ABSTRACT
The study was based on the follow-up of 20 patients with systemic juvenile rheumatoid arthritis who received intravenous immunoglobulin. The study comparatively analyzed the efficiency of the therapy alone and in combination with steroids. The immunoglobulin was shown to have positive effects on both articular and extraarticular manifestations of the disease particularly in a group of children untreated with corticosteroids. The duration of the disease did not affect the therapeutical properties of immunoglobulin.
Subject(s)
Arthritis, Juvenile/therapy , Glucocorticoids/therapeutic use , Immunoglobulins, Intravenous/therapeutic use , Adolescent , Child , Child, Preschool , Drug Therapy, Combination , Female , Follow-Up Studies , Humans , Male , Patient Satisfaction , Surveys and Questionnaires , Treatment OutcomeSubject(s)
Erythema Chronicum Migrans/etiology , Lyme Disease/complications , Lyme Disease/physiopathology , Nervous System Diseases/etiology , Adolescent , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Female , Humans , Lyme Disease/drug therapy , Male , Russia , Serologic TestsABSTRACT
The current classification of juvenile rheumatoid arthritis (JRA) consists of several distinct subsets. We describe 6 children (2 boys, 4 girls, mean age 3.7 years, range 2.0-4.9 years) with arthritis and eye involvement associated with infection with Chlamydia trachomatis. In some of the children, the clinical picture was similar to early onset pauciarticular JRA: onset within the first 4 years of life, predominance of girls, pauciarticular arthritis, subacute uveitis, and presence of antinuclear antibodies. Joint involvement was pauciarticular in 4 patients and polyarticular in 2. Two patients had clinical symptoms of Reiter's disease. Further investigations of this post chlamydial associated syndrome should be performed to establish appropriate diagnostic, therapeutic and prognostic measures.
Subject(s)
Arthritis, Infectious/complications , Arthritis, Juvenile/complications , Chlamydia Infections/complications , Chlamydia trachomatis , Uveitis/complications , Antibodies, Antinuclear/analysis , Arthritis, Infectious/diagnosis , Arthritis, Juvenile/diagnosis , Child, Preschool , Chlamydia Infections/diagnosis , Diagnosis, Differential , Female , Humans , Male , Prognosis , Uveitis/diagnosisABSTRACT
Patients with systemic juvenile rheumatoid arthritis (JRA) are often poorly responsive to existing therapeutic modalities. We evaluated the effectiveness of pulse therapy consisting of methylprednisolone 30 mg/kg/day for 3 consecutive days combined with cyclophosphamide 0.4 g/m2 body surface area on the 3rd day, for 18 patients with definite systemic JRA, who were enrolled in an open trial of 12 months' duration. The children received pulse therapy every 3 months; oral methotrexate 10 mg/m2 was started after the first pulse. A rapid and clinically significant suppression of systemic and articular manifestations was seen in all patients. Significant decreases in laboratory indices of disease activity were also observed. Side effects were minor and reversible. The results of our preliminary trial support the development of a controlled study to evaluate the efficacy of pulse therapy in systemic JRA.
Subject(s)
Arthritis, Juvenile/drug therapy , Cyclophosphamide/administration & dosage , Methotrexate/administration & dosage , Methylprednisolone/administration & dosage , Administration, Oral , Adolescent , Blood Sedimentation , C-Reactive Protein/analysis , Child , Child, Preschool , Cyclophosphamide/adverse effects , Cyclophosphamide/therapeutic use , Disability Evaluation , Drug Therapy, Combination , Female , Humans , Longitudinal Studies , Male , Methotrexate/adverse effects , Methotrexate/therapeutic use , Methylprednisolone/adverse effects , Methylprednisolone/therapeutic useABSTRACT
The treatment for systemic JRA is among actual problems of pediatric rheumatology. To evaluate the effectiveness of pulse therapy (PT) with methylprednisolone 25-30 mg/kg/day for 3 consecutive days combined with cyclophosphamide 0.4-0.5 g/sq. m body surface area (BSA) on the 3rd day, repeated quarterly for 12 months, 30 patients with systemic JRA were randomized into 3 groups: 1--those with disease duration (DD) less than 2 years receiving PT (n = 13), 2--with DD 2 years and more (n = 8) receiving PT, and 3--with DD less than 2 years receiving no PT. Children in all 3 groups received concomitant medication (one of nonsteroidal anti-inflammatory drugs, methotrexate 10 mg/sq. m BSA/week and oral steroids). A rapid and significant improvement, according to systemic and articular manifestations as well as laboratory indices occurred in the 1st group, in most of the measured parameters exceeded effects in the other two groups and gave the opportunity to avoid the administration of oral steroids or to give the lesser initial dose. Side effects were minor and completely reversible.
