74 results on '"Saurenmann RK"'
Search Results
2. Maximal inter-incisal distance in healthy school children in Switzerland
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Saurenmann RK, Kellenberger CJ, Mueller L, Langerweger C, and van Waes H
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Pediatrics ,RJ1-570 ,Diseases of the musculoskeletal system ,RC925-935 - Published
- 2011
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3. Are growing pains a parasomnia?
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Jenni O, Werner H, Aeschlimann F, and Saurenmann RK
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Pediatrics ,RJ1-570 ,Diseases of the musculoskeletal system ,RC925-935 - Published
- 2011
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4. Observation of juvenile idiopathic arthritis in children with MEVF gene mutations in Armenia
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Gayane Khloyan, Saurenmann RK, Gayane Amaryan, and Alan Karibian
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Pediatrics ,RJ1-570 ,Diseases of the musculoskeletal system ,RC925-935 - Published
- 2008
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5. Juvenile Psoriatic Arthritis (JPsA) clinical features and outcome of 119 patients
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Aviel Y Butbul, Tyrrell PN, Feldman BM, Laxer RM, Saurenmann RK, Spiegel L, Cameron B, Tse S, and Silverman ED
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Pediatrics ,RJ1-570 ,Diseases of the musculoskeletal system ,RC925-935 - Published
- 2008
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6. New and updated recommendations for the treatment of juvenile idiopathic arthritis associated uveitis and idiopathic chronic anterior uveitis
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Foeldvari I, Maccora I, Petrushkin H, Rahman N, Anton-Lopez J, de Boer J, Calzada J, Carreras E, Diaz J, Edelsten C, Angeles-Han ST, Heiligenhaus A, Miserocchi E, Nielsen S, Saurenmann RK, Stuebiger N, Baquet-Walscheid K, Furst D, and Simonini G
- Abstract
OBJECTIVE: The Multinational Interdisciplinary Working Group for Uveitis in Childhood (MIWGUC) identified the need to update the current guidelines and worked to produce this document, which should serve to guide clinicians managing children with juvenile idiopathic arthritis associated uveitis (JIAU) and idiopathic chronic anterior uveitis (CAU). METHODS: The group analysed the literature published between December 2014- June 2020 after a systematic literature review conducted by two clinicians. Paediatric rheumatologists were paired with ophthalmologists to review the eligible 37 publications. The search criteria were selected to reflect those used for the 2018 SHARE recommendations in order to provide an update, rather than a replacement for that publication. The consensus meeting was moderated by Prof Dan Furst MD, UCLA, Los Angeles, USA. The summary of the current evidence for each SHARE recommendation was presented to the expert committee. These were then discussed and revised during a video consensus meeting on the 22(nd) of January 2021 with 14 voting participants, using a Nominal Group Technique to reach consensus. RESULTS: JIAU treatment was extended to include CAU. Fourteen recommendations regarding treatment of JIAU und CAU with > 80% agreement were accepted. CONCLUSION: An update to the previous 2018 SHARE recommendations for the treatment of children with JIAU with the addition of CAU was created using an evidence-based consensus process. This guideline should help support clinicians to care for children and young people with chronic anterior uveitis.
