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21 results on '"Raju Khubchandani"'

1. Joint injection practice variations in pediatric rheumatology – a global survey and call for action

Author

Raju Khubchandani and Anita Dhanrajani

Subjects
musculoskeletal diseases, medicine.medical_specialty, Consensus, lcsh:Diseases of the musculoskeletal system, Juvenile, Global Health, Pediatrics, Injections, Intra-Articular, Injections, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Intra articular, Rheumatology, Joint injection, Internal medicine, medicine, Humans, Immunology and Allergy, Practice Patterns, Physicians', Pediatric rheumatology, Child, Intensive care medicine, 030203 arthritis & rheumatology, Response rate (survey), Analysis of Variance, business.industry, Arthritis, Intraarticular Injections, lcsh:RJ1-570, Oligoarticular JIA, lcsh:Pediatrics, Arthritis, Juvenile, Inflamed joints, Pediatrics, Perinatology and Child Health, Intra-articular, lcsh:RC925-935, Surveys and questionnaires, business, Needs Assessment, Research Article
Abstract

Background Intraarticular injections (IAI) were first reported in adult rheumatology in the 1950s and subsequently gained acceptance as a safe and efficacious treatment in Juvenile idiopathic arthritis (JIA). IAIs are now widely performed and recommended as the initial or only treatment of oligoarticular JIA and ancillary treatment of actively inflamed joints in other varieties of JIA. However, the performance of the procedure is currently not guided by standardized recommendations, and several practice variations are observed. Methods This worldwide survey of pediatric rheumatologists (with 48.5% response from Pediatric Rheumatology International Trials Organization [PRINTO and Pediatric Rheumatology Collaborative Study Group [PRCSG] members) captures the differences in pre-procedural, procedural and post-procedural protocols and practices observed across the globe and asks the necessity of developing consensus in this area of Pediatric Rheumatology. Results This worldwide survey of Pediatric Rheumatologists had a response rate of just under 50% and the views of about 42% who routinely performed the procedure. It captured the differences in IAI protocols and practices observed across the globe. Significant variations in practice were noted in use of Local anesthesia, choice, and dose of therapeutic agent for the intraarticular injection and use of ultrasound to guide injections. While some practice variations may be explained by institutional protocols in different parts of the world, the clinical implications of these are largely unknown and beg the need for further studies. Conclusions Given these practice variations, the authors recommend further studies to explore the cost and clinical implications and subsequently work towards developing consensus plans to ensure uniformity in this widely used procedure in Pediatric Rheumatology.

Published
2020
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3. Van Wyk Grumbach Syndrome: A Rare Consequence of Hypothyroidism

Author

Kritika Tiwari, Abhishek Kulkarni, Pavan Reddy, Ketan Parikh, and Raju Khubchandani

Subjects
endocrine system, Pediatrics, medicine.medical_specialty, endocrine system diseases, Hormone Replacement Therapy, Isosexual precocious puberty, media_common.quotation_subject, Puberty, Precocious, 030209 endocrinology & metabolism, Short stature, Autoimmune thyroiditis, 03 medical and health sciences, 0302 clinical medicine, Hypothyroidism, Humans, Medicine, Precocious puberty, 030212 general & internal medicine, Girl, Ovarian mass, Child, media_common, Ovarian cyst, business.industry, Thyroiditis, Autoimmune, Bone age, Syndrome, medicine.disease, Ovarian Cysts, Thyroxine, Pediatrics, Perinatology and Child Health, Female, medicine.symptom, business, Intestinal Obstruction
Abstract

Long standing hypothyroidism presenting as an ovarian mass has been well described in literature as the Van Wyk Grumbach syndrome (hypothyroidism, isosexual precocious puberty and ovarian mass). Here, authors report this entity in a 11 y 7 mo old girl child who was referred to a surgeon in view of intestinal obstruction along with a multiloculated ovarian cyst. On evaluation, she was found to have raised serum creatinine, short stature, delayed bone age and pituitary enlargement. She was diagnosed with autoimmune thyroiditis and was started on replacement therapy with thyroxine, after which the ovarian cysts regressed. This entity should be kept in mind in cases of ovarian cysts, especially those with isosexual precocity, to prevent unnecessary evaluation and surgical misadventures.

Published
2018
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4. Course, Outcome and Complications in Children with Systemic Onset Juvenile Idiopathic Arthritis

Author

Mansi Dewoolkar, Rolando Cimaz, Raju Khubchandani, and Pranav R. Chickermane

Subjects
Male, Pediatrics, medicine.medical_specialty, India, Arthritis, Physical examination, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Adrenal Cortex Hormones, Severity of illness, Humans, Medicine, 030212 general & internal medicine, Child, 030203 arthritis & rheumatology, medicine.diagnostic_test, business.industry, Remission Induction, Infant, medicine.disease, Arthritis, Juvenile, Systemic-onset juvenile idiopathic arthritis, Methotrexate, Child, Preschool, Macrophage activation syndrome, Pediatrics, Perinatology and Child Health, Cohort, Disease Progression, Female, Observational study, business, Follow-Up Studies, medicine.drug
Abstract

To assess the course, outcome and complications in a mono-centric cohort of 53 patients with systemic onset juvenile idiopathic arthritis (s-JIA). In an observational study, 53 consecutive patients diagnosed with s-JIA on or before October 2009 were enrolled and followed up between October 2009 and September 2012. At each 6–12 weekly visit, clinical examination, laboratory investigations and details of on-going treatment were recorded. Disease course was classified as monocyclic, intermittent and persistent. At last visit, outcome was studied with respect to remission (Wallace criteria) and Steinbrocker functional classification. Juvenile Arthritis Damage Index (JADI) was measured on a subset. In 53 patients analysed, the mean follow-up period was 5.5 ± 1.85 y, with a cumulative follow-up period of 291.5 patient-years. The mean age at diagnosis was 6.3 ± 3.4 y. Thirty-three patients suffered from disease and/or drug related complications. Infections were observed in 16 (30%) and macrophage activation syndrome in 5 (9.4%). Nine (17%) had a monocyclic course, 31 (58.5%) had an intermittent course and 13 (24.5%), a persistent course. At last visit, 9/9 patients of the monocyclic group, 17/31 in the intermittent group and 3/13 in the persistent group were in remission. At the end of the study, 96.2% of the index patients were Steinbrocker functional class I and II with the monocyclic group having the best functional outcome. JADI was performed on 20/53 patients. Nine had significant articular damage. The range of Juvenile arthritis damage index-articular (JADI-A) was 0–25/72 (median-6) and of Juvenile arthritis damage index-extra articular (JADI-EA) was 0–4/17 (median-1). The outcome of patients with s-JIA in a resource limited setting where early diagnosis, multidisciplinary care and availability of biologics are hurdles, is further altered by complications related to longstanding disease and over use of steroids.

