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Juvenil idiopathic arthritis

M J Santos, M Conde, A F Mourão, F O Ramos, M Cabral, I Brito, M P Ramos, R C Marques, S M Gomes, M Guedes, M J Gonçalves, P Estanqueiro, C Zilhão, M Rodrigues, C Henriques, M Salgado, H Canhão, J E Fonseca, J M Gomes
OBJECTIVE: To provide evidence-based guidance for the rational and safe prescription of biological therapies in children and adolescents with juvenile idiopathic arthritis (JIAs) considering the latest available evidence and the new licensed biologics. METHODS: Rheumatologists and Pediatricians with expertise in Pediatric Rheumatology updated the recommendations endorsed by the Portuguese Society of Rheumatology and the Portuguese Society of Pediatrics based on published evidence and expert opinion...
July 2016: Acta Reumatológica Portuguesa
Natasha Gautam, Ramandeep Singh, Aniruddha Agarwal, Sonam Yangzes, Mohit Dogra, Ashok Sharma, Reema Bansal, Vishali Gupta, Mangat R Dogra, Amod Gupta
PURPOSE: To report the pattern of pediatric uveitis in a tertiary care referral center in North India. METHODS: In a retrospective study, records of pediatric uveitis cases presenting at our center between 1996 and 2015 were reviewed for demographic data, anatomic distribution, and diagnosis. RESULTS: Out of 9600 patients with uveitis, 369 children (3.84%; age ≤16 years; males: 54.20%) were included in the study. Anterior uveitis was the commonest presentation (n = 158; 42...
October 21, 2016: Ocular Immunology and Inflammation
Alessandro Consolaro, Esi M Morgan, Gabriella Giancane, Silvia Rosina, Stefano Lanni, Angelo Ravelli
Information technology in paediatric rheumatology has seen several exciting developments in recent years. The new multidimensional questionnaires for juvenile idiopathic arthritis, juvenile dermatomyositis, and juvenile autoinflammatory diseases integrate all major parent- and child-reported outcomes (PCROs) used in these diseases into a single tool, and provide an effective guide to manage, document change in health, assess effectiveness of therapeutic interventions, and verify the parent and child satisfaction with illness outcome...
September 2016: Clinical and Experimental Rheumatology
Rille Pullerits, Hanna Schierbeck, Karin Uibo, Hille Liivamägi, Sirje Tarraste, Tiina Talvik, Erik Sundberg, Chris Pruunsild
OBJECTIVE: High mobility group box protein 1 (HMGB1) is an important pro-inflammatory mediator in adult rheumatoid arthritis. The diagnostic utility of HMGB1 in Juvenile Idiopathic Arthritis (JIA) is still unclear. The aim was to examine whether serum HMGB1 levels are associated with inflammation, radiological disease progression, and long-term prognosis in JIA. METHODS: We included 131 children with JIA from a population-based prevalence study; 38 of them were prospectively followed up for 10 years...
August 26, 2016: Seminars in Arthritis and Rheumatism
M Maddah, S Harsini, V Ziaee, M H Moradinejad, A Rezaei, S Zoghi, M Sadr, Y Aghighi, N Rezaei
Juvenile idiopathic arthritis (JIA) is a heterogeneous autoimmune disorder of unknown origin. As proinflammatory cytokines are known to contribute towards the pathogenesis of JIA, this case-control study was performed to examine the associations of certain single nucleotide polymorphisms (SNPs) of tumour necrosis factor-α (TNF-α) gene. Fifty-three patients with JIA participated in this study as patients group and compared with 137 healthy unrelated controls. Genotyping was performed for TNF-α gene at positions -308 and -238, using polymerase chain reaction with sequence-specific primers method...
October 18, 2016: International Journal of Immunogenetics
Filipa Oliveira-Ramos, Mónica Eusébio, Fernando M Martins, Ana Filipa Mourão, Carolina Furtado, Raquel Campanilho-Marques, Inês Cordeiro, Joana Ferreira, Marcos Cerqueira, Ricardo Figueira, Iva Brito, Helena Canhão, Maria José Santos, José A Melo-Gomes, João Eurico Fonseca
OBJECTIVES: To determine how adult juvenile idiopathic arthritis (JIA) patients fulfil classification criteria for adult rheumatic diseases, evaluate their outcomes and determine clinical predictors of inactive disease, functional status and damage. METHODS: Patients with JIA registered on the Rheumatic Diseases Portuguese Register ( older than 18 years and with more than 5 years of disease duration were included. Data regarding sociodemographic features, fulfilment of adult classification criteria, Health Assessment Questionnaire, Juvenile Arthritis Damage Index-articular (JADI-A) and Juvenile Arthritis Damage Index-extra-articular (JADI-E) damage index and disease activity were analysed...
