Bibliography August 2002- AGGARWAL A, MISHRA R: Cytokine production by peripheral blood mononuclear cells from patients with juvenile idiopathic arthritis. Indian Pediatr. 2002, 39:739-742.
Organism:Department of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226 014, UP, India amita@sgpgiacin
Internet : PM:12196685 - ALEXIADES-ARMENAKAS M: Juvenile rheumatoid arthritis (juvenile chronic arthritis). Dermatol.Online.J. 2001, 7:19
Organism:Department of Dermatology, New York University, USA
Internet : PM:12165235 - ALPIGIANI MG, CERBOI M, BERTINI I, D'ANNUNZIO G, HAUPT R, LESTER A, LORINI R: Endocrine autoimmunity in young patients with juvenile chronic arthritis. Clinical And Experimental Rheumatology 2002, 20:565-568.
Organism:Dr. R. Lorini, Department of Pediatrics, University of Genoa, Gaslini Children's Hospital, Largo G. Gaslini no. 5, I-16148 Genova
Abstract: Objective. The aim of our study was to investigate the coexistence of autoimmune diseases (autoimmune thyroid disease and type 1 diabetes mellitus, T1DM) in patients affected by Juvenile Chronic Arthritis (JCA). Methods. We studied 66 patients affected by JCA, 42 females and 24 males: 42/66 patients had a pauciarticular form of JCA, 13/66 had a poly-articular form and 11/66 had a systemic form. All the patients underwent autoimmune thyroid screening through determination of anti-thyroglobulin (TgA) and anti-peroxidase (TPOA) autoantibodies. Patients with TgA and/or TPOA, underwent thyroid sonography. T1DM screening included determination of anti-glutamic acid decarboxylase (GADA), anti-insulin (IAA), anti-tyrosine phosphatase-like protein (IA-2A) and anti-islet cell (ICA) autoantibodies. Oral glucose tolerance test (OGTT) was performed only in patients with autoantibody positive values. HLA typing for risk of T1DM was performed in 43 patients. Results. Nine female patients (14%) showed anti-thyroid autoantibodies, in particular: TgA in 3 cases, TPOA in 5, TgA and TPOA in only 1. In 3 of these patients, ultrasound examinations showed thyroid abnormal pattern, suggesting Hashimoto's thyroiditis. As regards T1DM, only 2 patients showed positive levels of GADA. As regards HLA typing, one or more T1DM susceptibility heterodimers were detected in 20 patients (46%) (13 with 1 heterodimer, 7 with 2 heterodimers). Conclusion. Our study showed that anti-thyroid autoantibody frequency (9/66, 14%) was higher in JCA than in the general population, while T1DM markers (islet autoantibodies and genetic markers) were not frequent. These results suggest to investigate specific markers of thyroid autoimmunity in patients with JCA, in particular in females with JCA pauciarticular form
Internet : reumatologia@ospedale-gaslini.ge.it - BERMAN MA, TAI L-Q, IMFELD KL, ZALDIVAR F, MCCURDY DK: Cytokine stimulation by developmental antigens, a potential mechanism for autoimmune disease. Journal of Leukocyte Biology Supplement 2001, 83-84.
Organism:Children's Hospital of Orange County, Orange, CA USA - CIMAZ R, GATTORNO M, SORMANI MP, FALCINI F, ZULIAN F, LEPORE L, BARDARE M, CHIESA S, CORONA F, DUBINI A, LENHARDT A, MARTINI G, MASI L, BIANCHI ML: Changes in markers of bone turnover and inflammatory variables during alendronate therapy in pediatric patients with rheumatic diseases. Rinsho Ganka 2002, 29:1786-1792.