Published
2017
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5. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two

Author

David Kern, Masato Yashiro, Gerd Horneff, Ana P. Sakamoto, Berent J. Prakken, Paula Vähäsalo, Juergen Brunner, Ezgi H. Baris, Helen McCarthy, Janet E. McDonagh, A. Grom, Adriana Albu, Lenka Linkova, I. Nikishina, Daniel Álvarez de la Sierra, Bruno Papia, Peggy Lee, Luisa Giannone, Tobias Schwarz, Mekibib Altaye, Margarita Onoufriou, Tatiana Sleptsova, N. Ruperto, O Thana, A. Baheti, Ilonka Orbán, Kai Lehmberg, F. Zulian, Helga Sanner, Karin Palmblad, Kousuke Shabana, Sebastiaan Vastert, Marta Rusmini, Olga Vougiouka, Dirk Holzinger, D. Shaikhani, Shouichi Ohga, Ismail Dursun Dursun, Claire T Deakin, Ingrid Herta Rotstein Grein, Maria Trachana, Ariane Klein, Eugenia Enriquez, Angelo Ravelli, Paul A. Brogan, L.S. Nazarova, Laila Al Shaqshi, Paulina Vele, Liana Guerra, Antonia Pascarella, Jelena Vojinovic, Juliana Molina, Kjell Tullus, S. Rodionovskaya, Chris Scott, A. N. Olivieri, Cliff Taggart, Clare Heard, Ricardo Pujol Borrell, Jens Klotsche, Grendel Burrell, Oriany L. Pereira, Silvia Giliani, Sandra Pereira, Jennifer Horonjeff, Beth A. Mueller, Lyudmyla M. Byelyaeva, Sergio Tufik, Carlo Agostoni, Valentina Muratore, Rostislav M. Filonovich, Fiona Hawke, Virginia Messia, Bo Magnusson, Kerry West, Sara Murias, Mustafa Doğan, Hafize Emine Sönmez, Annet van Royen-Kerkhof, K. Minden, Raquel Campanilho-Marques, Reem Abdawani, Maria Ceci, Maria Ekelund, Seza Ozen, Ratna Puri, Girolamo Luppino, Shannon Carr, Rita A. Amorim, K Kobrová, Rachael D. Wright, Chantal Job-Deslandre, Daniel J. Lovell, Jorge Kalil, Yi-jin Gao, Kubra Ozturk, Fulvio Parentin, Ursula Fearon, Frank Weller-Heinemann, Elizabeth Ang, Charles A Mebus, Andrea Superti-Furga, Alina Ferster, Rikard Wicksell, Mohammadreza Modaressi, F La Torre, Ela Tarakci, Wendy Thomson, Giorgia Malighetti, Antonio Eleuteri, Helena K. Khrustaleva, Alan Easton, Alexander Mushkin, Sara Marsal Barril, Erkan Demirkaya, Florence Kanakoudi-Tsakalidou, Diana Ekdawy, Lana Tambić Bukovac, Suvi Peltoniemi, Nur Arslan, Hermine I. Brunner, Tim Rapley, Donatella Vairo, Kirill Savostyanov, Fumiko Okazaki, Rachel Corkhill, Tufan Kutlu, MG Alpigiani, Fabio Fernandes Morato Castro, Juliana Farhat, Butsabong Lerkvaleekul, Scolozzi Paolo, Akihiko Saitoh, Jason Dare, Gustavo Rocha, Tatiana V. Viktorova, Riva Brik, Jason Palman, Fabrizia Corona, Susan Nielsen, Johannes Roth, Ma. Theresa M. Collante, Leonardo Oliveira Mendonça, D. Alexeev, Randy Q. Cron, Sriharsha Grevich, Andrea L. Jorgensen, Lúcia Maria de Arruda Campos, Kiran Nistala, Fernando Martins, R. Cimaz, Angela C. Mosquera, Ruy Carrasco, Reyhan Dedeoglu, Giovanni Filocamo, J. Dare, Paula Keskitalo, Ana J. D. F. C. Lichtenfels, Florence Uettwiller, Umberto Conte, Gecilmara Salviato Pileggi, Michal Uher, Mercedes Chan, Sarka Fingerhutova, Anne M. Stevens, Peter Bale, Mikel Alberdi-Saugstrup, Olga L Kopchak, Thomas A. Griffin, Constantin Ailioaie, Clifton Bingham, Ekaterina Alexeeva, Loshinidevi D Bathi, Jane Hurst, AnnaCarin Horne, Laura Muntean, Nermin Uncu, Mara Carraro, C Vargas, Lorenzo Quartulli, Ayşenur Paç Kısaarslan, Angela Mauro, F. Corona, Donato Rigante, Helen J. Lachmann, Ana Cordeiro, Ivan Foeldvari, Faysal Gok, Tatiana Gonzalez, S. S. M. Kamphuis, Hasret Ayyildiz-Civan, Claudia Pastorino, Gleice C. S. Russo, J. B. Kuemmerle-Deschner, Serena Pastore, Nigel Klein, M. Jorini, Tatjana Freye, Maria Tsolia, Philippe Jacqmin, Suzanne M M Verstappen, Syuji Takei, Khalid Hussain, Renzo Marcolongo, Yuichi Yamasaki, Sharmila Jandial, K. Leon, Maria Pia Sormani, T. A. Simon, Mohammed Muzaffer, Catalina Mosquera, Clovis Aa Silva, Zelal Ekinci, Zübeyde Gündüz, Bernd Denecke, Felicitas Bellutti Enders, Despina Eleftheriou, Ishbel MacGregor, Andrew Cant, Luisa Bonafé, Valda Staņēviča, Helen E. Foster, Alberto Tommasini, Nora Bartholomä, Nural Kiper, A. Kardolus, Eloisa Bonfa, Alessandro Consolaro, Lillemor Berntson, Umberto Garagiola, Richard K. Vehe, Vanessa Bugni Miotto e Silva, Chihaya Imai, Kathleen G. Lomax, Brian Best, Barbara Bonafini, M. Toth, D. Rigante, Eiman Abdalla, Leona Prochazkova, Lucy Wedderburn, Lovro Lamot, S. Verazza, Raffaella Carlomagno, Gillian I. Rice, Norm Ilowite, K. de Leeuw, Havva Evrengül, Jerold Jeyaratnam, Andrew Zeft, Andrea Taddio, R. Podda, Samuel Cassidy, Grant S. Schulert, Silvia Rosina, Marija Jelušić, Olivier Gilliaux, Rubén Burgos-Vargas, Mao Mizuta, Akihiro Yachie, Angel Phuti, Antonio