Bibliography September 2002- BLOOM BJ, NELSON SM, ALARIO AJ, MILLER LC, SCHALLER JG: Synovial fluid levels of E-selectin and intercellular adhesion molecule-1: Relationship to joint inflammation in children with chronic arthritis. Rheumatol.Int. Berlin 2002, 22:175-177.
Organism:B.J. Bloom, Hasbro Children's Hospital, Pediatric Ambulatory Medicine, Potter Building, 593 Eddy Street, Providence, RI 02903
Abstract: E-selectin and intercellular adhesion molecule (ICAM)-1 are crucial to the inflammatory response in chronic inflammatory arthritis. Soluble (s) levels of these molecules in sera and synovial fluid (SF) correlate with some clinical parameters and synovial tissue expression of the same molecules in rheumatoid arthritis. Studies of sera from children with chronic inflammatory arthritis corroborate this information; corresponding SF data are relatively lacking. We thus studied SF sE-selectin and sICAM-1 in 28 children with active juvenile rheumatoid arthritis or a spondyloarthropathy. Levels were correlated with erythrocyte sedimentation rate (ESR), SF leukocyte counts, duration of disease, and duration of response to concomitant intra-articular corticosteroid injection. Levels were compared according to use of methotrexate and/or sulfasalazine. Synovial fluid sE-selectin correlated with ESR and SF leukocyte counts. There was a trend toward lower sICAM-1 in patients treated with sulfasalazine and/or methotrexate. We conclude that SF levels of sE-selectin accurately reflect intra-synovial inflammation. Soluble ICAM-1 levels may reflect the effects of disease-modifying agents
Internet : bbloom@lifespan.org - BRITTON CA, MOORE A: Views from the inside, part 1: Routes to diagnosis - Families' experience of living with a child with arthritis. British Journal of Occupational Therapy 2002, 65:374-380.
Organism:Dr. C.A. Britton, PO Box 58, Hove BN3 5WN
Abstract: This is the first of a trilogy of articles that presents the experiences and perspectives of 46 families about what it is like to live with and care for a child with juvenile idiopathic arthritis (JIA). An independent professional recruited the children from a random sample of families who attended consecutive outpatient appointments at the juvenile arthritis clinic and who fulfilled the inclusion criteria. Qualitative and quantitative data from self-completion questionnaires, transcripts from semi-structured interviews with family members in their homes, family-filmed video diaries, and diaries written by siblings and children with arthritis were analysed. These different types of data were gathered over 18 months in order to collect information about the fluctuating nature of this disease and the impact of this changeability on family members. Part 1 concentrates on a brief presentation of relevant literature, presents a simplified map of the findings and introduces the families' early experiences of seeking and coping with the diagnosis of JIA. The article explores the myth that arthritis only affects elderly and infirm people, explains the mirage effect and discusses the significance of different routes to diagnosis. The majority of the families felt that these early events had a significant, sometimes considerable, impact upon how they coped later, including how they related subsequently to health care professionals and engaged with continuing prescribed health care programmes. The findings report the families' experience as recipients of health care by many different professionals and relate to their recollection and interpretation of events. Research into the professionals' perspectives would be illuminating but did not fall within the scope of the present study. The experiences of families of children with arthritis are shared by families of children with other chronic conditions and by other carers and service users
Internet : info@kidswitharthritis.org - BROWNE GJ, HORT J, LAU KC: Pericardial effusions in a pediatric emergency department. Pediatric Emergency Care 2002, 18:285-289.
Organism:G.J. Browne, Emergency Services, Department of Emergency Medicine, Children's Hospital at Westmead, Corner of Hawkesbury Road, Westmead, NSW 2145 - CUMMINS C, CONNOCK M, FRY-SMITH A, BURLS A: A systematic review of effectiveness and economic evaluation of new drug treatments for juvenile idiopathic arthritis: Etanercept. Health Technology Assessment 2002, 6:34p
Organism:Dr. C. Cummins, West Midlands Hlth. Technol. Assess., Institute of Child Health, University of Birmingham, Birmingham - FAIZAN MK, VAN NIEL CW, MCDONALD RA, SHERRY DD, STAPLETON FB: Prevalence of complementary and alternative medicine use in pediatric patients using immunosuppressive therapy. Pediatric Research 2002, 51:434A
Organism:Department of Pediatrics, University of Washington School of Medicine, Seattle, WA USA - HAAS J-P, REUTTER G: Algorithms to design therapeutic concepts of juvenile idiopathic arthritis. Pediatrics and Related Topics 2002, 41:185-197.
