Rice bodies imaging in juvenile idiopathic arthritis.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to Francesco Zulian.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We describe a case of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO syndrome) in an 8-year-old boy with an unusual presentation of acute transitory hemiparesis. SAPHO syndrome has been reported in association with inflammatory bowel diseases, chest complications, and pulmonary involvement. No patient with both SAPHO syndrome and neurologic complaints has been previously described. Further observations are needed to confirm if SAPHO syndrome and hemiparesis represent a coincidence or a new association.
OBJECTIVE: Alendronate treatment for 12 months in pediatric patients with rheumatic diseases and secondary low bone mass was reported to result in a substantial increase in bone mineral density (BMD). In this study, we evaluated the changes in bone metabolism and disease activity markers in 45 patients ages 5 to 18 years (31 female, 14 male) with rheumatic diseases treated with alendronate for 12 months. METHODS: Variables analyzed included demographic and anthropometric data, biochemical markers of bone metabolism, disease activity indexes, and BMD values. For all variables, the differences between levels at baseline and at 12 months were calculated; correlations between the variables and between the BMD variation over 12 months and baseline levels of the different variables were also evaluated. RESULTS: There was a statistically significant decrease of both bone resorption and bone formation markers over the 12 month treatment period. By contrast, no disease activity index changed significantly over one year. BMD Z score change over one year did not correlate with erythrocyte sedimentation rate, matrix metalloproteinase-3, interleukin 6, or C-reactive protein variations over the same period. CONCLUSION: These results support the conclusion that alendronate treatment is accompanied by a reduction of bone turnover in pediatric patients and that the observed BMD increase is not secondary to a reduction of inflammatory activity.
OBJECTIVE: To determine whether demographic, clinical, and laboratory variables at onset of arthritis can predict the development and the severity of anterior uveitis (AU) in oligoarticular juvenile idiopathic arthritis (JIA). METHODS: In a retrospective study, a cohort of 366 patients with oligoarticular onset JIA from 3 pediatric rheumatology centers were evaluated. Patients were classified in 3 groups: severe uveitis (SU) with a mean >/= 2 uveitis relapses/year with complications or need for immunosuppressive therapy; mild uveitis (MU) with a mean </= 1 uveitis relapse/year with no complications; and no uveitis. Variables that were significant with univariate tests or were clinically relevant for each outcome underwent multivariate logistic regression analysis. RESULTS: There were 316 patients available for analyses: 66 in the SU group, 64 in the MU group, and 186 in the no uveitis group. Multivariate analysis showed the following factors to be significant as predictors of AU onset: low age at onset (OR 0.96), a2-globulin plasma concentration (OR 1.34), and HLA-A19 (OR 2.87), B22 (OR 4.51) and DR9 (OR 2.33), while HLA-DR1 conferred protection (OR 0.13). This model was not good in predicting which patient would develop uveitis (sensitivity 55%, specificity 26%). Time interval between onset of arthritis and the first AU and elevated a2-globulin level in the serum were the best predictors of AU severity (OR 1.62 and 0.85, respectively). When applied prospectively, the model revealed good sensitivity (89.2%), specificity (76.1%), and efficiency (86.3%). CONCLUSION: Clinical and laboratory variables measurable at onset of arthritis can be used to predict severity of the course of AU in oligoarticular JIA, but not its onset. More accurate prediction can shorten or lengthen the intervals between ophthalmologic evaluations and can change the therapeutic approach undertaken on the basis of expected disease severity.