Zea Mendoza, Emily Boulter, Zane Dāvidsone, Sofia Torreggiani, Marco Cattalini, Natali W. Gormezano, Fatma Dedeoglu, Hercília Guimarães, A. Insalaco, Andrea Coda, Viktor A. Malievsky, Thomas Zumbrunn, Agostino Nocerino, Ronald Pederson, Katarzyna Kobusinska, Anasuya Hazra, Ananadreia S. Lopes, Elena Campione, Toshiyuki Kitoh, Elena Tsitsami, Henny G. Hotten, Radka Kaneva, R. J. E. M. Dolhain, Ndate Fall, Francesco Licciardi, Deepti Suri, G. D’Angelo, Valentina Seraya, Elżbieta Smolewska, Anastasia Dropol, Ezgi Deniz Batu, Andreas Woerner, Christine Arango, Nadia E. Aikawa, Zoilo Morel, Megan Yuasa, Sandra Ammann, Erbil Unsal, Tomohiro Kubota, Toshitaka Kizawa, Fabrizio De Benedetti, Catherine Laing, Liudmila Rakovska, Yonatan Butbul Aviel, J-Peter Haas, Marta Minute, Christine Alvey, Vasiliko Dermentzoglou, Vania Schinzel, Isree Leelayuwattanakul, Ekim Taskiran, Gabriele Simonini, N. Martin, Nathalie Canham, Nicky Brice, Beatrice Vergara, Ika Birkić, Cengizhan Acikel, Johannes-Peter Haas, Ruth Fritsch, Alisa Vitebskaya, Fatih Yazici, Iva Brito, Nataša Toplak, Veronica Moshe, Gordon J Hendry, Nadia Luca, Deniz Doğru-Ersöz, Marco Matucci-Cerinic, Claudia Toppino, Zoë Johnson, Beatrice Goilav, Siyaram Didel, K. Marzan, Tamar B. Rubinstein, Angela Barnicoat, Peter Nourse, Thita Pacharapakornpong, Adele Civino, Inmaculada Calvo Penades, H. I. Brunner, Massimo Imazio, V. Gerloni, Ayla Kacar, Heinrike Schmeling, Marija Perica, Silvestre García de la Puente, Tadej Avcin, Filipa Oliveira-Ramos, S. Arsenyeva, Phillip J Hashkes, Sabrina Schuller, Adriana Rodriguez Vidal, Kathy de Graaf, Giedre Januskeviciute, M. Kaleda, Lee Dossetter, Jelena Basic, Elena Kaschenko, Erik Sundberg, Gizem Pamuk, Marek Zak, I. Foeldvari, Rachael Quarmby, Marc D. Natter, Antonarakis Gregory, P. A. Brogan, João Eurico Fonseca, Andrea Jorgensen, Ana F. Mourão, Gaurav Gulati, Yelda Bilginer, Banu Acar Celikel, Utako Kaneko, Karen L. Durrant, Alice Grossi, Maurizio Aricò, Ibrahim Al Zakwani, Yildirim Karslioglu, Takuji Murata, Monika Stoll, Maria Teresa Terreri, Ariana Kariminejad, Teresa A. Simon, Laura B Lewandowski, Marina Garcia Prat, Walter G. Ferlin, Albena Telcharova, Giovanni Maria Severini, Judith Wienke, Panagiota Nalbanti, Hakan Poyrazoglu, Athimalaipet V. Ramanan, Manisha Lamba, Z. Guo, J. Bohnsack, Norberto Guelbert, John F. Bohnsack, Lucy R. Wedderburn, Elvira Cannizzaro Schneider, Raul Gutiérrez Suárez, Debra Grech, Yonit Reis, Chris Pruunsild, Amit Rawat, Nienke M. ter Haar, Hiroshi Tamai, Alexander Pushkov, A. De Fanti, Valentina Marzetti, Sheila Weitzman, I. E. M. Bultink, Dilek Keskin, Sania Valieva, Klaus Tenbrock, Ana Luisa Rodriguez-Lozano, Lianne Kearsley-Fleet, Luca Messina, Chiara Gorio, Amra Adrovic, Stephanie J. W. Shoop, Davide Cumetti, Sana Al Zuhbi, Helena Khrustaleva, E. Zirkzee, Elio Castagnola, Clarissa Pilkington, Jingyao Leong, Vitor A. Teixeira, Reinhard Würzner, Sonia Melo Gomes, Orla Killeen, Antony C. Fisher, Sevket Erbil Unsal, Edward M. Behrens, Kristiina Aalto, Rebecca Nicolai, Thomas C. Stock, Luiz Cláudio Danzmann, Y. K. O. Teng, Stephen D. Marks, Fotios Papachristou, Valda Stanevicha, Richard Saffrey, Elizabeth Ralph, Johannes Peter Haas, Mary Slatter, Maria Tsinti, Mehmet Alikasifoglu, Mónica Martínez Gallo, Rayfel Schneider, Rosa Maria Rodrigues Pereira, Maria F. D. A. Giacomin, Alfésio Luís Ferreira Braga, Giulia Camilla Varnier, James McElnay, Jessica Foster, Ingrida Rumba-Rozenfelde, Francesca Minoia, Laurence Goffin, Roger C. Allen, Zehra S. Arıcı, Mette Nørgaard, Alberto Martini, Hofer Michaël, Andreas Eikelberg, Junko Yasumura, Maria José Santos, Tom Wolfs, Ada B. Sinoplu, Natalia Balera Ferreira Pinto, Michael Lang, Umberto Corpora, Hidenobu Kaneyasu, Fiorenzo Gaita, Olga Lomakina, Dimitrina Mihaylova, Gian Luca Erre, Fugen Cullu-Cokugras, Mesut Topdemir, Sriram Krishnaswami, Irina Nikishina, Noortje Groot, S. Pastore, Joke Dehoorne, Paula Estanqueiro, Shafe Fahoum, Francisca Aguiar, Mabel Ladino, Nico M Wulffraat, Jana Franova, Helena Erlandsson-Harris, Denise Pires Marafon, Adrian Liston, Edward H. Schuchman, Jaime C. Branco, Maria Teresa R. Terreri, Radoslava Saraeva, Ulrika Järpemo Nykvist, Maria Cristina Maggio, Kazuko Yamazaki, Lídia Teixeira, Hanquinet Sylviane, Ricardo Yepez, Susan Maillard, Tommy Gerschman, G. Horneff, Anne-Louise Ponsonby, Meredith Riebschleger, Alessandra Alongi, José Melo-Gomes, Iris Haug, Maria De Iorio, Ekaterina Alekseeva, Jan-Inge Henter, Elisa Pisaneschi, H. Kupper, Martina Niewerth, Berta