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- 2022
7. Phenotypic variability and disparities in treatment and outcomes of childhood arthritis throughout the world: an observational cohort study
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Consolaro, A, Giancane, G, Alongi, A, van Dijkhuizen, Ehp, Aggarwal, A, Al-Mayouf, Sm, Bovis, F, De Inocencio, J, Demirkaya, E, Flato, B, Foell, D, Garay, Sm, Lazăr, C, Lovell, Dj, Montobbio, C, Miettunen, P, Mihaylova, D, Nielsen, S, Orban, I, Rumba-Rozenfelde, I, Magalhães, C, Shafaie, N, Susic, G, Trachana, M, Wulffraat, N, Pistorio, A, Martini, A, Ruperto, N, Ravelli, A &, Abdwani R, Aghighi, Y, Aiche, Mf, Ailioaie, C, Aktay Ayaz, N, Al-Abrawi, S, Alexeeva, E, Anton, J, Apostol, A, Arguedas, O, Avcin, T, Barone, P, Berntson, L, Boteanu, Al, Boyko, Y, Burgos-Vargas, R, Calvo Penades, I, Chédeville, G, Cimaz, R, Civino, A, Consolini, R, Constantin, T, Cuttica, R, Dallos, T, Martin, N, Magni-Manzoni, S, De Cunto, C, Dolezalova, P, Ekelund, M, El Miedany, Y, Espada, G, Estmann Christensen, A, Foeldvari, I, Gallizzi, R, Ganser, G, Gerloni, V, Haas, Jp, Harel, L, Harjacek, M, Hashad, S, Herlin, T, Herrera, C, Hofer, M, Holzinger, D, Horneff, G, Huppertz, Hi, Iagăru, N, Ibanez Estrella, A, Ioseliani, M, Joos, R, Knupp Oliveira, S, Kamphuis, S, Kasapcopur, O, Katsicas, Mm, Khubchandani, R, Kondi, A, Kröger, L, La Torre, F, Laday, M, Lahdenne, P, Maggio, Mc, Magnolia, Mg, Malagon, C, Malin, M, Martino, S, Melo-Gomes, Ja, Mesa-Del-Castillo, P, Militaru, A, Minden, K, Miniaci, A, Moradinejad, Mh, Morel Ayala, Z, Nikishina, I, Norambuena, X, Nordal, Eb, Pagava, K, Panaviene, V, Pastore, S, Pieropan, S, Podda, Ra, Pruunsild, C, Putto-Laurila, A, Quartier, P, Remesal, A, Rigante, Donato, Ringold, S, Rutkowska-Sak, L, Rygg, M, Saurenmann, Rk, Sawhney, S, Scott, C, Shiari, R, Smolewska, E, Sozeri, B, Swart, Jf, Sztajnbok, F, Torcoletti, M, Tsitsami, E, Tzaribachev, N, Unsal, E, Uziel, Y, Vähäsalo, P, Varbanova, B, Vargova, V, Vesely, R, Vijatov-Djuric, G, Vilaiyuk, S, Vojinovic, J, Vougiouka, O, Weiss, P, Wouters, C, Rigante D (ORCID:0000-0001-7032-7779), Consolaro, A, Giancane, G, Alongi, A, van Dijkhuizen, Ehp, Aggarwal, A, Al-Mayouf, Sm, Bovis, F, De Inocencio, J, Demirkaya, E, Flato, B, Foell, D, Garay, Sm, Lazăr, C, Lovell, Dj, Montobbio, C, Miettunen, P, Mihaylova, D, Nielsen, S, Orban, I, Rumba-Rozenfelde, I, Magalhães, C, Shafaie, N, Susic, G, Trachana, M, Wulffraat, N, Pistorio, A, Martini, A, Ruperto, N, Ravelli, A &, Abdwani R, Aghighi, Y, Aiche, Mf, Ailioaie, C, Aktay Ayaz, N, Al-Abrawi, S, Alexeeva, E, Anton, J, Apostol, A, Arguedas, O, Avcin, T, Barone, P, Berntson, L, Boteanu, Al, Boyko, Y, Burgos-Vargas, R, Calvo Penades, I, Chédeville, G, Cimaz, R, Civino, A, Consolini, R, Constantin, T, Cuttica, R, Dallos, T, Martin, N, Magni-Manzoni, S, De Cunto, C, Dolezalova, P, Ekelund, M, El Miedany, Y, Espada, G, Estmann Christensen, A, Foeldvari, I, Gallizzi, R, Ganser, G, Gerloni, V, Haas, Jp, Harel, L, Harjacek, M, Hashad, S, Herlin, T, Herrera, C, Hofer, M, Holzinger, D, Horneff, G, Huppertz, Hi, Iagăru, N, Ibanez Estrella, A, Ioseliani, M, Joos, R, Knupp Oliveira, S, Kamphuis, S, Kasapcopur, O, Katsicas, Mm, Khubchandani, R, Kondi, A, Kröger, L, La Torre, F, Laday, M, Lahdenne, P, Maggio, Mc, Magnolia, Mg, Malagon, C, Malin, M, Martino, S, Melo-Gomes, Ja, Mesa-Del-Castillo, P, Militaru, A, Minden, K, Miniaci, A, Moradinejad, Mh, Morel Ayala, Z, Nikishina, I, Norambuena, X, Nordal, Eb, Pagava, K, Panaviene, V, Pastore, S, Pieropan, S, Podda, Ra, Pruunsild, C, Putto-Laurila, A, Quartier, P, Remesal, A, Rigante, Donato, Ringold, S, Rutkowska-Sak, L, Rygg, M, Saurenmann, Rk, Sawhney, S, Scott, C, Shiari, R, Smolewska, E, Sozeri, B, Swart, Jf, Sztajnbok, F, Torcoletti, M, Tsitsami, E, Tzaribachev, N, Unsal, E, Uziel, Y, Vähäsalo, P, Varbanova, B, Vargova, V, Vesely, R, Vijatov-Djuric, G, Vilaiyuk, S, Vojinovic, J, Vougiouka, O, Weiss, P, Wouters, C, and Rigante D (ORCID:0000-0001-7032-7779)
- Abstract
