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Biomedical subjects

P Malleson

Publications and source records attributed to P Malleson.

12 recordsLinked to original sources
PubMed1992

Seroprevalence survey of borreliosis in children with chronic arthritis in British Columbia, Canada.

A seroprevalence survey using an indirect immunofluorescence assay (IFA) for IgG antibodies to Borrelia hermsii and Borrelia burgdorferi was conducted for varied pediatric chronic arthritis patients and a nonrheumatic control group in the province of British Columbia, Canada. Overall, a higher rate of sera with IFA titers > or = 1/256 was found for B. hermsii (36.6%) compared to B. burgdorferi (12.5%). There were no significant differences among the arthritis subgroups and controls for the distribution of IFA titers for either organism. IgG immunoblotting of selected high titered sera to either borrelia species confirmed the lack of specificity of the IFA assay. Serological tests for borreliosis should be cautiously interpreted in children with chronic arthritis.

Adolescent↗
PubMed1991

The role of ultrasound in evaluation of Takayasu's arteritis.

Duplex ultrasound was used to assess the vascular status and predict the angiographic findings in 3 patients with Takayasu's arteritis. The most striking sonographic feature was the presence of concentric arterial wall thickening. Using pulsed Doppler, stenotic lesions were quantified, occlusive lesions were identified and collateral circulation was demonstrated. A high resistive flow pattern was demonstrated in diseased vessels compared with carotid wave-forms of control subjects. Subtle mural irregularity, minor stenotic lesions and areas of stenosis in branch vessels were missed by duplex evaluation. The thoracic aorta and occasionally major arterial branches in the abdomen were impossible to evaluate with ultrasound. Vascular magnetic resonance imaging was successful in delineating major aortic branches but was inferior to real-time ultrasound in resolving mural thickening. While angiography plays a major role as a baseline assessment of the entire vascular tree, duplex ultrasound can monitor disease progression and the effects of therapy. Serial duplex studies should greatly reduce the need for interval angiographic followup.

Adolescent↗
PubMed1990

Radiographic followup of joints injected with triamcinolone hexacetonide for the management of childhood arthritis.

Evidence of deleterious effects following intraarticular injection of triamcinolone hexacetonide was sought through a review of radiographs of 145 joints of 55 children with chronic arthritis. Possible deleterious effects were noted in 16 joints of 11 patients. These effects included: small patella (2 joints), patellar osteochondritis dissecans (1 joint), periarticular calcification (9 joints), intraarticular tibial bony spur (1 joint), avascular necrosis of the distal radial epiphysis (2 joints), and avascular necrosis of the proximal femoral epiphysis (1 joint). Only the latter possible complication was symptomatic. Serial radiographs of 76 joints of 30 children showed mild progressive changes compatible with the underlying disease, except in the hip joint, where changes were more severe. The intraarticular injection of triamcinolone hexacetonide is a procedure that appears to be associated with an acceptably low frequency of radiologic abnormalities for many joints in children with chronic arthritis, but its effects on the hip joint remain uncertain.

Anti-Inflammatory Agents↗
PubMed1990

Nephrotic syndrome associated with nonsteroidal anti-inflammatory drug use in two children.

Two children with nephrotic syndrome in association with nonsteroidal anti-inflammatory drug (NSAID) use are described, and the literature concerning this association is reviewed. NSAIDs are drugs with the potential for causing significant renal toxicity including the nephrotic syndrome, interstitial nephritis, and renal failure even in children without obvious preceding renal disease. Children prescribed such drugs should be regularly monitored with urinalyses and plasma creatinine estimations. The possibility of toxicity to over-the-counter use of NSAIDs should be remembered.

Adolescent↗
PubMed1989

Reactivity of antinuclear antibodies with histones and other antigens in juvenile rheumatoid arthritis.