Organism:Dr. R. Cimaz, Pediatric Department, Via Commenda 9, 20122 Milano
Abstract: Objective. Alendronate treatment for 12 months in pediatric patients with rheumatic diseases and secondary low bone mass was reported to result in a substantial increase in bone mineral density (BMD). In this study, we evaluated the changes in bone metabolism and disease activity markers in 45 patients ages 5 to 18 years (31 female, 14 male) with rheumatic diseases treated with alendronate for 12 months. Methods. Variables analyzed included demographic and anthropometric data, biochemical markers of bone metabolism, disease activity indexes, and BMD values. For all variables, the differences between levels at baseline and at 12 months were calculated; correlations between the variables and between the BMD variation over 12 months and baseline levels of the different variables were also evaluated. Results. There was a statistically significant decrease of both bone resorption and bone formation markers over the 12 month treatment period. By contrast, no disease activity index changed significantly over one year. BMD Z score change over one year did not correlate with erythrocyte sedimentation rate, matrix metalloproteinase-3, interleukin 6, or C-reactive protein variations over the same period. Conclusion. These results support the conclusion that alendronate treatment is accompanied by a reduction of bone turnover in pediatric patients and that the observed BMD increase is not secondary to a reduction of inflammatory activity
Internet : rolando.cimaz@unimi.it - DAVIES K, WOO P: Immunization in rheumatic diseases of childhood: an audit of the clinical practice of British Paediatric Rheumatology Group members and a review of the evidence. Rheumatology (Oxford) 2002, 41:937-941.
Organism:Department of Rheumatology, Great Ormond Street Hospital, London WC1N 3EJ, UK
Abstract: OBJECTIVES: To establish opinion and clinical practice of senior clinicians working with children with rheumatic diseases with regard to immunization and to determine whether or not this is in accordance with current recommendations. To review published guidelines on the subject and examine the evidence base supporting them. METHODS: A questionnaire was sent to all consultant members of the British Paediatric Rheumatology Group. Information on a variety of issues relating to immunization practice in children with rheumatic diseases was collected. A review of published guidelines and the medical literature on the subject was undertaken to assess current recommendations for immunization in patients on immunosuppressive agents and the evidence supporting these. RESULTS: A number of different sources of information are being used to decide whether or not to immunize patients with rheumatic diseases. Clinical practice varies between individuals. Areas of discordance include the doses of corticosteroids and disease-modifying drugs at which significant immunosuppression is felt likely to occur, the level of immunosuppression conferred by rheumatological diseases themselves and whether or not vaccination should be deferred in the presence of active disease. There was also variation in policy with regard to immunizations not part of the routine recommended schedule. CONCLUSIONS: There is variation in both opinion and clinical practice regarding immunization in children with rheumatic diseases amongst senior clinicians working in the field of paediatric rheumatology. This reflects the lack of consistency between various sets of published guidelines and their non-specificity for rheumatic diseases and their treatment, and the lack of published evidence on the safety and efficacy of different vaccines in these situations. Further research is indicated in the hope that more specific guidelines may be developed for this not uncommonly encountered area of uncertainty
Internet : PM:12154212 - EBERHARD BA, MURRAY KJ, NISTALA K: Coexistent sickle cell disease and juvenile rheumatoid arthritis: 2 Cases with delayed diagnosis and severe destructive arthropathy [3] (multiple letters). Rinsho Ganka 2002, 29:1802-1803.
Organism:B.A. Eberhard, Division of Rheumatology, Schneider Children's Hospital, New Hyde Park, NY
Internet : aeberhar@lij.edu - EPPS H, HURLEY M, UTLEY M: Development and evaluation of a single value score to assess global range of motion in juvenile idiopathic arthritis. Arthritis Care and Research 2002, 47:398-402.
Organism:H. Epps, Centre for Rheumatology, University College London, Arthur Stanley House, 40-50 Tottenham Street, London W1P 9PG
Abstract: Objectives. To develop a global range of motion score (GROMS) and to investigate the association between this newly developed measure of joint range of motion and physical function in children with active juvenile idiopathic arthritis (JIA). Methods. Two scales were calculated, 1 measuring 56 selected joints and 1 measuring 10 joints assessed as important to function by experts from the British Paediatric Rheumatology Group. These were measured in 50 patients with JIA whose disability was assessed using the Child Health Assessment Questionnaire (CHAQ). Results. The GROMS measuring all joints and the GROMS measuring 10 joints closely agreed with each other, and both GROMS correlated significantly with the CHAQ (r = -0.52 and -0.62, respectively). Conclusion. The 10-joint GROMS is a simple, easy-to-use tool that measures overall change in joint range of motion that affects physical function in JIA
Internet : heather@hepps.fsnet.co.uk - LIE BA, JOHANSSON S, SMERDEL A, AKSELSEN HE, UNDLIEN DE, THORSBY E: Disease predisposing genes in the HLA complex other than those encoding the peptide-presenting HLA molecules. Tissue Antigens 2002, 59:17-18.