Subject(s)
Arthritis, Juvenile/drug therapy , Cyclophosphamide/administration & dosage , Methylprednisolone/administration & dosage , Analysis of Variance , Arthritis, Juvenile/epidemiology , Arthritis, Juvenile/immunology , Arthritis, Juvenile/physiopathology , Child , Cyclophosphamide/adverse effects , Drug Therapy, Combination , Drug Tolerance , Female , Humans , Male , Methylprednisolone/adverse effects , Time FactorsABSTRACT
The authors describe the results of prospective multicenter Soviet-American placebo-controlled 6-month investigations concerned with assessment of the therapeutic efficacy of auranofin in juvenile rheumatoid arthritis (JRA). 231 patients with JRA were placed under observation. Auranofin was found to be slightly superior to placebo. The drug was tolerated well. It is noted that in the treatment of JRA, of importance are long (6-month) courses of non-steroidal anti-inflammatory drugs.
Subject(s)
Arthritis, Juvenile/drug therapy , Auranofin/therapeutic use , Adolescent , Auranofin/adverse effects , Child , Child, Preschool , Double-Blind Method , Humans , Infant , Multicenter Studies as Topic , Placebos , Prospective Studies , Tablets , Time Factors , USSR , United StatesABSTRACT
A considerable rise in indices of chemoluminescence (CL) of the whole blood in children with juvenile rheumatoid arthritis was noted. A correlation of CL with clinico-laboratory indices of the disease activity was revealed. The highest level of CL was observed in the articulovisceral form and in the maximum degree of the disease activity. There was a significant difference in CL intensity in the minimum degree of the disease activity and remission of the pathological process.
Subject(s)
Arthritis, Juvenile/blood , Oxygen/blood , Adolescent , Child , Child, Preschool , Chronic Disease , Humans , Luminescent Measurements , Luminol , MethodsABSTRACT
Investigation findings are generalized based on quantitation of antibodies against the antigens of intestinal microorganisms of Enterobacteriaceae family conducted in 66 children with various joint disease using the enzyme-linked immunoassay (ELISA) methodology. High antibody titres were revealed in 77.1% juvenile rheumatoid arthritis cases and in 80% cases with chronic juvenile arthritis which was not defined nosologically. All the patients with reactive arthritis associated with intestinal infection showed high tension of immunity to all tested enterobacteriaceae antigens with cross reactions to them. Patients with reactive arthritis associated with oral infection, with Reiter's disease and other disorders exhibited high antibody titres at the same rate as in the control.
Subject(s)
Antibody Formation , Antigens, Bacterial/immunology , Arthritis, Juvenile/immunology , Arthritis/immunology , Enterobacteriaceae/immunology , Child , HumansABSTRACT
The authors summed up the results of a many-year study of 13 children with Sjogren's diseases and syndrome, presented clinical characterization of patients, a course of this childhood pathology, some therapeutic problems and catamnestic data. An excerpt from a case history of a child with Sjogren's syndrome was given. Characteristic features of this childhood pathology were defined in comparison with adult patients.
Subject(s)
Collagen Diseases/classification , Sjogren's Syndrome/classification , Adolescent , Age Factors , Arthritis, Juvenile/diagnosis , Child , Child, Preschool , Collagen Diseases/diagnosis , Dental Caries/diagnosis , Diagnosis, Differential , Female , Humans , Male , Mixed Connective Tissue Disease/diagnosis , Scleroderma, Systemic/diagnosis , Sjogren's Syndrome/diagnosis , Xerostomia/diagnosisABSTRACT
The paper is concerned with the results of a long-term study of 16 children with a verified diagnosis of Reiter's syndrome. Preceding factors, the clinical symptom complex, laboratory findings and the evolution of the disease were described. Emphasis was placed on the necessity of early diagnosis and adequate therapy including antiinflammatory drugs and antibiotics to prevent serious complications, especially of the eyes.
Subject(s)
Arthritis, Reactive/diagnosis , Adolescent , Anti-Inflammatory Agents/therapeutic use , Arthritis, Juvenile/diagnosis , Arthritis, Reactive/drug therapy , Child , Child, Preschool , Diagnosis, Differential , Female , Humans , Infant , MaleABSTRACT
A study of 82 cases with the prolapse of the mitral valve (PMV) and 169 of their first degree relatives has shown that PMV can be a symptom of a number of hereditary diseases, in the first place of the diseases of the connective tissue. Intrafamilial variations of cardiac changes have been recorded. It is established that the idiopathic PMV is aetiologically variable, which makes it difficult to evaluate the type of heredity of PMV as a whole.