2016: RMD Open
Carmelo Guerrero-Laleona, Joan Calzada-Hernández, Matilde Bustillo-Alonso, Jorge Gil-Albarova, Marta Medrano-San Ildefonso, Estibaliz Iglesias-Jiménez, Antoni Noguera-Julian
Treatment with tumor necrosis factor-α inhibitors is a risk factor for tuberculosis. Despite previous treatment with isoniazid for latent tuberculosis, a 9-year-old girl with juvenile idiopathic arthritis developed disseminated tuberculosis after changing therapy with etanercept to adalimumab and after new contact with a smear-positive relative. Genotyping strain matches and susceptibility to isoniazid make reinfection more likely than reactivation in our patient.
October 3, 2016: Pediatric Infectious Disease Journal
Ellen A Lipstein, Daniel J Lovell, Lee A Denson, Sandra C Kim, Charles Spencer, Richard F Ittenbach, Maria T Britto
OBJECTIVES: To understand the association between parents' perceptions of the decision process and the decision outcomes in decisions about the use of biologics in pediatric chronic conditions. METHODS: We mailed surveys to parents of children with IBD (inflammatory bowel disease) or JIA (juvenile idiopathic arthritis) who had started treatment with biologics in the prior two years and were treated at either of 2 children's hospitals. The survey included measures of the decision process, including decision control and physician engagement, and decision outcomes, including conflict and regret...
September 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
Gerd Horneff, Ariane Klein, Prasad T Oommen, Anton Hospach, Ivan Foeldvari, Isa Feddersen, Kirsten Minden
OBJECTIVES: While tumour necrosis factor (TNF)-α-inhibitor treatment improved outcome of juvenile idiopathic arthritis (JIA) management markedly, concerns have been raised about an association of TNF-α-inhibitor treatment and an increased risk for malignancies especially lymphoma. METHODS: Cases of suspected malignancies documented in the German Biker Registry are reviewed in detail. RESULTS: Until Dec 31, 2015, 3695 JIA patients were prospectively followed with a total of more than 13,198 observation years...
September 8, 2016: Clinical and Experimental Rheumatology
Gabriella Giancane, Alessandro Consolaro, Stefano Lanni, Sergio Davì, Benedetta Schiappapietra, Angelo Ravelli
Juvenile idiopathic arthritis is a broad term that describes a clinically heterogeneous group of arthritides of unknown cause, which begin before 16 years of age. This term encompasses several disease categories, each of which has distinct presentation, clinical manifestations, and, presumably, genetic background and etiopathogenesis. Although none of the available drugs has curative potential, prognosis has greatly improved as a result of substantial progresses in disease management. The most important new development has been the introduction of the biologic medications, which constitute a valuable treatment option for patients who are resistant to conventional antirheumatic agents...
August 12, 2016: Rheumatol Ther
Nancy A Chauvin, Asef Khwaja
The hallmark of juvenile idiopathic arthritis is synovial inflammation, and the goal of treatment is to suppress inflammation to prevent cartilage damage and bone erosions. Ultrasound and MRI are widely used imaging modalities in evaluating disease burden and response to treatments and are superior to clinical examination alone. However, differentiating between the normal appearance of the developing skeleton and pathologic conditions can be difficult, particularly in early disease. Larger, long-term studies are needed to standardize imaging definitions and protocols and to fully understand the clinical implications of imaging findings...
November 2016: Rheumatic Diseases Clinics of North America
Signe Hanghøj, Kirsten A Boisen, Kjeld Schmiegelow, Bibi Hølge-Hazelton
BACKGROUND: International guidelines recommend planned and structured transition programmes for adolescents with chronic illness because inadequate transition may lead to poor disease control and risk of lacking outpatient follow-up. OBJECTIVE: To investigate the feasibility of a transition intervention aimed at adolescents with chronic illness focusing on declines, drop-outs, no-shows and advantages and disadvantages of participating. METHODS: We invited 236 adolescents (12-20 years) with juvenile idiopathic arthritis (JIA) to participate in a randomised controlled trial (RCT) transition intervention...
October 14, 2016: International Journal of Adolescent Medicine and Health
Tayyeb Bahrami, Samaneh Soltani, Kasra Moazzami, Mir Saeed Yekaninejad, Arash Salmaninejad, Ehsan Soltaninejad, Vahid Ziaee, Nima Rezaei
Juvenile idiopathic arthritis (JIA), the most common cause of chronic arthritis in children, is a complex immune-mediated disease with considerable long-term morbidity and mortality. According to previous studies, PTPN22 gene has been associated with JIA in several populations. In the present study, we attempted to determine the association of PTPN22 single nucleotide polymorphisms (SNPs) with susceptibility to JIA in Iranian population. Using the Real-time PCR allelic discrimination method, samples consisting of 55 unrelated patients and 93 healthy controls were genotyped...