Organism:Institute of Immunology, Rikshospitalet University Hospital, Oslo Norway - MCGHEE JL, BURKS FN, SHECKELS JL, JARVIS JN: Identifying children with chronic arthritis based on chief complaints: Absence of predictive value for musculoskeletal pain as an indicator of rheumatic disease in children. Pediatrics 2002, 110:354-359.
Organism:Dr. J.N. Jarvis, Department of Pediatrics, Rheumatology Research, Basic Sciences Education Bldg #235A, 940 Stanton L. Blvd, Oklahoma City, OK 73104
Abstract: Objective. To examine complaints for which children were referred to a pediatric rheumatology service and to determine whether there are specific complaints that are more likely to indicate the presence of chronic arthritis or chronic, systemic inflammatory disease. Methods. A retrospective chart review of 414 children referred to the pediatric rheumatology service at the Children's Hospital of Oklahoma from April 1998 to July 2001. Results. Musculoskeletal pain was the most common complaint for which children were referred (n = 226). Of these, 111 had musculoskeletal pain as an isolated complaint. One of these children had a chronic inflammatory disease. Another 115 children had pain as 1 of several reasons for seeking a rheumatology consultation, including positive results on laboratory tests (antinuclear antibody, erythrocyte sedimentation rate, and rheumatoid factor). Nineteen of these children had a chronic inflammatory disease, including 12 with juvenile rheumatoid arthritis (JRA). Thus, musculoskeletal pain as a presenting complaint had a strong negative predictive value for the presence of either JRA (0.95) or any other chronic inflammatory disease that might be characterized by arthritis. Children who were referred, in part, because of positive antinuclear antibody and/or rheumatoid factor tests were no more likely to have a chronic inflammatory disease than children who did not include such results as a reason for referral. Joint swelling, in contrast, was the most likely complaint to be associated with a diagnosis of JRA. Conclusions. Musculoskeletal pain was the most common reason for referral to our pediatric rheumatology clinic. However, isolated musculoskeletal pain, in the absence of other signs or symptoms, is almost never a presenting complaint of children with chronic forms of arthritis. Children with arthritis more commonly present with complaints of joint swelling and/or gait disturbance. Neither ANA nor rheumatoid factor evaluations were useful in evaluating children with musculoskeletal complaints
Internet : james-jarvis@ouhsc.edu - MORI H: Study on the mechanism of the growth failure in children with juvenile rheumatoid arthritis. Medical Journal of Kagoshima University 2002, 53:67-72.
Organism:Department of Pediatrics, Faculty of Medicine, Kagoshima University, Kagoshima, 890-8520 Japan
Abstract: Growth failure is a feature of juvenile rheumatoid arthritis (JRA), but its mechanism has not been clearly explained. A total of 23 JRA children were examined for their annual growth rate with several factors relating to the growth and bone metaborism. Growth impairment was observed only in active stage of systemic and polyarticular JRA. In these patients, the growth rate significantly correlated with levels of insuline-like growth factor-1, osteocalcine, hyarulonic acid, and pyridinoline. As these markers are known to correlate with inflammatory cytokines, it is suggested that the inflammatory cytokines may play an essential role in the development of growth retardation in JRA - MOYER-MILEUR LJ, ROBERTS R, BALL SD: New assessment method to identify bone fragility and fracture risk using peripheral quantitative computed tomography (pQCT) or dual energy X-ray absorptiometry (DXA) in children and adolescents. Pediatric Research 2002, 51:189A
- OGUZ F, AKDENIZ C, UNUVAR E, KUCUKBASMACI O, SI dM: Parvovirus B19 in the acute arthropathies and juvenile rheumatoid arthritis. J.Paediatr.Child Health 2002, 38:358-362.