López Montesinos, Shunji Hasegawa, Zahra Hadipour, R. M. Kuester, Silvia Maestroni, Pilar Guarnizo, Antonio Brucato, Tamaki Nakamura, Gustavo Antonio Moreira, Chaim Putterman, A. Hospach, Joost Frenkel, Svetlana O Salugina, A. Ravelli, Pavla Dolezalova, Gunnar L. Olsson, Eva González-Roca, Ellen Dalen Arnstad, Mohammad Alhemairi, Tina Hinnershitz, P. Quartier, Yildirim Karsioglu, Davinder Singh Grewal, Sergio Davì, Gökçen D. Tuğcu, Tomo Nozawa, Emily Robinson, M. C. Maggio, Maria Ballabio, Eleonora Bellucci, Alexei A. Grom, Rosa M. Pereira, Federica Vanoni, Shumpei Yokota, Justine A. Ellis, Helen Bristow, Mohammad-Hassan Moradinejad, Ricardo Russo, Harun Evrengül, Mario Abinun, Laura Carenini, Francesca Santarelli, C. Wallace, Maria Beatriz Fonseca, Timothy Beukelman, Saša Sršen, Véronique Hentgen, Sezgin Sahin, Silvia Zaffarano, Salvatore Albani, Valentin Brodszky, Clovis A. Silva, Graciela Espada, Jana Pachlopnik Schmid, Margaux Gerbaux, Stefano Stagi, Valentina Leone, Brian Leroux, Isabelle Koné-Paut, Gabriella Giancane, Soley Omarsdottir, Benedetta Schiappapietra, Alessandra Carobbio, Ricardo Menendez-Castro, Yoshifumi Kawano, Ozge Erdemli, Monia Lorini, Arjan Boltjes, Ellen Nordal, Carol A. Wallace, Mustafa Çakan, Reni Tzveova, Stefano Lanni, Salah Shokry, Kirsty McLellan, Qiong Wu, Nilay Arman, Adelina Tsakova, Michael W. Beresford, A. Consolaro, Francesca Bovis, Margarita Ganeva, Christoph Kessel, A. Martini, Taichi Kanetaka, Andre Schultz, Flora McErlane, Ronnie Wang, Mojca Zajc Avramovič, Thaschawee Arkachaisri, Boris Huegle, Funda Öztunç, Jane E Munro, Yanick J. Crow, Hiroyuki Wakiguchi, Rita Fonseca, Kim E. Nichols, Mia Glerup, Nils Venhoff, R. Filonovich, Erika Van Nieuwenhove, Nadia Rafiq, Elena Kamenets, Yasuo Nakagishi, Giampietro Farronato, Consuelo Modesto Caballero, Tulay Erkan, Jan Bonhoeffer, Jack Bukowski, Myrthes Toledo Barros, Gladys C. C. Esteves, Mirta Lamot, Rosa Alcobendas, Cláudia Moura, Florencia María Barbé-Tuana, Joo Guan Yeo, Mark Friswell, Yuko Sugita, Ari Shapiro, Nagla Abdelrahman, Phu-Quoc Lê, Kevin Murray, Susanne M Benseler, Anna Monica Bianco, J. Kalabic, Ana Catarina Duarte, Ivan Caiello, Joyce Davidson, Maria Isabel Gonzalez Fernandez, Larisa Zajtseva, Ebun Omoyinmi, Jaime de Inocencio, Dragana Lazarevic, Ritambhra Nada, Claudia Saad-Magalhães C, G. Conti, Andrew Gennery, Caroline Jones, Christophe Lelubre, Brian Rusted, Geneviève Lapeyre, Giulia Zani, Alina Boteanu, Maria T. Terreri, Nataliya Panko, Julia Albrecht, Federica Mongini, Lucio Giordano, Daniela Kaiser, Robert Nelson, Hans-Iko Huppertz, Gonca Keskindemirci, Karla Ištuk, Raffaele Strippoli, Dorota Rowczenio, Emma MacDermott, Roberta Caorsi, Emiliano Marasco, Sandra Sousa, Fatoş Yalçınkaya, Jaanika Ilisson, Yuki Kimura, Marco Turco, Nami Okamoto, Parveen Bhatti, Ekaterina M. Kuchinskaya, Stefano Volpi, Min Wang, Jeffrey M. Craig, M. Bijl, Giusi Prencipe, Fatemeh Tahghighi, W. van Dijk, Christiaan Scott, Masaki Shimizu, Alexey Maletin, Braydon Meyer, Joost F Swart, Sylvia Costa Lima Farhat, Anna Taparkou, R. Fritsch-Stork, Paolo Cressoni, Reiji Hirano, I. Chyzheuskaya, Stefania Simou, Kseniya Isayeva, Mariluz Gámir Gámir, Paivi Miettunen, Francesca Ricci, Ruta Šantere, George Lazaros, Madeleine Rooney, Stefan Stefanov, Huseyin Ozkan, Céline La, Boris Hügle, Vita Dolžan, P. Barone, R. Gallizzi, Aline L. de Oliveira, Silvia Federici, Lauren J. Lahey, Kimme L. Hyrich, Claudia Saad-Magalhães, Selçuk Yüksel, Valda Stanevica, Silvia De Pauli, Seid-Reza Raeeskarami, Calin Lazar, Sema Akman, Laurence Chatel, Kirsten Minden, Ismaiel A. Tekko, Philipp Henneke, E. Cortis, Elena Košková, Gil Amarilyo, Ana M. Marín Sánchez, Antonella Insalaco, Z. Birsin Ozcakar, Melissa Mariti Fraga, Lena Klevenvall, Luis Lira, Phoi-Ngoc Duong, Tatiana Bzarova, Neus Quilis, Wilco de Jager, Gary Sterba, Rina Denisova, Miroslav Harjacek, Eve M D Smith, N Ruperto, Gemma Lepri, Evgeniya Chistyakova, Rachel Kaufmann, Liliana Lourenço Jorge, Violeta Panaviene, Helena Canhão, Riccardo Belli, Grigoris Pardalos, Larisa I. Zajtseva, Nicolino Ruperto, Ezgi Batu, Paola Montesano, Alexander Solyom, Nicola Smith, Ales Janda, Sagar Bhattad, Liora Harel, Philip N. Hawkins, Gozde Yucel, François Willermain, Paolo Picco, Alessandro Rimini, Gordana Susic, Esi M. Morgan, Jessica Beckmann, Arina Lazareva, Agustin Remesal, Özge Altuğ Gücenmez, Troels Herlin, Andreas Groll, T. Yuraga, Ekaterina Zaharova, Adriana E. M. Sallum, Zeynep Birsin Özçakar, D. Milojevic, Can Kosukcu, Isabella