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Query: UMLS:C0003864 (arthritis)
 69,039 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Data of 46 patients with juvenile chronic arthritis were evaluated. All of them were under the age of 16 at the time of study. Patients with juvenile ankylosing spondylitis, psoriatic arthritis, and arthritis associated with inflammatory bowel disease were excluded from this series. Twenty-six patients had pauciarticular, 9 had systemic, 8 had polyarticular, and 3 patients had seropositive 'adult type' JCA. In all patient groups IgG, IgM, IgA, and C3 levels were significantly higher than in the control group. None of the controls but 13 of 46 patients had high IgE levels. IgA and IgG values were significantly higher in the seropositive subgroup than in the pauciarticular subgroup. There was no other positive correlation between levels of immunoglobulins, C3, and clinical features of disease. Platelet counts were significantly higher in patients with active disease. In the control group 4 out of 10 children had 'hidden' rheumatoid factor. All these children with positive findings were young.
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PMID:Serological abnormalities in juvenile chronic arthritis: a review of 46 cases. 696 8

Thirty-nine children with a syndrome of seronegative enthesopathy and arthropathy were evaluated. The group included 25 patients with no apparent underlying primary disease and 13 with either ankylosing spondylitis, inflammatory bowel disease, reactive arthritis, or Reiter's syndrome. Significant distinguishing characteristics of the group included male predominance, late age at onset, positive family histories of arthritis, oligoarthropathy, axial skeleton involvement, and the presence of the B27 histocompatibility antigen. This syndrome is distinguishable from other childhood rheumatic disorders, including juvenile rheumatoid arthritis. Its recognition may reliably identify children with the prodromal manifestations of seronegative spondylarthropathies.
Arthritis Rheum 1982 Sep
PMID:A syndrome of seronegative enthesopathy and arthropathy in children. 712 88

Ulcerative colitis and Crohn's disease are significant childhood illnesses. With their many extraintestinal manifestations, they may masquerade as fever of unknown etiology, arthritis, anorexia nervosa, growth hormone deficiency, collagen-vascular disease, idiopathic growth retardation and even irritable bowel syndrome of childhood. In any child who presents with growth failure and/or chronic abdominal pain with fever or weight loss, the diagnosis of inflammatory bowel disease must be considered. As in any other chronic disease of childhood, long-term management will often challenge the physician emotionally and intellectually. As the etiology is yet unknown and a definitive cure is lacking, proper treatment depends on optimal medical and surgical management and supportive care.
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PMID:Inflammatory bowel disease in children and adolescents. 737 73

The spondyloarthropathies comprise four distinct entities--ankylosing spondylitis, psoriatic arthritis, the arthritis associated with inflammatory bowel disease, and Reiter's syndrome and other related forms of reactive arthritis. Although these are distinct diseases, they have a number of clinical, radiologic, and genetic characteristics in common which permit them to be classified under the unifying term "spondyloarthropathy". They are diseases of young adults, and when they present in patients under 16 years of age we refer to them as the "juvenile" spondyloarthropathies. They must be distinguished from juvenile rheumatoid arthritis, which is a totally separate entity; however the distinction may not always be obvious. Involvement of peripheral and sacroiliac joints commonly occurs in the juvenile spondyloarthropathies. The peripheral arthritis may be erosive and associated with bone apposition at the joint margins. Axial involvement is usually a late finding. Dactylitis and tenosynovitis are frequently present early on. Enthesitis, a highly specific feature, occurs much more often in the juvenile spondyloarthropathies than in the adult forms and it may be the only presenting feature. The plain radiograph is the primary and most important imaging modality for the assessment of these diseases. However, an expanding role of magnetic resonance imaging is evident.
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PMID:Juvenile spondyloarthropathies: clinical manifestations and medical imaging. 748 95

Sulphasalazine is an effective drug for the treatment of rheumatoid arthritis in adults. In paediatric patients, the drug has been used to treat inflammatory bowel disease and is currently under investigation for the treatment of juvenile chronic arthritis. Although sulphasalazine has a rather low incidence of serious side effects, one of the most common is skin rash, thought to be an allergic reaction. In adults, sulphasalazine desensitization programmes have proven to be effective for the treatment of this side effect. We present the case of a 7-year-old boy suffering from HLA-B 27 positive juvenile chronic arthritis. After initiation of treatment with sulphasalazine he developed an allergic skin rash, but tolerated the drug well after completion of a desensitization programme. To our knowledge, this is the first report of a paediatric patient with juvenile chronic arthritis successfully desensitized with sulphasalazine.
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PMID:Sulphasalazine desensitization in a paediatric patient with juvenile chronic arthritis. 748 28