Organism:Division of Social Paediatrics, Institute of Child Health and Department of Microbiology, Istanbul Medical Faculty, University of Istanbul, Istanbul, Turkey
Abstract: Objective: To evaluate the prevalence of recent parvovirus B19 infection in a cohort of children presenting with acute arthropathy and to determine the prevalence of a subsequent diagnosis of juvenile rheumatoid arthritis in this cohort. Method: In this prospective study, parvovirus B19 IgM antibody was investigated in 75 patients who were referred to our clinic with acute joint complaints and also in 75 healthy controls. One patient in each group was excluded due to neuroblastoma and acute lymphoblastic leukaemia. The characteristics of parvovirus B19 IgM positive patients who were accepted as parvovirus B19 arthropathy were further evaluated. All the patients were followed up for at least 6 weeks and the patients with chronic progression of joint complaints were followed for at least 6 months to determine their progress. The cases of juvenile rheumatoid arthritis in this chronic group were identified. Results: Parvovirus B19 IgM was detected in 16 of 74 patients (21.6%) with acute arthropathy compared with 3 of 74 (4.1%) in the healthy control group (chi2 = 8.67; P = 0.003). The parvovirus B19 positive patients with arthropathy were more likely to become chronic (P = 3.7 x 10-7) and to be diagnosed as juvenile rheumatoid arthritis (P = 0.03) than the parvovirus B19 IgM negative group with arthropathy. Additional joint destruction developed in one case who was parvovirus B19 IgM positive in whom juvenile rheumatoid arthritis was diagnosed during follow up. Conclusion: These data support the hypothesis that parvovirus B19 infection may be associated with the onset of juvenile rheumatoid arthritis in a proportion of patients
Internet : PM:12173996 - PAJOT C, PARIENTE D, MULLER S, GABOLDE M, CROISILLE L, ARCHAMBAUD F, DOMMERGUES JP, BADER-MEUNIER B: [Non infectious inflammatory fever in children: Diagnosis and usefulness of diagnosis procedures.]
<ORIGINAL> Syndromes inflammatoires febriles non infectieux de l'enfant : Diagnostic, contribution des examens complementaires. Archives De Pediatrie 2002, 9:671-678.
Organism:Federation de pediatrie, Assistance publique, hopital de Bicetre, 78, rue du General-Leclerc, 94275, Le Kremlin-Bicetre C France^E-Mail: brigitte.bader-meunier@bct.ap-hop-paris.fr
Abstract: Objective.-To determine the causes and to quantify the benefits obtained from further diagnostic investigations in children presenting with a non infectious inflammatory fever. Methods.-The records of 62 children aged from two-months to 15 years (median: four years) admitted to a paediatric department between 1990 and 2000 for the evaluation of a fever associated to an inflammatory syndrome, defined as temperature over 38 degreeC with an increase of the erythrocyte sedimentation rate (ESR) more than 20 mm/h and/or a serum C-reactive protein level (CRP) >20 mg/L, and excluding overt infectious diseases, were retrospectively reviewed. Results.-Of these patients, 79% children (49 cases) had inflammatory systemic disease, 3.2% (two cases) had malignancy, and 17.8% (11 cases) had undiagnosed disorders. The most frequent disease was Kawasaki disease (22 children), especially in young children. Increase of ESR above 100 mm/h and of CRP above 100 mg/L was present in 59% of Kawasaki disease, 71% of idiopathic juvenile arthritis, 100% of malignancies and 7% of unknown diagnoses. Increase of ESR below 50 mm/h and of CRP below 50 mg/L was present in 75% of hemophagocytic syndromes and 46% of unknown diagnosis. The polymorphonuclear count, hepatic function evaluation, triglycerides levels, abdominal ultrasound, abdominal computed tomography, echocardiography, biopsies were useful diagnosis tools. Technetium scintigraphy was helpful only when abnormalities were found on physical examination. Conclusion.-The diagnosis of Kawasaki disease must be quickly suspected in febrile young children with inflammatory syndrome without infection. ESR and CRP values, abdominal ultrasound and echocardiography are helpful tools for the diagnostic procedure - PAJOT C, PARIENTE D, MULLER S, GABOLDE M, CROISILLE L, ARCHAMBAUD F, DOMMERGUES JP, BADER-MEUNIER B: Non infectious inflammatory fever in children: Diagnosis and usefulness of diagnosis procedures. Archives De Pediatrie 2002, 9:671-678.