Ceccherini, Sandrine Lacassagne, Tania M. Castro, R. Consolini, Klaus Müller, Dogan Simsek, Frank Rühle, Katia Kozu, Femke van Wijk, Yasin Sahin, Jonathan S. Hausmann, Gokalp Basbozkurt, M. Cattalini, Mª José Santos, Norman T. Ilowite, Adriana M. E. Sallum, Simona Rednic, Sirisucha Soponkanaporn, Giancarla Di Landro, Semanur Özdel, Timothy R. Radstake, Anastasia Wiener, Betül Sözeri, Estefania Quesada-Masachs, E. Zholobova, Joshua Newson, Ozgur Kasapcopur, Davide Montin, Terence Flood, Amir Mendelson, Manuela Pardeo, Flávia Heloísa dos Santos, Jamie Eaton, Vignesh Pandiarajan, Lyudmila Belyaeva, Edson Amaro Junior, Claudio Arnaldo Len, Tamás Constantin, Livia de Freitas Keppeke, Cristina Ferrari, Margarita Soloshenko, C. Rabinovich, David Popp, Jeremy Sokolove, Jaymi Taiani, Chiara Passarelli, de Min Cristina, José Costa, Stefanie Herresthal, Thomas Giner, Laure Caspers, Dilek Konukbay, Ulrich Salzer, Jorre S. Mertens, Marijan Frković, Yosef Uziel, Sabrina Chiesa, Luisa Bracci-Laudiero, Anders Fasth, Raul A. Chavez Valencia, Jordan T. Jones, Francesca Lancini, Alessandra Ferrari, Dana Nemcova, Mark Difrancesco, Ricardo Figueira, John Mitchell, Zohreh Nademi, E. Fedorov, Thomas Vogl, Carine Wouters, Mónica Eusébio, Hannah Leahey, Alessandra Pontillo, Marco Gattorno, Mandica Vidović, Lucas L. van den Hoogen, Mikhail Kostik, Giovanni Corsello, Gian Marco Moneta, Richard Mouy, Mariana Rodrigues, Veronica Medeghini, Gökçe Gür, Lucas Kich Grun, Stephan Ehl, Edi Paleka Bosak, Walter Ferlin, Hanna Lythgoe, Tsuyoshi Yamatou, Navdha R. Ramchurn, Carolina Furtado, Estefania Barral, Cecilia Lazea, Nikolay Tzaribachev, Vahid Ziaee, Fatemeh Hadipour, Alberto Sifuentes Giraldo, Kimberly Gilmour, Marite Rygg, Anna Valenti, María M Katsicas, Raju Khubchandani, Despoina Maritsi, Alessandra Tesser, R. M. Laxer, Clotilde Alizzi, Francisco Rivas-Larrauri, Aysen Tezcaner, Anne Dennos, Vasiliki Tzimouli, Vibeke Strand, Banu Acar, Fabio Candotti, Kseniia V. Danilko, Joachim Schultze, María Luz Gámir Gámir, Alessia Omenetti, Berit Flatø, Ruth Eraso, Bernard Lauwerys, Angela Pistorio, Andressa G. F. Alves, Gerd Ganser, Sara Signa, Ana Lopes, Emese Kiss, Charlene Foley, Sylvia Kamphuis, Maja Di Rocco, Kenan Barut, Ilaria Parissenti, Aida Koka, Nicholas Ng, Francis Corazza, Vinícius L. Braga, Laura E. Schanberg, Karin Beutel, Camila Hirotsu, Jonathan D Akikusa, Mihaela Sparchez, Karoline Ehlert, Jordi Anton, Adriana M. Sallum, Maria Cristina Castiglione, Surjit Singh, Julie Jones, Katya Temelkova, Tania S. Amin, Jasmin B Kuemmerle-Deschner, Samantha Bell, Sakda A.-O. Vallipakorn, Manuel Salgado, Filipa Ramos, Balahan Makay, Nadezhda Tsurikova, Gianmaria Viglizzo, Rosalba Ferraro, Sandra Hansmann, Nilgün Çakar, Ismail Dursun, Maria Stavrakidou, T. Bzarova, Sally Pino, Dhouib Amira, Salla Kangas, Antonella Meini, Dirk Foell, Dolunay Gürses, Dace Bērziņa, A. Speziale, Juan I. Arostegui Gorospe, Kelly L. Mieszkalski, Dawn M. Wahezi, S. Davì, Radoslav Srp, Daniel J. Kingsbury, Alexei A Grom, Falcini Fernanda, Peng Yin, Claire T. Deakin, Eva Hlavackova, Pavla Doležalová, Maria Mercedes Picarelli, Ezgi D. Batu, Alessandra Tricarico, Soamarat Vilaiyuk, Ivan Costa-Filho, A. Civino, Lukas Hackl, Pilar Gomez, Michael Hofer, M Manuela Costa, Zbigniew Zuber, Elena Ligostaeva, Carlos D. Rose, Jozef Hoza, Pranoot Tanpaiboon, Bonnie Vlahos, Sandra Garrote Corral, Martina Finetti, Giedre Grigelioniene, Susanne M. Benseler, X Wei, Pieter Van Dijkhuizen, Lee Nelson, Elettra Santori, David Martino, Anju Gupta, Nuray Aktay Ayaz, Noa Rabinowicz, Susan Shenoi, Rachel Chiaroni-Clarke, Claudia Bracaglia, Ruhan Düşünsel, M. Hofer, Rolando Cimaz, Juan I. Aróstegui, Ana Filipa Mourão, Ivonne Arroyo, Laura Damian, Marco F. C. D. Silva, D. J. Lovell, Marta Torcoletti, Clara Malagón, Luisa Klotz, Krisztina Sevcic, Douglas Veale, Belen Serrano Benavente, N. Groot, Polyxeni Pratsidou, Nicole Johnson, Karen Wynne, SR Rodionovskaya, Melania Saifridova, Kaara Tiewsoh, Ryan F. Donnelly, Fernanda Falcini, Valérie Badot, M. G. Alpigiani, L. Breda, Farida Abduragimova, Veronika Gjertsen Rypdal, Sophie Hambleton, E. Chalom, Anna Horne, Antonio Novelli, O. Kostareva, Panagiotis Tziavas, Yara Barrense-Dias, Cecilia Bava, Sarah Ringold, William H. Robinson, Sirirat Charuvanij, D. Kingsbury, Shuichi Ito, Luiz A. A. Pereira, Marcus Herbert Jones, S. I. Valieva, Flavio Sztajnbok, Florence Guilhot, Cristina de Min, Adriana Diaz-Maldonado, Simone A. Lotufo, Beril Talim, M. Heinrich, Paul Newland, and Laura Pagani