Organism:Dr. J.-P. Haas, Zentrum fur Kinder/Jugendmedizin, Ernst-Moritz-Arndt-Universitat, Soldtmannstr. 15, 17487 Greifswald
Abstract: Successfull treatment of juvenile idiopathic arthritis involves cooperation of physicians, specialized medical centres and allied health workers. Planning of therapeutic strategies has to consider the individual problems of each patient. Potential dangers of the therapy should be weighted against the expected benefit. Recently there has been substancial progress in the area of immunosuppressive treatment. Thus successfull treatment with a minimum of side effects should be avaiable to most of our patients. With special respect to new strategies of medical treatment we have developed algorithms to different subtypes of JIA, which have been designed according to the nomenclature of the ILAR and are the result of comparative analyses of therapeutic strategies in the pediatric rheumatology centres of Erlangen, Nuremberg and Greifswald. Additionally a carefull review of the literature has been performed. The algorhithmic shemes have not been designed as a therapeutical standard. The intension is to set up a discussion platform in order to develop multicenter therapeutical standards. For that purpose we would strongly encourage anyone engaged with JIA to participate
Internet : jphaas@uni-greifswald.de - HENWOOD MJ, GRIMBERG A, MOSHANG T, Jr.: Expanded spectrum of recombinant human growth hormone therapy. Curr.Opin.Pediatr. 2002, 14:437-442.
Organism:Division of Pediatric Endocrinology, Children's Hospital of Philadelphia, 3615 Civic Center Boulevard, Abramson Research Center, Room 802, Philadelphia, PA, 19104-4318 USA^E-Mail: grimberg@email.chop.edu - HERLIN T: [In Process Citation]. Ugeskr.Laeger 2002, 164:3941-3946.
Organism:Arhus Universitetshospital, Skejby Sygehus, paediatrisk afdeling, DK-8200-Arhus N
Abstract: The new classification of juvenile idiopathic arthritis (JIA) is described in this review. Clinical characteristics divide JIA in to subtypes: systemic, oligoarticular (persistent and extended type), RF-positive and--negative polyarticular, enthesitis-related arthritis and psoriatic arthritis. In addition to the clinical characteristics, genetic and biochemical differences suggest that JIA could be regarded as a general term covering various diseases. Complications described are uveitis, temporomandibular joint affection and growth disturbances. The therapeutic strategy should be planned individually according to age, subtype and disease activity and carried out as teamwork with several specialities. Drugs showing significant effectiveness in controlled studies are primarily methotrexate and sulphasalazine. An immunomodulating agent, etanercept, a soluble TNF alpha-receptor fusion protein, has shown a promising effect in severe polyarticular JIA refractory to methotrexate treatment
Internet : PM:12212473 - ISHIHARA K, HIRANO T: IL-6 in autoimmune disease and chronic inflammatory proliferative disease. Cytokine Growth Factor Rev. 2002, 13:357
Organism:Department of Molecular Oncology (C7), Graduate School of Medicine, Osaka University, 2-2 Yamada-oka Suita, 565-0871, Osaka, Japan
Abstract: Interleukin 6 (IL-6), which was originally identified as a B-cell differentiation factor, is now known to be a multifunctional cytokine that regulates the immune response, hematopoiesis, the acute phase response, and inflammation. Deregulation of IL-6 production is implicated in the pathology of several disease processes. The expression of constitutively high levels of IL-6 in transgenic mice results in fatal plasmacytosis, which has been implicated in human multiple myeloma. Increased IL-6 levels are also observed in several diseases, including rheumatoid arthritis (RA), systemic-onset juvenile chronic arthritis (JCA), osteoporosis, and psoriasis. IL-6 is critically involved in experimentally induced autoimmune disease, such as antigen-induced arthritis (AIA), and experimental allergic encephalomyelitis. All these clinical data and animal models suggest that IL-6 plays critical roles in the pathogenesis of autoimmune diseases. Here we review the evidence for the involvement of IL-6 in the pathophysiology of autoimmune diseases and chronic inflammatory proliferative diseases (CIPD) and discuss the possible molecular mechanisms of its involvement
Internet : PM:12220549 - IWANOWICZ EJ, DHAR TGM, LEFTHERIS K, LIU C, MITT T, WATTERSON SH, BARRISH JC: Inhibitors of IMPDH enzyme. Official Gazette of the United States Patent and Trademark Office Patents 2002, 1260:No
Organism:30 Haverford Rd., Cranbury, NJ, 08512 USA