BACKGROUND: To our knowledge, the characteristics and burden of childhood arthritis have never been studied on a worldwide basis. We aimed to investigate, with a cross-sectional study, the prevalence of disease categories, treatment methods, and disease status in patients from across different geographical areas and from countries with diverse wealth status. METHODS: In this multinational, cross-sectional, observational cohort study, we asked international paediatric rheumatologists from specialised centres to enrol children with a diagnosis of juvenile idiopathic arthritis, according to International League of Associations for Rheumatology criteria, who were seen consecutively for a period of 6 months. Each patient underwent retrospective and cross-sectional assessments, including measures of disease activity and damage and questionnaires on the wellbeing and quality of life of the children. We qualitatively compared the collected data across eight geographical areas, and we explored an association between disease activity and damage and a country's gross domestic product (GDP) with a multiple logistic regression analysis. FINDINGS: Between April 4, 2011, and Nov 21, 2016, 9081 patients were enrolled at 130 centres in 49 countries, grouped into eight geographical areas. Systemic arthritis (125 [33·0%] of 379 patients) and enthesitis-related arthritis (113 [29·8%] of 379) were more common in southeast Asia, whereas oligoarthritis was more prevalent in southern Europe (1360 [56·7%] of 2400) and rheumatoid factor-negative polyarthritis was more frequent in North America (165 [31·5%] of 523) than in the other areas. Prevalence of uveitis was highest in northern Europe (161 [19·1%] of 845 patients) and southern Europe (450 [18·8%] of 2400) and lowest in Latin America (54 [6·4%] of 849), Africa and Middle East (71 [5·9%] of 1209), and southeast Asia (19 [5·0%] of 379). Median age at disease onset was lower in southern Europe (3·5 years, IQR 1·9-7·3) than in other regions
- Published
- 2019
8. Toward Establishing a Standardized Magnetic Resonance Imaging Scoring System for Temporomandibular Joints in Juvenile Idiopathic Arthritis
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Tolend MA, Twilt M, Cron RQ, Tzaribachev N, Guleria S, von Kalle T, Koos B, Miller E, Stimec J, Vaid Y, Larheim TA, Herlin T, Spiegel L, Inarejos E, Moineddin R, van Rossum MA, Saurenmann RK, Doria AS, and Kellenberger CJ
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musculoskeletal diseases - Abstract
OBJECTIVE: The temporomandibular joints (TMJs) are frequently affected in children with juvenile idiopathic arthritis (JIA). Early detection is challenging, as major variation is present in scoring TMJ pathology on magnetic resonance imaging (MRI). Consensus-driven development and validation of an MRI scoring system for TMJs has important clinical utility in timely improvement of diagnosis and serving as an outcome measure. We report on a multi-institutional collaboration toward developing a TMJ MRI scoring system for JIA. METHODS: Seven readers independently assessed MRI scans from 21 patients (42 TMJs, from patients ages 6-16 years) using 3 existing MRI scoring systems from American, German, and Swiss institutions. Reliability scores, scoring system definitions, and items were discussed among 10 JIA experts through 2 rounds of Delphi surveys, nominal group voting, and subsequent consensus meetings to create a novel TMJ MRI scoring system. RESULTS: Average-measure absolute agreement intraclass correlation coefficients (avICCs) for the total scores of all 3 scoring systems were highly reliable at 0.96 each. Osteochondral items showed higher reliability than inflammatory items. An additive system was deemed preferable for assessing minor joint changes over time. Eight items were considered sufficiently reliable and/or important for integration into the consensus scoring system: bone marrow edema and enhancement (avICC 0.57-0.61, smallest detectable difference [SDD] ± 45-63% prior to redefining), condylar flattening (avICC 0.95-0.96, SDD ± 23-28%), effusions (avICC 0.85-0.88, SDD ± 25-26%), erosions (avICC 0.94, SDD ± 20%), synovial enhancement and thickening (previously combined, avICC 0.90-0.91, SDD ± 33%), and disk abnormalities (avICC 0.90, SDD ± 19%). CONCLUSION: A novel TMJ MRI scoring system was developed by consensus. Further iterative refinements and reliability testing are warranted in upcoming studies.