October 12, 2016: Fetal and Pediatric Pathology
Anne-Mieke J W Haasnoot, Lenneke A Vernie, Aniki Rothova, Patricia V D Doe, Leonoor I Los, Nicoline E Schalij-Delfos, Joke H de Boer
BACKGROUND: Typically juvenile idiopathic arthritis (JIA)-associated uveitis (further referred as 'JIA-uveitis') has its onset in childhood, but some patients suffer its, sometimes visual threatening, complications or ongoing disease activity in adulthood. The objective of this study was to analyze uveitis activity, complications and visual prognosis in adulthood. METHODS: In this multicenter study, 67 adult patients (129 affected eyes) with JIA-uveitis were retrospectively studied for best corrected visual acuity, visual fields, uveitis activity, topical/systemic treatments, ocular complications, and ocular surgeries during their 18th, 22nd and 30th year of life...
2016: PloS One
V Ziaee, M Maddah, S Harsini, A Rezaei, M Sadr, S Zoghi, M H Moradinejad, N Rezaei
BACKGROUND: Cytokines, including interleukin-1 (IL-1), seem to contribute towards the pathogenesis of juvenile idiopathic arthritis (JIA), so this study was designed to evaluate the associations of IL-1 gene cluster and IL-1 receptor (IL-1R) gene single nucleotide polymorphisms (SNPs) with JIA proneness in Iranian population. MATERIALS AND METHODS: Genomic DNA of 55 Iranian patients with JIA and 140 controls were extracted and typed for IL-1α gene at position -889, IL-1β gene at positions -511 and +3962, IL-1R gene at position Pst-I 1970, and interleikin-1 receptor antagonist (IL-1Ra) gene at position Mspa-I 11100, using polymerase chain reaction with sequence-specific primers method, and compared between patients and controls...
October 4, 2016: Allergologia et Immunopathologia
Gaetano Isola, Luca Ramaglia, Giancarlo Cordasco, Alessandra Lucchese, Luca Fiorillo, Giovanni Matarese
BACKGROUND: Patients affected by Juvenile Idiopathic Arthritis (JIA) may have several craniofacial growth disturbances and involvements at the temporomandibular joint (TMJ). The objectives of the present study were to evaluate the clinical effectiveness of functional therapy used to reduce asymmetry of mandibular growth and TMJ disorder in patients with JIA. METHODS: By a retrospective longitudinal design, a cohort of 54 patients with JIA (mean age, 13.2 ± 3.7 years; range, 5-17...
September 13, 2016: Minerva Stomatologica
D Windschall, G Horneff
The TNF inhibitors etanercept (ETA) and adalimumab (ADA) are approved for treating patients older than 2 years with polyarticular juvenile idiopathic arthritis (JIA). Because long-term experience of treating children younger than 4 years is limited, we evaluated the efficacy and safety of ETA or ADA in patients aged 2-4 years. This prospective, long-term, observational registry study documented baseline demographics, clinical characteristics, disease activity parameters, and safety of patients treated with ETA or ADA...
October 5, 2016: Clinical Rheumatology
Priyanka Gaur, Arpita Myles, Ramnath Misra, Amita Aggarwal
Microarray of peripheral blood (PB) and synovial fluid mononuclear cells (PBMC, SFMC) of patients with Enthesitis-related-arthritis (JIA-ERA) has shown the involvement of monocytes. On basis of CD14 and CD16 expression monocytes are classified as classical, intermediate and non-classical. In response to Toll-like Receptor (TLR) stimulation intermediate-monocytes produce pro-inflammatory cytokines and play a role in inflammatory diseases. Thus we have studied the microarray profile of monocytes, frequency of their subsets and cytokine production...
October 5, 2016: Clinical and Experimental Immunology
Jennifer J Schoch, Stanislav N Tolkachjov, Jonathan A Cappel, Lawrence E Gibson, Dawn Marie R Davis
BACKGROUND/OBJECTIVES: Pyoderma gangrenosum (PG) is a neutrophilic dermatosis rarely seen in children. Its features have not been well characterized in children. We sought to characterize the clinical features, etiologic associations, and treatment of PG in children younger than 18 years. METHODS: We performed a retrospective review of children younger than 18 years with PG at the Mayo Clinic from January 1976 to August 2013. RESULTS: Thirteen children with PG were identified (n = 8; 62% female)...
October 4, 2016: Pediatric Dermatology
Stephen J Balevic, C Egla Rabinovich
Uveitis refers to the presence of intraocular inflammation, and as a strict definition compromises the iris and ciliary body anteriorly and the choroid posteriorly (the uvea). Untreated, uveitis can lead to visual loss or blindness. The etiology of uveitis can include both infectious and noninfectious (usually immune-mediated) causes, the latter of which are often mediated predominantly by Th1 CD4(+) T-cells that secrete proinflammatory cytokines. Tumor necrosis factor-alpha (TNF-α) is a proinflammatory cytokine involved in the pathogenesis of uveitis, which at high concentrations can cause excess inflammation and tissue damage...
2016: Drug Design, Development and Therapy
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