Organism:B. Bader-Meunier, Federation de Pediatrie, Hopital de Bicetre, Assistance Publique, 78, rue du General-Leclerc, 94275 Le Kremlin-Bicetre Cedex
Abstract: Objective. - To determine the causes and to quantify the benefits obtained from further diagnostic investigations in children presenting with a non infectious inflammatory fever. Methods. - The records of 62 children aged from two-months to 15 years (median: four years) admitted to a paediatric department between 1990 and 2000 for the evaluation of a fever associated to an inflammatory syndrome, defined as temperature over 38 degreesC with an increase of the erythrocyte sedimentation rate (ESR) more than 20 mm/h and/or a serum C-reactive protein level (CRP) >20 mg/L, and excluding overt infectious diseases, were retrospectively reviewed. Results. - Of these patients, 79% children (49 cases) had inflammatory systemic disease, 3.2% (two cases) had malignancy, and 17.8% (11 cases) had undiagnosed disorders. The most frequent disease was Kawasaki disease (22 children), especially in young children. Increase of ESR above 100 mm/h and of CRP above 100 mg/L was present in 59% of Kawasaki disease, 71% of idiopathic juvenile arthritis, 100% of malignancies and 7% of unknown diagnoses. Increase of ESR below 50 mm/h and of CRP below 50 mg/L was present in 75% of hemophagocytic syndromes and 46% of unknown diagnosis. The polymorphonuclear count, hepatic function evaluation, triglycerides levels, abdominal ultrasound, abdominal computed tomography, echocardiography, biopsies were useful diagnosis tools. Technetium scintigraphy was helpful only when abnormalities were found on physical examination. Conclusion. - The diagnosis of Kawasaki disease must be quickly suspected in febrile young children with inflammatory syndrome without infection. ESR and CRP values, abdominal ultrasound and echocardiography are helpful tools for the diagnostic procedure. (c) 2002 Editions scientifiques et medicales Elsevier SAS
Internet : brigitte.bader-meunier@bct.ap-hop-paris.fr - PRESS J, NEUMANN L, UZIEL Y, BOLOTIN A, BUSKILA D: Assessment of quality of life of parents of children with juvenile chronic arthritis. Clin.Rheumatol. 2002, 21:280-283.
Organism:Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva
Abstract: The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low
Internet : PM:12189453 - ROSENBERG AM: Uveitis associated with childhood rheumatic diseases. Curr.Opin.Rheumatol. 2002, 14:542-547.
Abstract: Optimal management of childhood rheumatic diseases requires an appreciation of their multisystem nature. The eye represents an important site of involvement, and inflammation of the uveal tract is a particularly frequent and potentially debilitating extra-articular feature of some childhood rheumatic diseases. Anterior uveitis associated with oligoarticular juvenile idiopathic arthritis is an especially distinctive entity. Other disorders in children, however, can be associated with posterior and intermediate uveal tract inflammation. The potentially debilitating consequences of uveitis associated with childhood rheumatic diseases, the inadequacies of existing therapies, and the immunopathogenic basis for particular forms of uveitis have prompted the use of immunomodulatory therapy, including new biologic agents, to treat childhood uveitis. This review summarizes recent contributions to the literature that help to clarify the spectrum of conditions associated with uveitis in children, consider evidence for immunopathogenic processes associated with uveitis, and address new approaches to therapy
Internet : PM:12192252 - SMERDEL A, LIE BA, FINHOLT C, PLOSKI R, FORRE O, UNDLIEN DE, THORSBY E: A novel juvenile rheumatoid arthritis (JRA) susceptibility gene in HLA class I region marked by microsatellite D6S265. Tissue Antigens 2002, 59:35
Organism:The Center for Rheumatic Diseases, Rikshospitalet University Hospital, Oslo Norway - SPENCER CH, BERNSTEIN BH: Hip disease in juvenile rheumatoid arthritis. Curr.Opin.Rheumatol. 2002, 14:536-541.
