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spondyloarthropathy in pediatrics

Maxime Goirand, Sylvain Breton, Frédéric Chevallier, Ngoc-Phoi Duong, Florence Uettwiller, Isabelle Melki, Richard Mouy, Carine Wouters, Brigitte Bader-Meunier, Chantal Job-Deslandre, Pierre Quartier
BACKGROUND: Childhood-onset spondyloarthropathies usually start with enthesitis and peripheral arthritis. However, axial disease may develop afterward. Patients are most often classified, following revised (Edmonton 2011) ILAR criteria, as enthesitis-related arthritis, psoriatic arthritis, or unclassified juvenile idiopathic arthritis, particularly in cases of psoriasis in the patient or a first-degree relative. In adults, peripheral spondyloarthritis is classified by ASAS criteria. METHODS: We retrospectively studied patients with childhood-onset spondyloarthropathies followed for more than one year in our referral centre...
April 2, 2018: Pediatric Rheumatology Online Journal
Emanuela Del Giudice, Anna Dilillo, Luciana Tromba, Giuseppe La Torre, Sara Blasi, Fabrizio Conti, Franca Viola, Salvatore Cucchiara, Marzia Duse
The aims of this study were to identify the presence of endothelial dysfunction as a marker of early atherosclerosis by measuring aortic and carotid intimal-medial thickness (aIMT and cIMT) and flow-mediated dilation (FMD) and their correlation with traditional and no traditional risk factors for atherosclerosis in children with rheumatic diseases. Thirty-nine patients (mean age 15.3 ± 5.7 years), 23 juvenile idiopathic arthritis, 9 juvenile spondyloarthropathies, 7 connective tissue diseases (mean disease duration and onset respectively 5 ± 3...
October 12, 2017: Clinical Rheumatology
Ozgul Yigit, Meltem Erol, Ozlem Bostan Gayret, Isıl Ustun, Selami Ulas
INTRODUCTION: Tuberculosis remains a major public health problem in developing countries. Diagnosing extrapulmonary tuberculosis can be difficult, as it requires a higher index of suspicion than primary tuberculosis. Extrapulmonary tuberculosis may mimic malignancies and many other diseases, so it should be included in the differential diagnosis. Here, we present a case of extrapulmonary tuberculosis associated with Pott's disease and hip arthritis in a patient who recovered after 12 months of antituberculosis therapy...
July 2016: Iranian Red Crescent Medical Journal
Amra Adrovic, Kenan Barut, Sezgin Sahin, Ozgur Kasapcopur
Juvenile spondyloarthropathies represent a clinical entity separate from the adult disease. Initial clinical signs of juvenile spondyloarthropathies often include lower extremity arthritis and enthesopathy, without axial involvement at the disease onset. Asymmetrical oligoarthritis of lower extremities is typically seen in this type of arthritis. Enthesopathy, which is the hallmark of the disease, is most commonly seen in the Achilles tendon, being manifested by heel pain. Anterior uveitis and HLA-B27 positivity are seen in a proportion of cases...
August 2016: Current Rheumatology Reports
Angela R Bryan, C Egla Rabinovich
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood. Enthesitis-related arthritis (ERA) is one of the seven JIA subtypes classified by the International League of Associations for Rheumatology (ILAR). Due to inclusion and exclusion criteria, a pitfall of the ERA category is that it does not include all subsets of juvenile spondyloarthropathy, with many children ending up in the undifferentiated category. The ERA nomenclature also does not have a method for distinguishing between axial and peripheral disease, two phenotypes which vary in presentation and treatment requirements...
December 2014: Current Rheumatology Reports
Clara Lin, John D MacKenzie, Jesse L Courtier, Jeffrey T Gu, Diana Milojevic
BACKGROUND: Magnetic resonance imaging (MRI) is often used to diagnose and monitor treatment effects of juvenile spondyloarthropathy (SpA). Our objective was to describe MRI findings in juvenile SpA and determine predictors of active sacroiliitis and response to treatment. METHODS: Children who had MRI of the sacroiliac (SI) joints and were referred to the pediatric rheumatology clinic from 2009 to 2012 were retrospectively studied. The clinical parameters, laboratory studies and findings on MRI were collected and a composite score ratio (CR) was calculated for both SI joints on each MRI study based on a semi-quantitative scale that included evaluation of bone marrow edema (BME), synovial enhancement (SE), and erosions (ER)...