Subjects
030203 arthritis & rheumatology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, Rheumatology, business.industry, 030220 oncology & carcinogenesis, Family medicine, Pediatrics, Perinatology and Child Health, medicine, Immunology and Allergy, business, Paediatric rheumatology
Published
2017
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6. Cryosupernatant and Immunosuppression as Effective Alternative Therapies for TTP in Three Pediatric SLE Patients

Author

Sanwar Agarwal, Sarah Mathai, Pragathesh Palaniappan, Sathish Kumar, Leni G. Mathew, Purva Keni, Arul Premanand Lionel, Indira Agarwal, and Raju Khubchandani

Subjects
medicine.medical_specialty, Pediatrics, Hematology, business.industry, medicine.medical_treatment, Microangiopathic Anemia, Thrombotic thrombocytopenic purpura, Last follow up, Case Report, Immunosuppression, medicine.disease, Cryosupernatant, immune system diseases, hemic and lymphatic diseases, Internal medicine, medicine, Plasmapheresis, Pediatric SLE, skin and connective tissue diseases, business
Abstract

Thrombotic thrombocytopenic purpura (TTP) and systemic lupus erythematosus (SLE) very rarely present simultaneously and pose a diagnostic and therapeutic dilemma to the physician. Prompt diagnosis and management with plasma exchange and immunosuppression is life-saving. To describe the effectiveness of cryosupernatant and steroids in pediatric SLE with TTP. We describe three children aged 12–14 years with SLE who were diagnosed with TTP based on fever, CNS manifestations, ANA, anti-dsDNA, anti-sm positivity, hypocomplementemia, and microangiopathic anemia with thrombocytopenia. All three children were managed with cryosupernatant and steroids without plasmapheresis. All children improved with cryosupernatant and steroids. All attained remission within 10 days. They were doing well at last follow up without relapse or flare. Cryosupernatant and steroids may be an effective therapy for Thrombotic thrombocytopenic purpura with systemic lupus erythematosus

Published
2014
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7. When flexibility is not necessarily a virtue: a review of hypermobility syndromes and chronic or recurrent musculoskeletal pain in children

Author

Marco Cattalini, Rolando Cimaz, and Raju Khubchandani

Subjects
Joint Instability, Marfan syndrome, Pediatrics, medicine.medical_specialty, Hearing loss, Hearing Loss, Sensorineural, Review, Loeys–Dietz syndrome, Marfan Syndrome, hyperlaxity, Rheumatology, Recurrence, Internal medicine, Marfan, medicine, Humans, Immunology and Allergy, Stickler syndrome, Pediatrics, Perinatology, and Child Health, Child, Connective Tissue Diseases, musculoskeletal pain, Hypermobility (travel), hyperlaxity, musculoskeletal pain, Loeys-Dietz Syndrome, business.industry, Stickler, Arthritis, Retinal Detachment, Flexibility (personality), Loeys-Dietz, medicine.disease, Ehlers–Danlos syndrome, Chronic Disease, Pediatrics, Perinatology and Child Health, Ehlers-Danlos Syndrome, Ehlers-Danlos, medicine.symptom, business
Abstract

Chronic or recurrent musculoskeletal pain is a common complaint in children. Among the most common causes for this problem are different conditions associated with hypermobility. Pediatricians and allied professionals should be well aware of the characteristics of the different syndromes associated with hypermobility and facilitate early recognition and appropriate management. In this review we provide information on Benign Joint Hypermobility Syndrome, Ehlers-Danlos Syndrome, Marfan Syndrome, Loeys-Dietz syndrome and Stickler syndrome, and discuss their characteristics and clinical management.

Published
2015
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8. Disease patterns of juvenile dermatomyositis from western India

Author

Pranav R. Chickermane, Raju Khubchandani, and Deepali Mankad

Subjects
Male, medicine.medical_specialty, Adolescent, India, Dermatomyositis, Calcinosis, Internal medicine, Disease patterns, Pediatric surgery, medicine, Humans, Child, Juvenile dermatomyositis, Retrospective Studies, business.industry, Muscle weakness, medicine.disease, Dysphagia, Rash, Surgery, Treatment Outcome, Child, Preschool, Pediatrics, Perinatology and Child Health, Cohort, Female, Steroids, medicine.symptom, business
Abstract

A retrospective assessment of clinical characteristics, complications/ associations, laboratory investigations, treatment modalities and outcome in an inceptional cohort of 22 (male-13) children with juvenile dermatomyositis (JDM) receiving treatment at Jaslok Hospital, Mumbai during 1997- 2012 was performed . Mean age at diagnosis was 7.52 ± 3.99 years. Typical skin rash and muscle weakness were present in all children. Common complications included cutaneous ulcers (27.27%), dysphagia (22.72%) and calcinosis (18.18%).All patients presented with at least one of the serum muscle enzymes elevated. Absence of mortality and cardio-pulmonary complications and a monocyclic course in 72.7% of our patients are at variance from Western series.

Published
2013
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9. Initial evaluation of a child with arthritis—An algorithmic approach

Author

Raju Khubchandani and Surjit Singh

Subjects
medicine.medical_specialty, business.industry, Childhood arthritis, MEDLINE, Arthritis, medicine.disease, Surgery, Pediatrics, Perinatology and Child Health, Possible diagnosis, Medicine, Good prognosis, Medical diagnosis, business, Intensive care medicine
Abstract

Arthritis is one of the less common, yet challenging problems that may confront a pediatrician. The potential pathology is diverse ranging from the benign with a good prognosis to the serious and ultimately fatal. From a spot diagnosis to conditions that evolve over time, few other conditions challenge and stimulate the clinical acumen. Several diagnoses can be made clinically with the laboratory investigations providing additional support. An approach through which the clinician seeks answers through a logical sequence of questions is presented to help shortlist the possible diagnosis.