Abstract: The present invention discloses the identification of the novel inhibitors of IMPDH (inosine-5'-monophosphate dehydrogenase). The compounds and pharmaceutical compositions disclosed herein are useful in treating or preventing IMPDH-associated disorders, such as transplant rejection and autoimmune diseases - JEE SH, CLARK SJ, OLIANSKY DM, STEIN LD, FREED GL: A qualitative comparison of pediatricians' versus pediatric rheumatologists' views on juvenile rheumatoid arthritis care. Pediatric Research 2002, 51:219A
- JEE SH, CLARK SJ, OLIANSKY DM, STEIN LD, FREED GL: Examining the Referral and Management preferences of pediatricians caring for children with juvenile rheumatoid arthritis. Pediatric Research 2002, 51:219A
Organism:Pediatrics, University of Michigan, Ann Arbor, MI USA - KOOLMAN AH, KAMPHUIS SS, WEGGELAAR NM, VAN DEN BC, WULFFRAAT NM, REVESZ T: [In Process Citation]. Ned.Tijdschr.Geneeskd. 2002, 146:1613-1616.
Organism:Afd Hematologie en Oncologie, Universitair Medisch Centrum, locatie Wilhelmina Kinderziekenhuis, Postbus 85090, 3508 AB Utrecht ecroks@wkzazunl
Abstract: In two 3-year-old infants, a girl and a boy, systemic juvenile idiopathic arthritis was suspected because of daily fever peaks, signs of polyarthritis and general malaise. Drug treatment was unsuccessful, and after extensive laboratory investigation acute lymphoblastic leukaemia (ALL) was diagnosed and treated adequately. ALL is the most common malignancy in childhood. About one-third of the patients present with joint or bone pain and fever. In this group of children, it can be difficult to identify ALL because it may mimic the clinical picture of systemic juvenile idiopathic arthritis and because of the possibility of a normal blood count at presentation. ALL should always be considered in the differential diagnosis in children with musculoskeletal pain and fever, even in the face of a normal blood count. In any case, a bone-marrow examination should be done before steroid treatment is given
Internet : PM:12233152 - KOOLMAN AH, KAMPHUIS SSM, WEGGELAAR NM, VAN DEN BC, WULFFRAAT NM, REVESZ T: Children with fever peaks and bone and joint pain: Systemic juvenile idiopathic arthritis or acute lymphoblastic leukaemia after all? Ned.Tijdschr.Geneeskd. 2002, 146:1613-1616.
Organism:Dr. T. Revesz, Universitair Medisch Centrum, Locatie Wilhelmina Kinderziekenhuis, Postbus 85.090, 3508 AB Utrecht
Abstract: In two 3-year-old infants, a girl and a boy, systemic juvenile idiopathic arthritis was suspected because of daily fever peaks, signs of polyarthritis and general malaise. Drug treatment was unsuccessful, and after extensive laboratory investigation acute lymphoblastic leukaemia (ALL) was diagnosed and treated adequately. ALL is the most common malignancy in childhood. About one-third of the patients present with joint or bone pain and fever. In this group of children, it can be difficult to identify ALL because it may mimic the clinical picture of systemic juvenile idiopathic arthritis and because of the possibility of a normal blood count at presentation. ALL should always be considered in the differential diagnosis in children with musculoskeletal pain and fever, even in the face of a normal blood count. In any case, a bone-marrow examination should be done before steroid treatment is given
Internet : e.c.roks@wkz.azu.nl - MERT A, OZARAS R: What is the clinical importance of an evanescent rash in a patient with fever of unknown origin? Internal Medicine (Tokyo) 2002, 41:597
Organism:Cerrahpasa Medical Faculty, Department of Clinical Bacteriology and Infectious Disease, University of Istanbul, 34303, Aksaray, Istanbul Turkey - MYERS LK, SEYER JM, KANG AH: Synthetic peptide for treatment of autoimmune arthritis. Official Gazette of the United States Patent and Trademark Office Patents 2002, 1260:No
Organism:Memphis, TN USA
Abstract: Peptides that are capable of suppressing autoimmune arthritis are disclosed. The polypeptides described by the present invention which are capable of suppressing autoimmune arthritis in mammals include analogues of CII 245-270. The peptides do not provoke a material immunogenic response from T cells, and thus are useful therapeutic agents for suppressing autoimmune arthritis, rheumatoid arthritis, juvenile arthritis, psoriatic arthritis, spondylo arthritis, relapsing polychondritis and other connective tissue diseases. A method of surpressing autoimmune arthritis in mammals is also provided by the present invention - O'DONOGHUE NB, HIGGINS EM: Case 1. Clinical and Experimental Dermatology 2002, 27:339-340.
