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Anti-cyclic citrullinated peptide (anti-CCP) antibodies are considered to be specific for rheumatoid arthritis. The aim of the study consists in assessment of prevalence and clinical significance of anti-CCP antibodies in a cohort of juvenile idiopathic arthritis (JIA). In 55 patients with JIA, and a age and sex-matched control group (21 children with no articular sign) IgG anti-CCP antibodies were measured in serum using a commercial chemiluminescent immunoassay (CMIA) method (Architect ABBOTT). Positive anti-CCP values (above the 5U/ml cut-off value of the method) were found in 5 patients (9.1%). Statistical significant positive correlation had been found between anti-CCP antibodies titer and acute phase reactants, disease activity score and radiographic damage, respectively. Reevaluation after 3 months of the anti-CCP antibodies titer revealed statistical significant change. Anti-CCP is less prevalent in JIA than in rheumatoid arthritis, but its positivity denotes an erosive course of disease. [ABSTRACT FROM AUTHOR]

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood and is responsible for many growth disorders. Abnormalities of growth and development in JIA can be attributed to a combination of factors, as disease process (with enhanced pro-inflammatory cytokines production), perturbation of the growth hormone (GH) - insulin-like growth factor (IGF-1) axis, and glucocorticoid treatment. The aim of study was to assess the IGF-1 level in JIA patients and to evaluate correlation between IGF-1 levels and parameters of disease activity. IGF-1 serum concentration was measured using chemiluminescent immunoassay method. We found lower IGF-1 serum levels in polyarthritis and systemic JIA comparative with control group, but with normal mean IGF-1 values in oligoarticular and enthesitis-related arthritis, respectively. Weak to moderate negative correlations were found between IGF-1 levels and disease activity parameters. These results arise a few controversial questions: should we treat certain JIA types with GH to maintain normal growth, to prevent potential growth deterioration or to catch up growth delay? Or, perhaps a good control of disease activity in juvenile arthritis would be enough to avoid or to correct abnormalities of growth and development? [ABSTRACT FROM AUTHOR]

Introduction: Neurofibromatosis (NF) is an autosomal dominant disorder with a multisystemic involvement and a variety of problems presented in childhood. Objectives: The authors aimed to evaluate the endocrine pathology associated to patients diagnosed with NF. Material and method: Patients (0-18 years old) diagnosed with NF and admitted to the Endocrinology Departament of "Louis Turcanu" Children Emergency Hospital were studied over a period of 5 years from 2007 to 2012. The study protocol consisted in the family and patients' history, physical examination and anthropometric measurements. Serum levels of TSH, FT4 and FT3, GH, LH, FSH, testosterone or estradiol, DHEA, 17 OH progesterone, cortisol, adrenaline and prolactin were measured. The imagistic examination depended of cases and consisted in radiography, pelvic ultrasound or head MRI. Results and discussions: Our study lot comprised 12 patients (3 months to 18 years and 6 months) diagnosed with NF (type I - 91.6%) with a sex ration male: female 1:2. 33.4% children had a parents known with NF. Regarding of endocrine pathology associated, 58.4% of them had short stature secondary to GH deficiencies and one boy had gigantism caused by optic pathway gliomas responsible for GH hypersecretion. Half of the girls had abnormal menses due to the polycystic ovary syndrome. No cases of hypothyroidism or pheochromocytoma was encountered. Conclusions: Although NF pictures are characteristic, other rare conditions including endocrine pathology can be associated so clinical clues should be always sought and investigation should be performed for in these circumstances. [ABSTRACT FROM AUTHOR]

Introduction: Juvenile idiopathic arthritis (JIA) is the most important rheumatic disease of childhood. Aim: To study the correlations between biomarkers and the therapeutic response in JIA. Material and methods: In 58 children, diagnosed and classified according to ILAR (International League of Associations for Rheumatology), evaluation consisted in clinical and laboratory examination (ESR, CRP, RF-rheumatoid factor, alpha2-and gammaglobulins, total IgM and IgG, immunoglobulins, anticyclic citrullinated peptide antibody- ACPA, antinuclear antibodies-ANAs, interleukins - ILs). The outcome was assessed by ACR Pedi (American College of Rheumatology)score. Results: Patients distribution regarding diagnosis was: of patients was: 1 systemic JIA, 17 polyarthritis, 18 oligoarthritis, 22 spondyloarthropathies. There was a good, but inverted correlation between the ESR, CRP, serum immunoglobuline values and the ACR Pedi30 scores on NSAID treatment. ACPA was found positive in 6 cases, all associating important inflammation at the onset, but no correlations with ACR scores. ANAs was found positve in just 3 cases of extended oligoarthritis, all associating ocular complications. Plasma levels of IL- 1alpha, IL-1betha, IL-6 pro-inflammatory interleukins was determined in 8 cases. Both fractions of IL-1 were increased in two cases of reactive arthritis and one juvenile spondylitis (with normal IL-6 levels). Enhancement of IL-6 (and normal IL-1 values) was observed in 3 children with polyarthritis. Conclusions: Important biologic inflammatory syndrome at the moment of JIA diagnosis suggests a highly active disease, indicating a more aggressive therapeutic approach. Positive ACPA is less prevalent than in rheumatoid arthritis, but its positivity denotes an erosive course of JIA. ANAs were correlated with extended oligoarthritis and ocular complications. Interleukins could be correlated with clinical form of JIA (IL-1 with spondyloarthropaty, IL-6 with polyarthritis) and could suggest the timing of biological therapy withdrawal. Further studies are needed to sustain these observations. [ABSTRACT FROM AUTHOR]

Juvenile idiopathic arthritis (JIA) is the most important rheumatic disease of childhood. The aim of this study is to investigate the correlations between clinical signs and inflammatory biomarkers in JIA. In 58 children, diagnosed and classified according to ILAR (International League of Associations for Rheumatology), evaluation consisted in clinical and laboratory examination (ESR, CRP, RF-rheumatoid factor, anticyclic citrullinated peptide antibody- anti-CCP, interleukins - ILs). The distribution of patients was: 1 systemic JIA, 17 polyarthritis, 18 oligoarthritis, 22 spondyloarthropathies. There was a good correlation between the ESR, CRP values and the functional scores. Anti-CCP antibodies was found positive in 6 cases, but borderline levels, all associating important inflammation at the onset, but no correlations with functional indexes. Plasma levels of IL-1alpha, IL- 1betha, IL-6 pro-inflammatory interleukins was determined in 8 cases. Both fractions of IL- 1 were increased in two cases of reactive arthritis and one juvenile spondylitis (with normal IL-6 levels). Enhancement of IL-6 (and normal IL-1 values) was observed in 3 children with polyarthritis. In the studied group, we found no correlations between clinical form of JIA and anti-CCP titre. Interleukins could be correlated with clinical form of JIA (IL-1 with spondyloarthropaty, IL-6 with polyarthritis). Further studies need to sustain these observations. [ABSTRACT FROM AUTHOR]