1,721,065 research outputs found
Paediatric-onset systemic lupus erythematosus.
No full textPaediatric-onset systemic lupus erythematosus (SLE) is usually
more severe than its adult counterpart. In particular, there is a
higher incidence of renal and central nervous system involvement.
Specific measures to assess disease activity and damage have been
implemented. The disease is very rare before the fifth birthday and
therefore the onset of an SLE picture in the first years of life should
lead to the suspicion of the presence of one of the rare monogenic
diseases that causes SLE or of one of those congenital diseases that
has been showed to be closely associated with the SLE
Glucocorticoids in juvenile idiopathic arthritis.
No full textAlthough the use of corticosteroids in juvenile idiopathic arthritis (JIA) is now much more limited owing to the
availability of methotrexate and biological agents, there are clinical scenarios where it is still indicated. For example,
corticosteroids may be indicated for intraarticular injections to prevent joint deformities, as a “bridge” drug to
relieve symptoms in polyarticular disease while waiting for methotrexate and biologics to exert their full therapeutic
effects, and in the treatment of chronic iridocyclitis, macrophage activation syndrome, and systemic JIA, although
the advent of interleukin (IL)-1 and IL-6 blockers has greatly reduced the latter indication
Imaging in paediatric rheumatology: Is it time for imaging?
No full textJuvenile idiopathic arthritis (JIA) is a heterogeneous group of arthritides characterized by chronic synovial inflammation that can lead to structural damage. The main objective of JIA therapies is to induce disease control to avoid disability in childhood. The advances in therapeutic effectiveness have created a need to search for imaging tools that describe more precisely disease activity in children with JIA. Musculoskeletal ultrasound and magnetic resonance imaging have demonstrated to be more sensitive than clinical examination in early detection of synovitis. These modalities can detect both inflammatory and destructive changes. The unique characteristics of the growing skeleton and a scarce validation of imaging in children result in important challenges in evaluating paediatric population. This review describes indications and limitations of these imaging techniques and suggests some advices for a rational use in the management of JIA in clinical practice
The role of imaging in juvenile idiopathic arthritis
No full textIntroduction: The prognosis of juvenile idiopathic arthritis (JIA) has changed dramatically due to the availability of novel drugs. Prompt diagnosis and treatment are essential to prevent permanent joint damage. As a result, methods to improve JIA diagnosis and prognosis are of high priority to tailor treatment strategies and maximize their efficacy. Musculoskeletal ultrasound and magnetic resonance imaging are more sensitive than clinical examination and radiography in the detection of joint involvement and might play a substantial role to optimize the management of JIA. Areas covered: This review compiles an inventory of potential uses of imaging studies in the modern practice of pediatric rheumatology, together with a critical analysis of the major challenges that are still to be addressed. Imaging appearance of normal growth-related changes of the musculoskeletal system will be discussed. Expert commentary: Knowledge of the evolving patterns of skeletal maturity is paramount to define pathological findings and avoid misinterpretations. Establishing a novel radiological algorithm for a rational use of imaging in JIA is of high priority to allow a speedier integration of imaging into the clinical workflow and decision-making process
New autoantibodies and their clinical associations in juvenile myositis - a systematic review
No full textBackground: Novel autoantibodies targeting intracellular proteins are recently detected in patients with idiopathic inflammatory myopathies (IIMs). Objective. To evaluate the prevalence of these myositis-specific antibodies (MSAs) in juvenile IIMs (JIIMs) and their association with clinical characteristics and disease course. Methods: A systematic literature search was carried out to identify all studies concerning these novel MSAs (p155/140, p140, CADM-140, SAE and 200/100) in patients with JIIMs. Results: A total of 1003 references were identified, of which 118 were selected for detail -ed analysis and 13 included in the final review. Conclusions: The anti-p155/140, the anti-p140 and the anti-CADM-140 seem to be useful markers for define distinct clinical subsets and for predicting pro gnosis of JIIMs. Further studies are needed to clarify the importance of anti 200/100 and anti-SAE in juvenile myositis
Synovial and inflammatory diseases in childhood: role of new imaging modalities in the assessment of patients with juvenile idiopathic arthritis.
No full textAbstract
Juvenile idiopathic arthritis (JIA) represents a group of heterogeneous diseases characterized by a chronic inflammatory process primarily targeting the synovial membrane. A persistent synovitis is associated with an increased risk of osteocartilaginous damage.With the advent of effective structure-modifying treatment for JIA, it may be possible to significantly reduce or even completely prevent structural damage and associated functional disability. The trend towards early suppression of inflammation, in order to prevent erosive disease, shifts the emphasis away from conventional radiographic detectable structural damage to the slightest traces of early joint damage, and drives the need for alternative imaging techniques more sensitive in detecting early signs of disease activity and damage. In this regard MRI and US are playing an increasing role in the evaluation of arthritic joints.This article will review the key aspects of the current status and recent important advances of imaging techniques available to investigate the child with rheumatic disease, briefly discussing conventional radiography, and particularly focusing on MRI and US. In this era of advancing imaging technology, knowledge of the relative values of available imaging techniques is necessary to optimize the management of children with JIA
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