Antinuclear antibodies are found in serum samples from most children with juvenile rheumatoid arthritis (JRA), but the antigenic specificities of these antibodies are not known. Using an immunoblot technique, we found that JRA patients' sera react with a variety of proteins in the nuclei of HEp-2 cells. Antibody to histone H1 was found in 42% of the JRA serum samples. An IgG antibody to a 45-kd protein was found in serum samples from some patients without uveitis, but it was not found in any sample from patients with uveitis. The immunoblot reactivity patterns do not appear to be useful in distinguishing between disease onset types or disease course types in patients with JRA.

Antibodies↗
PubMed1989

Mycoplasma pneumoniae associated arthropathy: confirmation of the association by determination of the antipolypeptide IgM response.

The association of Mycoplasma pneumoniae with arthropathy in children and young adults has been established essentially on the basis of complement fixation (CF) serology. Because the CF test may be nonspecific for M. pneumoniae, we have confirmed the association by determination of IgM ELISA and IgM and IgG immunoblotting responses in 2 children. Mycoplasma pneumoniae should be considered in any patient with acute respiratory illness who subsequently develops arthropathy.

Antigens, Bacterial↗
PubMed1988

Functional asplenia in childhood onset systemic lupus erythematosus.

Fatal pneumococcal sepsis due to functional asplenia in a child with systemic lupus erythematosus (SLE) and transient hyposplenism in a 2nd child during an acute flare of SLE are described. Splenic ultrasound examinations and radionuclide spleen scans in 11 other children with SLE were normal. Splenic atrophy and dysfunction is an uncommon but potentially fatal complication of SLE in childhood.

Adolescent↗
PubMed1987

Chronic arthritis in two children with partial deletion of chromosome 18.

We describe 2 children with a partial deletion of chromosome 18 and chronic arthritis. A boy with r(18)(p11.3; q23) lacked serum IgA and had arthritis affecting both knees. A girl with del (18)(q21.2; q22) had arthritis in 5 joints. Her serum IgA was normal. In both children, the arthritis responded to nonsteroidal antiinflammatory drugs.

Arthritis↗
PubMed1986

Spondyloarthropathies of childhood.

The spondyloarthropathies of childhood present a diagnostic and therapeutic challenge. It is important to differentiate this group of arthritides from JRA because the nature and frequency of extra-articular complications are quite different, as is the prognosis and the therapeutic approach. JAS is the prototype of the spondyloarthropathies and probably accounts for greater than 75 per cent of all children with diseases included in this category. Unlike adult-onset ankylosing spondylitis, axial skeleton disease (sacroiliac, lumbar spine) is infrequent at onset of JAS and may not develop for months or years after the onset of arthritis in peripheral joints (particularly those of the lower extremity). Enthesitis, the inflammation of the insertion of tendon, capsule, ligament, or fascia to bone, is an important clinical diagnostic feature of this group of diseases. Extra-articular disease, such as rash in psoriatic arthritis, erythema nodosum, weight loss of abdominal pain (in the arthropathies of inflammatory bowel disease), urethritis, conjunctivitis, or Reiter's syndrome help to differentiate these spondyloarthropathies from JAS. Laboratory studies are of little assistance in differentiating JRA from the spondyloarthropathies except that in the latter group, RF is absent and HLA-B27 is frequently present. The high frequency of ANA in JRA contrasts with its corresponding low frequency in JAS. The long-term follow-up of chronic arthritis in childhood has demonstrated the variable and evolving nature of these conditions, and stresses the importance of continually questioning the accuracy of the diagnosis.

Arthritis↗
PubMed1986

Stridor due to cricoarytenoid arthritis in pauciarticular onset juvenile rheumatoid arthritis.

A 2-year-old girl developed severe inspiratory and expiratory stridor 2 months after onset of pauciarticular juvenile rheumatoid arthritis (JRA). Direct laryngoscopy demonstrated that both vocal cords were immobile and approximated to each other in the midline secondary to arthritis of the cricoarytenoid joints. High dose corticosteroid therapy resulted in clinical and laryngoscopic improvement and tracheostomy was avoided. Cricoarytenoid arthritis can be a life threatening complication in JRA. Early institution of corticosteroids appears to be the treatment of choice.

Arthritis, Juvenile↗
PubMed1986

Prepuce care.

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Humans↗