Published
2002
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11. PReS13-SPK-1127: Pediatric rheumatology in India

Author

Raju Khubchandani

Subjects
medicine.medical_specialty, Pediatrics, Telemedicine, education.field_of_study, Referral, business.industry, Population, Invited Speaker Presentation, Alternative medicine, Specialty, Day care, Rheumatology, Family medicine, Internal medicine, Pediatrics, Perinatology and Child Health, medicine, Immunology and Allergy, Pediatrics, Perinatology, and Child Health, business, education, Developed country
Abstract

Pediatric Rheumatology took birth in India with the formation of an interest group of the Indian Academy of Pediatrics and the first conference in 2001 in Mumbai. Now 11 conferences old, it has about 200 members and 12 centers offering part time or whole time care. With a population of over 1000 million, it may be extrapolated from Western data that India should have at least 400000 children with rheumatologic disease - JIA, JDM, SLE and vasculitides (excluding KD and HSP) Disease patterns are similar to a Western clinic and a little over a third of children attending a rheumatology clinic in Mumbai are diagnosed to have non rheumatologic musculoskeletal disease, notably leukemia, genetic disorders and chronic pain syndromes. The term 'musculoskeletal medicine clinic' seems more apt. Acute diseases such as septic arthritis/osteomyelitis are probably filtered at the primary care level and hence the clinic functions mainly as a chronic or day care facility. Fluorosis, musculoskeletal MDR tuberculosis, brucellosis and HIV associated arthropathy are unique issues. Most centers report declining trends of Rheumatic fever but an alarming increase of KD with consequent IViG requirement. Rare diseases such as hereditary fever syndromes are seen, some possibly representing the vestiges of early European colonization. Individual trends differ with SOJIA and ERA forming the bulk of JIA rather than OJIA. Uveitis is not a major concern. Outcomes of individual diseases seem different to the West with most centers in India reporting a milder phenotype of JDM. Paradoxically 80% of the world's pediatric rheumatologists care for 20% of the world's children and vice versa. Our undergraduate teaching ignores rheumatology while our post graduate teaching focuses more on acute cross sectional care rather than chronic longitudinal care. Patents usually reach through complex pathways of referral, often having consulted adult orthopaedic surgeons or alternative medicine systems prior to their visit, highlighting the need for increasing awareness about our specialty to lay public. They often have to travel 300-500 km for a consultation. Consequently, delay in diagnosis of various diseases, irregular follow up and frequent usage of steroid prior to referral are common. While raising money for one time use of IViG is still feasible (selfpaid or charity), a country with a per capita income of 1219 USD and much larger problems is unable to adapt treatment guidelines suggested by the West when it comes to the use of biologicals and consequently lesser studied drugs and treatment algorithms are resorted to. The crunch for interested and trained personnel (at least 200) has been addressed through a 3 level process -Preach -sensitizing large gatherings of pediatricians, Reach and Teach-intensive weeklong courses to committed smaller groups and Each to Each -one on one teaching through fellowships. The results are slow but visible. India can contribute to the world of pediatric rheumatology through its sheer numbers and its English speaking medical community thus providing an excellent collaborative research and teaching opportunity to centers with knowhow but lacking in numbers. The developed world can help us through facilitating student exchange, concessional diagnostic tests and courses, telemedicine, bulletin board, Asian editions of books or open access publications and patient information.

Published
2013
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12. OR3-002 – Blau Syndrome cohort study: ocular outcome

Author

S Oliveira Knupp, Brigitte Bader-Meunier, Carlos D. Rose, A Naranjo-Hernandez, Raju Khubchandani, G Espada, Miroslav Harjacek, P Brissaud, Carine Wouters, Rolando Cimaz, SJ Vastert, F Mackenson, NM Wulffraat, Juan I. Aróstegui, R Russo, Rosa Merino, J Fernandez-Martin, Caroline Thomee, and J. Antón López

Subjects
Pediatrics, medicine.medical_specialty, business.industry, medicine.disease, Rash, Natural history, Rheumatology, NOD2, Meeting Abstract, Pediatrics, Perinatology and Child Health, medicine, Immunology and Allergy, Polyarthritis, Pediatrics, Perinatology, and Child Health, medicine.symptom, business, Prospective cohort study, Blau syndrome, Uveitis, Cohort study
Abstract

BS is an autosomal dominant monogenic granulomatous disease due to gain of function mutations at or near the NACHT domain of NOD2. It is characterized by a triad of granulomatous polyarthritis, uveitis and rash. Retrospective work by our group showed a life time risk of ocular involvement of 60% with significant morbidity and poor visual outcome. Prospective studies on natural history of visual outcome are not available. In view of current lack of effective therapies, research on relevant pathways downstream NOD2 is essential and may lead to appropriate targeted drug development.

Published
2013
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13. Sleep disorders in patients with juvenile idiopathic arthritis as assessed by the sleep disturbance scale for children

Author

AA Bagde, Rachana Hasija, Raju Khubchandani, and Angela Pistorio

Subjects
medicine.medical_specialty, Pediatrics, Sleep disorder, lcsh:Diseases of the musculoskeletal system, business.industry, lcsh:RJ1-570, Arthritis, lcsh:Pediatrics, medicine.disease, Sleep in non-human animals, Rheumatology, Arousal, Internal medicine, Poster Presentation, Pediatrics, Perinatology and Child Health, Mann–Whitney U test, Immunology and Allergy, Medicine, Juvenile, Pediatrics, Perinatology, and Child Health, lcsh:RC925-935, Post treatment, business
Abstract

Methods Out of 35 patients with JIA, enrolled after parental consent, 31 (23 males and 8 females) completed the study. Mean age of the patients was 9.8 years (Range 6.114.5 years). The patients were enrolled when they demonstrated active disease at presentation or during relapse, as ‘active disease group’ and followed up regularly at 6-8 weekly intervals, till they improved with treatment. Disease activity of JIA was assessed by ACR PEDI criteria. Sleep was studied using SDSC which is a validated screening tool (for the age interval studied), that categorizes sleep disturbances into six different categories: Disorders of initiating and maintaining sleep (DIMS), Sleep disordered breathing (SDB), Disorders of arousal (DA), Sleep wake transition disorders (SWTD), Disorders of excessive somnolence (DOES) & Sleep hyperhydrosis (SHY). The SDSC questionnaire was filled by the parent / patient in the waiting room at each follow up visit. When the patients showed maximum improvement in JIA, they were included in the ‘post treatment’ group. For quantifying sleep disorders, we compared the scores of the subjects with scores derived from a sample of normal population in a similar age band from our city. Differences between the active and post treatment groups were analyzed by non parametric Wilcoxson test for paired data and non parametric Mann-Whitney U test for unpaired data