2014: Pediatric Rheumatology Online Journal
Genowefa Matuszewska, Katarzyna Zaniewicz-Kaniewska, Monika Włodkowska-Korytkowska, Patrycja Smorawińska, Fadhil Saied, Wojciech Kunisz, Iwona Sudoł-Szopińska
Radiological imaging plays a fundamental role in the diagnosis and monitoring of rheumatic diseases. The basic method of imaging is a classic X-ray picture, which for many years has been used as a single method for the recognition and evaluation of the effects of disease management. In today's modern day treatment of rheumatic diseases, ultrasonography and magnetic resonance are more commonly performed for early detection of inflammatory changes in the region of soft tissue, subchondral bone and bone marrow...
2014: Polish Journal of Radiology
Alysha J Taxter, Nancy A Chauvin, Pamela F Weiss
Back pain in the pediatric population is a common complaint presenting to sports medicine clinics. There is a wide differential that should be considered, including mechanical, infectious, neoplastic, inflammatory, and amplified musculoskeletal pain. The history, pain quality, and examination are key components to help distinguish the etiologies of the pain and direct further evaluation. Laboratory investigations, including blood counts and inflammatory markers, can provide insight into the diagnosis. The HLA-B27 antigen can be helpful if a spondyloarthropathy is suspected...
February 2014: Physician and Sportsmedicine
Sabrina Cardile, Claudio Romano
Joint involvement is the most common extraintestinal manifestation in children with inflammatory bowel disease (IBD) and may involve 16%-33% of patients at diagnosis or during follow-up. It is possible to distinguish asymmetrical, transitory and migrating arthritis (pauciarticular and polyarticular) and spondyloarthropathy (SpA). Clinical manifestations can be variable, and peripheral arthritis often occurs before gastrointestinal symptoms develop. The inflammatory intestinal pattern is variable, ranging from sub-clinical inflammation conditions, classified as indeterminate colitis and nodular lymphoid hyperplasia of the ileum, to Crohn's disease or ulcerative colitis...
January 7, 2014: World Journal of Gastroenterology: WJG
Amy M Nguyen, Carrie L Francis, Christopher G Larsen
Patients with human leukocyte antigen (HLA)-B27 seropositivity have a genetic predisposition to form spondyloarthropathies, especially ankylosing spondylitis. Other related inflammatory or autoimmune disorders include reactive arthritis, uveitis, psoriatic arthritis, and Crohn's disease. Although juvenile recurrent parotitis is not uncommon, recurrent submandibular sialadenitis is rare in pediatric patients. Sialadenitis is typically caused by salivary stones, infection, or duct stricture. To our knowledge, there has not been report of HLA-B27 positivity and recurrent sialadenitis described previously...
June 2013: International Journal of Pediatric Otorhinolaryngology
Daniel Wendling, Julien Paccou, Jean-Marie Berthelot, René-Marc Flipo, Séverine Guillaume-Czitrom, Clément Prati, Emmanuelle Dernis, Guillaume Direz, Véronique Ferrazzi, Jean-Michel Ristori
UNLABELLED: Uveitis may be associated with various inflammatory diseases. Previous reports suggested that tumor necrosis factor (TNF) blockers, especially anti-TNF monoclonal antibodies, may reduce the incidence of uveitis flares in some inflammatory diseases. Under these circumstances, de novo occurrence, ie, new onset of the first episode of uveitis under anti-TNF therapy, is uncommon. OBJECTIVES: The aim of this study was to collect cases of new onset of uveitis under anti-TNF therapy, using a nationwide network, to describe these cases, and to gather with cases reported in the literature...
December 2011: Seminars in Arthritis and Rheumatism
Pierre Quartier
Juvenile idiopathic arthritis (JIA) is a heterogeneous group of diseases, most of which differ from the main adult-onset inflammatory joint diseases. Nonsystemic forms of JIA (oligoarthritis, polyarthritis with or without rheumatoid factors, and spondyloarthropathies) are managed similarly to adult-onset rheumatoid arthritis or spondylarthritis, with a few differences. More specifically, JIA-associated chronic uveitis may require the use of biotherapies that remain experimental in JIA, such as monoclonal antibodies to TNFα or abatacept...
December 2010: Joint, Bone, Spine: Revue du Rhumatisme
M Aloi, G Di Nardo, F Conte, L Mazzeo, N Cavallari, F Nuti, S Cucchiara, L Stronati
BACKGROUND: Patients with ulcerative colitis often receive thiopurines as immunomodulators (IMs) to maintain remission and avoid corticosteroids. If unresponsive or intolerant to these agents, patients are treated with methotrexate, an antimetabolite never assessed in paediatric ulcerative colitis. AIM: To describe the experience with methotrexate in children with ulcerative colitis. METHODS: Thirty-two patients (median age 13.9 years) received methotrexate...