An association between inflammatory bowel disease and enteroarthritis and the spondyloarthropathies has been known of for a while. Within the past few years, ileocolonic studies have expanded the diagnostic accuracy of asymptomatic gut inflammation, and it now seems evident that chronic gut inflammation is either associated with or is even the cause of chronicity of peripheral arthritis and the development of ankylosing spondylitis. This situation, previously studied in adult patients, now appears also to affect pediatric patients with spondyloarthropathies, who seem to have similar genetic and inflammatory bowel findings. Chronic infection in the gut has been demonstrated in Whipple's disease. Analogously, infection or immunologic aberrations probably contribute to chronicity in other forms of spondyloarthropathy. Infection also might be involved, at least partly in attacks of uveitis, but activation of immunologic mechanisms can mediate tissue destruction during eye inflammation.
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PMID:Enteropathic arthritis, Whipple's disease, juvenile spondyloarthropathy, and uveitis. 752 Jul 27

The term seronegative spondylarthropathies is used for an entity of rheumatic syndromes of peripheral joints and the spine (ankylosing spondylitis, reactive arthritis, Reiter's syndrome, arthritis in psoriasis and in inflammatory bowel disease) which are strongly associated with the MHC class I molecule HLA-B27. However, the mechanisms whereby HLA-B27 confers disease susceptibility have so far remained unknown. There is strong evidence that gut inflammation and infection with gram-negative bacteria play a role in the induction of B27-associated disease. HLA-B27, like other MHC class I molecules, physiologically binds antigenic peptides in its binding groove and presents them to CD8+ T lymphocytes. Consequently, if the disease association with HLA-B27 arises from its role as a T-cell restriction element, synovial fluid CD8+ rather than CD4+ T cells should play a prominent pathogenetic role and should be detectable within the affected joints. In this paper, recent studies on bacteria-specific cytotoxic T cells and on peptide binding to HLA-B27 are reviewed. Particular emphasis is laid on the role of HLA-B27 restricted synovial CD8+ T cells with specificity for bacterial antigens or autoantigens. These cytotoxic T cells could provide a missing link in the pathogenesis of the spondylarthropathies and could now serve as tools to identify the critical antigenic epitopes of bacterial and self peptides which are involved in disease induction.
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PMID:Bacteria-specific cytotoxic CD8+ T cells: a missing link in the pathogenesis of the HLA-B27-associated spondylarthropathies. 753 15

The term spondyloarthropathy, currently used to describe some forms of idiopathic arthritis of childhood, may be inappropriate because most children included in this category do not have arthritis of the spine, and inflammatory disease of the sacroiliac joints is an infrequent or late finding. Juvenile AS, the archetype, or "complete" disease may account for only one fifth of the so-called "spondyloarthropathies". "Incomplete" or "early" spondyloarthropathies are most frequent. Such children may not develop axial symptoms and signs for 5 to 10 years after onset, and they may be better characterized as having enthesitis-related arthritis, a term proposed by a recent task force of the International League Against Rheumatism (ILAR). Reactive arthritis, although etiologically linked with the spondyloarthropathies, uncommonly progresses to AS in childhood; most patients have peripheral arthritis with or without enthesitis resolving in the relatively short term. The arthritis associated with IBD is more commonly peripheral than axial. Although axial disease undoubtedly occurs in JPsA, in the authors' experience it is very uncommon.
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PMID:Spondyloarthropathies of childhood. 756 86

Inflammatory bowel diseases are often associated with extra-intestinal manifestations, such as arthritis and iritis/uveitis. Using magnetic-resonance imaging we found hyperintense focal white-matter lesions in the brain in 20 of 48 (42%) patients with Crohn's disease, in 11 of 24 (46%) patients with ulcerative colitis, but in only 8 of 50 (16%) healthy age-matched controls (relative risk [95% CI] vs controls 2.6 [1.3-5.3] and 2.9 [1.3-6.2], respectively). These findings may represent another extra-intestinal manifestation of inflammatory bowel disease.
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PMID:Focal white-matter lesions in brain of patients with inflammatory bowel disease. 1032 45

Ankylosing spondylitis is the prototype of an interrelated group of disorders termed spondyloarthropathies, which include reactive arthritis, psoriatic arthritis, and rheumatic disorders associated with inflammatory bowel disease. It can be difficult to differentiate between these disorders because they may occur simultaneously or sequentially. In addition, some of the clinical characteristics of these diseases, such as enthesiopathy and eye involvement, are similar no matter what the diagnosis. The monitoring, diagnosis, and treatment of these diseases are related more to their clinical presentation than to the precise diagnosis.
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PMID:Management of refractory ankylosing spondylitis and related spondyloarthropathies. 773 63


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