Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0599766 (functional recovery)
 13,441 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The present revision has been carried out in order to final out to what extent corticosteroids have improved the vital and functional prognosis of dermatomyositis. Over the sixties and in the early seventies, statistical tables have not shown any substantial differences compared with those of the pre-steroid era. It has been observed since 1973 that early treatment with high doses (1-2 mg of prednisone per kg per day) clearly improves the vital prognosis of infantile dermatomyositis, but not the functional one. In adults, there is less experience and the problem always exists of a possible underlying neoplasm. In cases with resistance to corticosteroids, the association of immunosuppressors, particulary methotrexate, has begun to be tested. There is no proved effective treatment of calcinosis which results in functional recovery.
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PMID:[Prognosis and current treatment of dermatomyositis]. 36 60

The medical records of 47 children with dermatomyositis who were seen in the pediatric rheumatology clinic at the University of Michigan between 1964 and 1982 were reviewed. Although most children with dermatomyositis have a good prognosis, the best predictor of both good functional recovery and minimal calcinosis is early treatment after the onset of symptoms, using high doses of prednisone for an adequate length of time. Of the children given such treatment, 78% had good functional outcomes, and disabling calcinosis was seen in 20% or less. Children given treatment late in the course of disease and with low doses of steroids are more likely to be functionally limited and have a greater amount of dystrophic calcium salt deposition. In our study, only 33% of patients given such treatment had a mild disease course with good functional outcome. We have identified a subgroup of children with dermatomyositis who appear to do poorly despite optimal therapeutic regimens. These patients are distinguished by a severe disease course responding minimally to corticosteroid therapy and manifested by persistent muscle weakness, elevations of muscle enzyme activity, and severe generalized cutaneous vasculitis. These children are at high risk for the development of exoskeleton-like calcification; consideration should be given to combined immunosuppressive therapy early in the course of disease.
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PMID:Childhood dermatomyositis: factors predicting functional outcome and development of dystrophic calcification. 664 23

Thirty-six patients with juvenile dermatomyositis, seen consecutively between 1983 and 1996 and treated initially with low doses of corticosteroids (prednisolone 1 mg/kg/day), were studied retrospectively to evaluate their long-term evolution and to identify factors predictive of the functional outcome. After a mean follow-up of 4.9 years, 28 (78%) of the patients were well without functional impairment; five patients had inactive disease but with persisting disabilities; and three patients had active disease despite several years of treatment. Fifteen children (42%) developed dystrophic calcifications which, in five of these patients, interfered with functions. These patients treated for juvenile dermatomyositis with a low dose corticosteroid regimen had an evolution identical to that of the published series of patients treated with higher doses and probably had a better quality of life. The best predictors of good functional recovery and minimal calcinosis were early treatment after the onset of symptoms and low creatine kinase serum level at the time of diagnosis.
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PMID:Childhood dermatomyositis: clinical course of 36 patients treated with low doses of corticosteroids. 1072 93

Juvenile dermatomyositis is rare but still the most common idiopathic inflammatory myopathy of the childhood. Operative treatment may be indicated, whenever joint motion and patients mobility is limited through the manifestation of calcinosis cutis. Although Vitamin K dependent coagulation pathways have been described, the entire pathophysiological mechanism of its occurrence is currently not clarified. Standard therapy includes the systemic application of steroids and cytotoxins, other options involve aluminum-hydroxid or diltiazem. Only in serious functional obstructions operative resection may be indicated. The case of a 39-year-old female with a 24 year history of dermatomyositis involving most areas of the upper and lower extremities like a coat of mail is presented. Surgical resection of the calcification revealed a good functional recovery of the joint but because of a high recurrency rate the operation is only indicated in special cases.
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PMID:[Extraosseous calcifications in dermatomyositis. A rare differential diagnosis of a benign heterotropic ossification]. 1505 4

Juvenile dermatomyositis (JDM) is an inflammatory multi-system disease of unknown etiology with classic involvement of the skin and striated muscles. Following a prodromal period, patients develop a progressive proximal muscle weakness. Typical skin involvement includes heliotrope rash, facial erythema, Gottron's sign and nailfold capillary abnormalities. For the diagnosis of JDM, modified Bohan and Peter criteria are used including clinical skin and muscle signs plus elevated muscle enzymes and typical findings from electromyography, muscle biopsy and - more recently - also on magnetic resonance imaging. Steroids are administered classically as high-dose oral treatment. Intravenous pulse therapy with intermittent lower dose oral treatment and other immunosuppressive drugs such as methotrexate may reduce steroid side-effects. Prognosis in JDM has improved, and most patients eventually make a full functional recovery. However, a few patients still die from their disease, and in a minority significant sequelae with muscle atrophy or severe calcinosis ensue.
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PMID:[Juvenile dermatomyositis]. 1705 62