Organism:E.M. Higgins, Department of Dermatology, Kings College Hospital, London
Internet : nualaodonoghue@doctors.org.uk - OEN K, MALLESON PN, CABRAL DA, ROSENBERG AM, PETTY RE, CHEANG M: Disease course and outcome of juvenile rheumatoid arthritis in a multicenter cohort. Rinsho Ganka 2002, 29:1989-1999.
Organism:Dr. K. Oen, RR149 Rehabilitation Centre, Health Sciences Centre, 800 Sherbrook Street, Winnipeg, Man. R3A 1M4
Abstract: Objective. To determine the disease course and outcome in a multicenter cohort of patients with juvenile rheumatoid arthritis (JRA). Methods. All patients with JRA seen at 3 pediatric rheumatology centers were identified from databases and/or clinic records. Inclusion criteria were a diagnosis of JRA (1977 American College of Rheumatology criteria), a followup period of at least 5 years since onset, and a minimum age of 8 years. Patients were examined and completed a Childhood Health Assessment Questionnaire (CHAQ). Kaplan-Meier curves were constructed to estimate rates of remission, relapse, and arthroplasty. Remission was defined as absence of active arthritis while off treatment for at least 2 years. Outcome measures were active disease duration, CHAQ scores, pain determined by visual analog scales, physician's global assessments, and Steinbrocker functional classifications. Years of education and employment status were ascertained. Results. We studied 392 patients of 652 (60%) who met the selection criteria. The probabilities of remission at 10 years after onset were 37, 47, 23, and 6% for patients with systemic, pauciarticular, RF-polyarticular, and RF+ polyarticular JRA, respectively. The probability of relapse varied from 30 to 100% at 15 years. The probability of arthroplasty varied from 13 to 57% after 15 years of active disease. We found 2.5% of patients assessed were in Steinbrocker Classes III or IV and 6% were in the highest CHAQ score (> 1.5) group. Compared with national statistics, fewer female patients received post-secondary education and unemployment rates for patients 20 to 24 years of age were higher. Conclusion. Our results indicate that JRA is a disease that often extends into adulthood. Compared to previous decades, functional outcome has improved; however, the estimated rate of arthroplasty remains very high. Patients with JRA may have difficulty entering the workforce - OG c, AKDENIZ C, UNUVAR E, KUC c, SIDAL M: Parvovirus B19 in the acute arthropathies and juvenile rheumatoid arthritis. J.Paediatr.Child Health 2002, 38:358-362.
Organism:Prof. E. Unuvar, Sok. 65:4, TR-34300 Haseki, Istanbul
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 (XSUP2 = 8.67; P = 0.003). The parvovirus B19 positive patients with arthropathy were more likely to become chronic (P = 3.7 x 10SUP-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 : eunuvar@yahoo.com - PINEDA MM: [Neurological involvement in rheumatic disorders and vasculitis in childhood]. Rev.Neurol. 2002, 35:290-296.