Abstract: In contrast to adult rheumatoid arthritis, hips are commonly affected joints in severe, destructive, juvenile rheumatoid arthritis (JRA). Hip disease develops in 30 to 50% of children with JRA. Because of the importance of the hip joint in weight bearing the advent of hip disease in a child with JRA warns of future disability [ 1, 2]. The challenges for the clinician are to prevent significant hip involvement, to halt further damage when hip disease is noted, and in the event that conservative treatment fails, to guide the child and family through hip arthroplasty and rehabilitation. Recent trends suggest that today's more aggressive treatment approach and more effective drugs are resulting in fewer children with JRA developing into severe hip disease requiring hip surgery. Similarly, with improvements in orthopedic surgery, the results of hip arthroplasty have improved
Internet : PM:12192251 - VENKATRAMAN JT, MEKSAWAN K: Effects of dietary omega3 and omega6 lipids and vitamin E on chemokine levels in autoimmune-prone MRL/MpJ-lpr/lpr mice. Journal of Nutritional Biochemistry 2002, 13:479-486.
Organism:J.T. Venkatraman, Nutrition Program, Department of Physical Therapy, State University of New York, Buffalo, NY 14214
Abstract: Elevated levels of chemokines, such as Regulated upon Activation, Normal T cell Expressed and Secreted (RANTES), Monocyte Chemotactic Protein-1 (MCP-1), Macrophage Inflammatory Protein-1alpha (MIP-1alpha), and Macrophage Inflammatory Protein-1beta (MIP-1beta) have been found in rheumatoid arthritis (RA) and juvenile arthritis (JA), and they may be associated with the pathogenesis of these diseases. These chemokines are implicated in the migration of specific leukocytes into the joints. Omega-3 (omega3) fatty acid rich-fish oil (FO) and vitamin E may delay the progress of certain autoimmune diseases. The present study was designed to understand the effects of dietary lipids (omega-6 and omega-3 fatty acids) and vitamin E on the production of chemokines in autoimmune-prone MRL/lpr (a mouse model for RA) and congenic control MRL/++ mice. The MRL mice were fed for 4.5 months omega-6 and omega-3 diets that varied in lipid sources (corn oil; CO and fish oil; FO) and vitamin E levels (269 I.U./kg and 694 I.U./kg diet). Spleen cells were isolated and cultured aseptically in the presence of PHA for 48 h at 37degreesC and the levels of chemokines (RANTES, JE/MCP-1 and MIP-1alpha) were determined in the cell-free supernatants. The levels of RANTES and JE/MCP-1 were significantly higher in MRL/lpr mice compared to MRL/++ mice. The FO had differential effect on RANTES and MCP-1 production by spleen cells. The production of RANTES and JE/MCP-1 by spleen cells in mice fed the FO diets was significantly lower than in mice fed the CO diets (p < 0.0001). The levels of vitamin E did not affect the production of RANTES and JE/MCP-1. The levels of vitamin E had a significant effect on MIP-1alpha as the spleen cells of mice fed diets containing 694 IU/kg diet of vitamin E produced significantly higher levels of MIP-1alpha compared to the group of mice fed the diets containing 269 IU of vitamin E (p < 0.0001). The data obtained from this study in MRL/lpr and MRL/++ mice suggest that FO diets containing omega-3 fatty acids are beneficial in decreasing the levels of certain pro-inflammatory chemokines (RANTES and MCP-1) thereby delaying the onset of and severity of autoimmune symptoms in MRL/lpr mouse model. (c) 2002 Elsevier Science Inc. All rights reserved
Internet : jtv@acsu.buffalo.edu