October 2010: Alimentary Pharmacology & Therapeutics
V Gerloni, I Pontikaki, M Gattinara, F Fantini
The therapeutic approach to JIA is sometimes very troublesome and progression to erosive polyarthritis may occur in all JIA categories. Only Methotrexate has shown efficacy and safety in a large controlled trial. Nevertheless, in many cases, drug resistance or intolerance has led to try other therapeutic options, with still debatable results. Therefore, there has been space, in the last few years, for new therapies as the TNF-inhibitors. This therapeutic approach has shown a dramatic clinical benefit in active polyarticular refractory JIA: the rate and rapidity of response have exceeded those of all other studied DMARDs...
July 2007: Reumatismo
Cal Shapiro, Lynn Maenz, Alomgir Hossain, Punam Pahwa, Alan Rosenberg
OBJECTIVE: To determine time intervals between onset of symptoms of a childhood rheumatic disease and first visit to a pediatric rheumatology clinic and to evaluate factors influencing onset to first visit intervals. METHODS: Onset to first visit intervals were analyzed in 836 children representing the 10 most common diseases in a pediatric rheumatology clinic population of 1093. RESULTS: Among 836 subjects, 469 (56.1%) could identify month of symptom onset...
September 2007: Journal of Rheumatology
Lara Maxwell, Nancy Santesso, Peter S Tugwell, George A Wells, Maria Judd, Rachelle Buchbinder
The Cochrane Musculoskeletal Group (CMSG), one of 50 groups of the not-for-profit international Cochrane Collaboration, prepares, maintains, and disseminates systematic reviews of treatments for musculoskeletal diseases. To enhance the quality and usability of systematic reviews, the CMSG has developed tailored methodological guidelines for authors of CMSG systematic reviews. Recommendations specific to musculoskeletal disorders are provided for various aspects of undertaking a systematic review, including literature searching, inclusion criteria, quality assessment, grading of evidence, data collection, and data analysis...
November 2006: Journal of Rheumatology
Sulaiman M Al-Mayouf
BACKGROUND: Familial arthropathy comprises a heterogeneous group of arthropathies. It can be either an inflammatory or a noninflammatory condition. The worldwide frequency of these disorders is unknown. OBJECTIVE: To study the demographic, clinical and biochemical features, and survival of a large series of children with familial arthropathies. METHODS: The medical records of children who had an arthropathy and a family history of a similar condition at the Pediatric Rheumatology Clinic at King Faisal Specialist Hospital-Riyadh between 1990 and 2005 were reviewed...
February 2007: Seminars in Arthritis and Rheumatism
Yosef Uziel, Yonatan Butbul-Aviel, Judith Barash, Shai Padeh, Masza Mukamel, Natalia Gorodnitski, Riva Brik, Philip J Hashkes
OBJECTIVE: To describe the outcome of children with recurrent transient synovitis (TS) of the hip. METHODS: A retrospective chart review of children with at least 2 separate episodes of TS between 1986 and 2003. We described the diagnostic investigations and outcome of these patients. A followup telephone survey for disability and pain scores was performed in 2004. RESULTS: We studied 39 children, 26 boys and 13 girls, from 6 pediatric rheumatology centers...
April 2006: Journal of Rheumatology
Alan M Rosenberg
OBJECTIVE: To analyze a prospectively maintained pediatric rheumatology clinic disease registry. METHODS: A total of 3269 consecutive referrals to the Pediatric Rheumatology Clinic, University of Saskatchewan, during the period 1981-2004 were analyzed. RESULTS: Among 3269 patients, a diagnosis was established in 2098 (64.2%). Within this group, 72 subjects (3.4%) were determined to be healthy. Of the remaining 2026 diagnosed patients (62.0% of the total population), 1032 (50...
October 2005: Journal of Rheumatology
Anne M Selvaag, Gunhild Lien, Dag Sørskaar, Odd Vinje, Øystein Førre, Berit Flatø
OBJECTIVE: . To describe the 3 year disease course in early juvenile rheumatoid arthritis (JRA) and juvenile spondyloarthropathy (JSpA), to compare the health status after 3 years of followup with that of normal controls, and to investigate the relationship between physical function at followup and disease characteristics recorded during the first 6 months. METHODS: One hundred and ninety-seven children (median age 6:6 yrs) with JRA and JSpA and disease duration <1...
June 2005: Journal of Rheumatology
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