Organism:Consorci Hospitalari Clinic Sant Joan de Deu, Esplugues de Llobregat, Espa a
Abstract: INTRODUCTION. The rheumatic disorders and vasculites are inflammatory processes affecting connective tissue in different organs. The inflamed cells liberate destructive enzymes which harm tissues, producing IgE, IgM, IgG antibodies and autoimmune complexes. OBJECTIVE. To review the current classification of these conditions and describe the commonest neurological complications in children. Infantile systemic lupus erythematosus is the commonest; it affects the dermis, joints, blood vessels, heart, kidney and brain. Neurological features: vertigo, ataxia, convulsions, chorea and headache are seen in 25% of the patients. Juvenile idiopathic arthritis is another inflammatory disorder of unknown origin which affects joints, connective tissue and visceras. Neurological involvement is seen in 5%, in the form of cerebral vasculitis, cervical myelopathy, trapping and compression of peripheral nerves and neuropathy due to arteritis. Sydenham s rheumatic chorea, caused by b haemolytic streptococcal A infection, causing a pathological auto immune response is the best known and has increased in frequency again in recent years. Vasculitis is caused by inflammatory changes in the walls of large, medium and small blood vessels. They lead to deposits of auto immune antigen antibody complexes in the blood vessel walls. In the commonest infantile vasculites neurological complications are uncommon, but not rare, as occurs with Kawasaki disease, infantile Wegener s granulomatosis, Sch nlein Henoch purpura and Beh et s disease. The usual treatment for this group of disorders is corticosteroids and immunosuppressive drugs
Internet : PM:12235593 - ROTHSCHILD BM: Surgery and the patient with arthritis. Comprehensive Therapy 2001, 27:104-107.
Organism:Arthritis Center of Northeast Ohio, 5500 Market Street, Youngstown, OH, 44512 USA - SCHWANKOVSKY L, MOUSA H, ROWHANI A, DI LORENZO C, HYMAN PE: Quality of life outcomes in congenital chronic intestinal pseudo-obstruction. Digestive Diseases and Sciences 2002, 47:1965-1968.
Organism:Dr. P.E. Hyman, Pediatric Gastroenterology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS
Abstract: The goal of this study was to assess the quality of life for children with chronic intestinal pseudoobstruction. We used a retrospective chart review to identify children with congenital chronic intestinal pseudoobstruction, then a structured telephone interview with parents that included the Child Health Questionnaire to gather information about the current status and quality of life for each patient and family. Children with chronic intestinal pseudo-obstruction had less freedom from pain, depression, and anxiety than healthy children or children with juvenile rheumatoid arthritis (P < 0.05 for all three parameters). Parents of children with chronic intestinal pseudo-obstruction had poorer emotional status than parents of healthy children or children with juvenile rheumatoid arthritis. The time required for parents to care for children with chronic intestinal pseudo-obstruction was greater than the time required to care for healthy children or children with juvenile rheumatoid arthritis (P < 0.01). In conclusion, the quality of life for children with chronic intestinal pseudo-obstruction lags behind that of healthy children and children with another chronic illness. Appropriate treatment of chronic pain may improve the quality of life for children with chronic intestinal pseudo-obstruction and their families. Moreover, attention to reducing each family's burden of time and emotional distress may help them cope better with their chronically ill child - THOMSON W, DONN R: Genetic epidemiology: Juvenile idiopathic arthritis genet. Arthritis Res. 2002, 4:302-306.
Organism:Arthritis Research Campaign Epidemiology Unit, School of Epidemiology and Health Sciences, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, UK wendy@fs1sermanacuk
Abstract: Studies have established the magnitude of the genetic basis of juvenile idiopathic arthritis (JIA). JIA is a complex genetic condition and the genes that influence susceptibility are actively being sought. A candidate gene approach is being used by several groups. MHC-, cyto
Internet : PM:12223104 - THOMSON W, DONN R: Juvenile idiopathic arthritis genetics - What's new? What's next? Arthritis Research 2002, 4:302-306.
