporosis has been known for a long time but new methods of bone measurements highlight the rate and cause of bone loss. Generalised skeletal changes in rheumatoid arthritis, in systemic lupus erythematosus and juvenile chronic arthritis have been proved by epidemiological studies. At present, there is no evidence supporting generalised bone loss in other chronic inflammatory diseases. Despite the fact that clinically apparent osteoporosis in autoimmune diseases is associated with severe health impairment and reduced survival rates, osteoporosis is still underdiagnosed and prophylactic strategies have yet to be found for this group of patients. These facts indicate calling specialists' attention to the importance of osteoporosis in inflammatory diseases