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Pediatric uveitis can lead to sight‐threatening complications and can impact quality of life (QoL) and functioning. We aimed to examine health‐related QoL, mental health, physical disability, vision‐related functioning (VRF), and vision‐related QoL in children with juvenile idiopathic arthritis (JIA), JIA‐associated uveitis (JIA‐U), and other noninfectious uveitis. We hypothesized that there will be differences based on the presence of eye disease. A multicenter cross‐sectional study was conducted at four sites. Patients with JIA, JIA‐U, or noninfectious uveitis were enrolled. Patients and parents completed the Pediatric Quality of Life Inventory (PedsQL; health‐related QoL), the Revised Childhood Anxiety and Depression Scale (RCADS; anxiety/depression), the Childhood Health Assessment Questionnaire (C‐HAQ; physical disability), and the Effects of Youngsters' Eyesight on Quality of Life (EYE‐Q) (VRF/vision‐related QoL). Clinical characteristics and patient‐reported outcome measures were compared by diagnosis. Of 549 patients, 332 had JIA, 124 had JIA‐U, and 93 had other uveitis diagnoses. Children with JIA‐U had worse EYE‐Q scores compared to those with JIA only. In children with uveitis, those with anterior uveitis (JIA‐U and uveitis only) had less ocular complications, better EYE‐Q scores, and worse C‐HAQ and PedsQL physical summary scores compared to those with nonanterior disease. In children with anterior uveitis, those with JIA‐U had worse PedsQL physical summary and C‐HAQ scores than anterior uveitis only. Further, EYE‐Q scores were worse in children with bilateral uveitis and more visual impairment. There were no differences in RCADS scores among groups. We provide a comprehensive outcome assessment of children with JIA, JIA‐U, and other uveitis diagnoses. Differences in QoL and function were noted based on underlying disease. Our results support the addition of a vision‐specific measure to better understand the impact of uveitis.

The Effects of Youngsters’ Eyesight on Quality of Life (EYE‐Q) questionnaire measures vision‐related functioning (VRF) and vision‐related quality of life (VRQoL) in children with uveitis. Our aim was to revise the alpha version of the EYE‐Q to refine VRF and VRQoL subscales and to assess the validity of the EYE‐Q. Children with juvenile idiopathic arthritis (JIA), JIA‐associated uveitis, and other noninfectious uveitis were enrolled. Patients and parents completed the EYE‐Q, Pediatric Quality of Life Inventory (overall quality of life), and Childhood Health Assessment Questionnaire (physical functioning). The development site completed the alpha version of the EYE‐Q, and the composite sites completed the beta version. We compared item‐subscale correlations, internal consistency, and construct and discriminant validity among the different versions. Of the 644 patients enrolled, 61.6% completed the alpha version, and 38.4% the beta version of the EYE‐Q. Mean ± SD patient age was 11.1 ± 4.2 years, and 70% were female. Fewer White patients (73.5%) completed the alpha version compared to the beta version (86.2%; P< 0.001). With the exception of patient‐reported VRF, both versions had similar item‐subscale correlations. Version comparisons on scale internal consistencies indicated significant differences for parent‐ and patient‐reported VRF, but each scale had a Cronbach's α of >0.80 beta. When data were combined, the EYE‐Q showed significant differences between JIA‐only and uveitis patients on all parent and patient scores, except for patient‐reported VRF. The EYE‐Q appears to be a valid measure of VRF and VRQoL in pediatric uveitis. Our results suggest it may be used as an outcome measure in multicenter pediatric uveitis studies.

Background: Previously Etheridge et al reported rapid resolution of large coronary artery aneurysms(CAA) after treatment with abciximab(Abc), an antibody to platelet GP IIb/IIIa receptors. We report our experience with this treatment on 8 pts from Southern California and Arizona. Patients and Methods: These pts either presented with CAA prior to IVIG or developed giant CAA despite IVIG. All pts received a standard recommended dose of Abc: 2.5 mg/kg IV bolus followed by continuous infusion of 0.125 mcg/kg/min for 12 to 24 hrs. Largest CAA diameters were echographically measured in each pt before Abc, and at various time points after Abc. Available coronary angiograms were also reviewed. All pts remained on low-dose aspirin. Platelet aggregation study immediately after Abc showed effective inhibition. Additionally, those pts with CAA greater than 7 mm received warfarin. Results: Average duration of follow-up was 215 days (14 to 351). Initially, 7 pts had aneurysms in right coronary artery (RCA) and 8 pts in LCA. At the end of follow-up greater than 50 % reduction in CAA diameter was noted in only in 1 pt, increase in CAA size in 2 pts and no change in the rest. Intracoronary thrombus was noted in 1 pt before Abc with subsequent resolution. Compared to echo, angiographic CAA measurements were slightly smaller. No CA stenosis or thrombotic occlusion was seen. Conclusions: (1) Abc at current dosage is well tolerated by KS pts. (2) Abc has failed to produce dramatic CAA regression. (3) Abc may prevent thrombotic complications in giant CAA. Speculation: The optimum dose of Abc in KS is unknown, and may be higher than the adult dose in order to counter systemic platelet activation.

Rheumatoid factor (RF), particularly IgM RF, may play an important role in the pathogenesis of rheumatoid arthritis. IgG and IgA have been reported. In children with juvenile rheumatoid arthritis (JRA), IgM RF is not routinely found. The incidence of IgA RF is not known. This study was designed to determine the incidence of IgA RF in children with JRA and correlate its presence with disease activity and outcome. An ELISA assay using rabbit IgG antigen was used to detect IgA RF in the sera of 61 children with JRA. The overall incidence of IgA RF seropositivity was 47%. The incidence was 84% in patients with inactive disease, as manifested by warm joints and morning stiffness and 3% in patients with inactive disease or disease in remission. IgA RF disappeared from active seropositive patients when the disease became inactive. Of thirty-one patients with active disease, 27 were IgA RF positive, of whom 22 were in functional Class III-IV and 5 were in functional Class I-II. In summary, IgA RF is present in the majority of patients with active JRA.