Published
2011
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14. Bilateral Central Retinal Artery Occlusion: An Unusual Presentation of Polyarteritis Nodosa

Author

Arpita Thakker, Alka Jadhav, Raju Khubchandani, Mona Gajre, Rupesh R. Mendadkar, and Ashish Doshi

Subjects
myalgia, medicine.medical_specialty, Abdominal pain, Retinal Artery Occlusion, medicine.diagnostic_test, Polyarteritis nodosa, business.industry, Cherry-red spot, medicine.disease, Gastroenterology, Internal medicine, Pediatrics, Perinatology and Child Health, Skin biopsy, Necrotizing Vasculitis, medicine, Central retinal artery occlusion, medicine.symptom, business
Abstract

To the Editor: Polyarteritis Nodosa (PAN) is a disease of medium sized arteries with typical involvement of the abdominal viscera, skin and kidneys. Sudden visual loss due to bilateral centralretinalartery-obstruction (CRAO) is an unusual presentation of childhood classic PAN. A three-year-old boy presented to us with one month history of intermittent high grade fever and tender erythematous nodules over both extremities. He also had malena, abdominal pain and sudden decrease in vision since 4 d. He had a blood pressure of 150/90 mmHg (more than 99th percentile for age and height). Fundus revealed cherry red spot, dot-blot-hemorrhages surrounding the macula and optic disc edema suggestive of bilateral CRAO (Figs. 1 and 2). Significant investigations were as follows: Hb-8.3 g/dL, WBC-16,300/cumm (neutrophils 70 %), platelet count6,97,000/dL, CRP-20 mg/dL (elevated), elevated ESR75 mm at end of 1 h. Various markers i.e., HIV, HBsAg, HCV, Anti-ds DNA, Anti-neutrophillic cytoplasmic antibody, ASLO titre were negative . Urine analysis, renal and liver function tests were normal. Chest radiograph, echocardiography, carotid and renal doppler studies were normal. Skin biopsy showed arterial wall inflammation and perivascular infiltrate of neutrophils and lymphocytes. In view of histological evidence of necrotizing vasculitis in medium artery, skin involvement, hypertension and bilateral CRAO, a diagnosis of PAN with bilateral CRAO was made. Computed-tomography-angiogram of the abdomen and brain were normal. The child was treated with injection methylprednisolone (30 mg/kg) for 3 d followed by oral prednisolone. He also received cyclophosphamide injection (500 mg/m) once a month for 6 mo followed by oral azathioprine. Antihypertensives were given during the acute episode and then tapered. The new criteria for PAN are: histopathological evidence of necrotizing vasculitis in medium or small arteries or angiographic abnormality (aneurysm, stenosis or occlusion) as a mandatory criterion; plus one of the following five: skin involvement, myalgia, hypertension, peripheral neuropathy, renal involvement [1–3]. Permanent remission can be achieved unlike other vasculitides [4]. Relapses can also occur if treatment is delayed or inadequate.

Published
2014
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16. 14.2 Causes of early death in juvenile onset systemic lupus erythematosus (JSLE)

Author

Brigitte Bader-Meunier, Tadej Avcin, A. Klein, Flavio Sztajnbok, Rolando Cimaz, Rosa Merino, S. Knupp, Ricardo Russo, Amita Aggarwal, Pierre Quartier, Seza Ozen, Raju Khubchandani, and Çocuk Sağlığı ve Hastalıkları

Subjects
Pediatrics, medicine.medical_specialty, business.industry, Early death, medicine.disease, Rheumatology, Intravenous cyclophosphamide, Juvenile onset, Internal medicine, Pediatrics, Perinatology and Child Health, medicine, Oral Presentation, Immunology and Allergy, Organ involvement, Pediatrics, Perinatology, and Child Health, business, Nephrotic syndrome, Paediatric rheumatology
Published
2008
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17. Brucellosis – forgotten but not gone

Author

V Vishwanathan, Raju Khubchandani, C Khemani, and PR Chickermane

Subjects
medicine.medical_specialty, Pediatrics, lcsh:Diseases of the musculoskeletal system, Zoonotic Infection, business.industry, lcsh:RJ1-570, lcsh:Pediatrics, Brucellosis, Disease, medicine.disease, Rash, Rheumatology, Serology, Internal medicine, Poster Presentation, Pediatrics, Perinatology and Child Health, medicine, Immunology and Allergy, Pediatrics, Perinatology, and Child Health, lcsh:RC925-935, medicine.symptom, Family history, business, Serositis
Abstract

Brucellosis, a zoonotic infection, is transmitted to children primarily by consumption of unpasteurized milk products. It can present with symptom complexes that mimic common chronic arthritis/connective tissue disorders, notably Still's disease. We describe three children (Table ​(Table1)1) suffering from brucellosis, seen in the last year in our rheumatology services. Table 1 These cases reemphasize the need for pattern recognition in rheumatologic disease. All three were referred by primary care physicians with a working diagnosis of systemic onset JIA/autoimmune disorder. However the lack of a "perfect fit" for such diagnoses,(pattern of fever, absence of rash/serositis, normal white cell/platelet counts) led us to explore a history of travel/residence in endemic areas and ingestion of unpasteurized milk. A family history of similarly afflicted members in one case was also relevant. Serology is helpful but false positives may occur in hyper-gammaglobulinemic states. Blood cultures take weeks and the organism is a fastidious one. All three children responded well to a combination of streptomycin (2 weeks) and doxycycline (6 weeks).

Published
2008
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19. Editorial

Author

Raju Khubchandani and Surjit Singh

Subjects
medicine.medical_specialty, business.industry, Family medicine, Pediatrics, Perinatology and Child Health, medicine, Pediatric rheumatology, business
Published
2002
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20. Arthritis in infancy

Author

Chetna Khemani, J. B. Ghosh, and Raju Khubchandani

Subjects
Pediatrics, medicine.medical_specialty, business.industry, Pediatrics, Perinatology and Child Health, medicine, Arthritis, medicine.disease, business
Published
2010
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21. Primaquine induced Methemoglobinemia

Author

Raju Khubchandani, Shruti Mody, and Jyothi Raman

Subjects
medicine.medical_specialty, Primaquine, business.industry, Pediatrics, Perinatology and Child Health, Medicine, business, Methemoglobinemia, medicine.disease, Dermatology, medicine.drug
Published
2003
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