Organism:W. Thomson, Arth. Res. Campaign Epidemiol. Unit, School of Epidemiol./Health Sciences, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT
Abstract: Studies have established the magnitude of the genetic basis of juvenile idiopathic arthritis (JIA). JIA is a complex genetic condition and the genes that influence susceptibility are actively being sought. A candidate gene approach is being used by several groups. MHC-, cytokine- and T-cell-related genes have all been positively associated with JIA. Here we review some of the latest genetic data, and discuss ways in which JIA genetic research might proceed
Internet : wendy@fs1.ser.man.ac.uk - TYNDALL A, KOIKE T: High-dose immunoablative therapy with hematopoietic stem cell support in the treatment of severe autoimmune disease: Current status and future direction. Intern.Med. 2002, 41:608-612.
Organism:Dr. A. Tyndall, Department of Rheumatology, University of Basel, Burgfelderstrasse 101, 4012 Basel
Abstract: In the past 5 years approximately 500 patients worldwide suffering from severe autoimmune disease (AD) have received an autologous hematopoietic stem cell transplantation (HSCT) as treatment following high-dose chemotherapy. The EBMT and EULAR data base contains 370 registrations, the most frequently transplanted ADs being multiple sclerosis (MS), systemic sclerosis (SSc), rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), systemic lupus erythematosus (SLE) and idiopathic thrombocytopenic purpura (ITP). Around 70% responded initially well, with durable remission/stabilization seen more frequently in MS and SSc than in RA and SLE, the latter having around 2/3 relapses, the majority of which respond to simple agents. Overall 8% transplant-related mortality was seen with large inter AD differences (12.5% in SSc and only one patient in RA) probably reflecting the degree ot vital organ involvement at the time of transplant. This phase I/II data has led to a running phase III randomized trial in SSc called the Autologous Stem cell Transplantation International Scleroderma (ASTIS) trial, and it will soon begin in MS (ASTIMS) and RA (ASTIRA). The concept of immunological "re-setting" has evolved, and needs to be confirmed by longer follow-up and the multicentre, international phase III randomized studies - WANG SJ, YANG YH, LIN YT, YANG CM, CHIANG BL: Attained Adult Height in Juvenile Rheumatoid Arthritis with or without Corticosteroid Treatment. Clin.Rheumatol. 2002, 21:363-368.
Organism:National Taiwan University Hospital, Taipei, Taiwan
Abstract: Growth impairment has been described in patients with juvenile rheumatoid arthritis (JRA). Both the direct action of underlying disease and prolonged corticosteroid usage for disease management may contribute to growth impairment. The purpose of this retrospective study was to evaluate the effect of systemic corticosteroid treatment on attained adult height in patients with JRA. We reviewed patients who first visited our hospital from 1973 to 1995 with a diagnosis of JRA. Adult height (AH) and the reported parental heights of these patients were recorded. Target height (TH) is estimated according to midparental height. Patients who never had or had only transient (less than 1 week) systemic corticosteroid therapy were classified as group 1. Group 2 included patients who had corticosteroid therapy for more than 1 week but never continuously for more than 12 months, and group 3 included patients on long-term steroid treatment (continuously for more than 1 year). Height data were analysed using adult height and the difference between adult height and target height (AH minus TH). Thirty-three patients fulfilling the diagnostic criteria for JRA were reviewed. Fourteen belonged to group 1, 13 to group 2 and six to group 3. The difference between adult height and target height in group 1 was 2.96 +/- 4.54 cm, in group 2 0.71 +/- 6.08 cm (group 1 vs. group 2, P = 0.28), and in group 3 -11.65 +/- 10.71 cm (group 1 vs. group 3, P<0.05). In 15 patients who never received corticosteroid therapy continuously for more than 1 year, AH-TH was statistically correlated neither with the cumulative corticosteroid exposure dose nor with cumulative corticosteroid exposure period by linear regression ( P = 0.408, P = 0.278, respectively). We concluded that continuous systemic corticosteroid usage for less than 1 year does not affect attained adult height in JRA patients; however, prolonged corticosteroid treatment for more than 1 year can lead to irreversible growth impairment
Internet : PM:12223982 - WEDDERBURN L, VARSANI H, PATEL A, WOO P: Cells of dendritic cell type within the inflamed joints of children with arthritis which express high levels of receptor activator of NFkB (RANK) are also positive for the novel dendritic cell marker, DC-SIGN. Clinical Science (London) 2002, 103:30P-31P.
Organism:Institute of Child Health/GOSH, London UK^E-Mail: l.wedderburn@h.ucl.ac.uk