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- 2018
9. The provisional paediatric rheumatology international trials organisation/Americal college of rheumatology/European league against reumatism disease activity core set for the evaluation of response to therapy in juvenile dermatomyositis: a prospective validation study
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Ruperto, N, Ravelli, A, Pistorio, A, Ferriani, V, Calvo, I, Ganser, G, Brunner, J, Dannecker, G, Silva, CA, Stanevicha, V, ten Cate, R, Smit, LWA, Voygiyka, O, Fischbach, M, Foeldvari, I, Hilario, O, Modesto, C, Saurenmann, RK, Sauvain, MJ, Scheibel, I, Sommelet, D, Tambic-Bukovac, L, Barcellona, R, Brik, R, Ehl, S, Jovanovic, M, Rovensky, J, Bagnasco, F, Lovell, DJ, Martini, A, and Pediatrics
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- 2008
10. The provisional pediatric rheumatology international trial organization/american college of rheumatology/european league against rheumatism disease activity core set for the evaluation of response to therapy in juvenile dermatomyositis: a prospective validation study
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Ruperto, R, Ravelli, Angelo, Pistorio, A, Ferriani, V, Calvo, I, Ganser, G, Brunner, J, Dannecker, G, Silva, Ca, Stanevicha, V, TEN CATE, R, VAN SUIJLEKOM SMIT LWA, Voygioyka, O, Fischbach, M, Foeldvari, I, Hilario, O, Modesto, C, Saurenmann, Rk, Sauvain, M. J., Scheibel, I, Sommelet, D, TAMBIC BUKOVAC, L, Barcellona, R, Brik, R, Ehl, S, Jovanovic, M, Rovensky, J, Bagnasco, F, Lovell, Dj, and Martini, Alberto
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- 2008
11. Are growing pains a parasomnia?
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Aeschlimann, F, primary, Werner, H, additional, Jenni, O, additional, and Saurenmann, RK, additional
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- 2011
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12. Association of the CD226 (DNAM-1) Gly307Ser polymorphism with juvenile idiopathic arthritis
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Reinards, THCM, primary, Albers, HM, additional, Brinkman, DMC, additional, Kamphuis, SSM, additional, van Rossum, MAJ, additional, Hoppenreijs, EPAH, additional, Girschick, HJ, additional, Wouters, C, additional, Saurenmann, RK, additional, Houwing-Duistermaat, JJ, additional, Toes, REM, additional, Huizinga, TWJ, additional, ten Cate, R, additional, and Schilham, MW, additional
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- 2011
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13. Maximal inter-incisal distance in healthy school children in Switzerland
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van Waes, H, primary, Langerweger, C, additional, Mueller, L, additional, Kellenberger, CJ, additional, and Saurenmann, RK, additional
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- 2011
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14. Association of the CCR5 Δ32 variant with juvenile idiopathic arthritis in a meta-analysis
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Reinards, THCM, primary, Albers, HM, additional, Brinkman, DMC, additional, Kamphuis, SSM, additional, van Rossum, MAJ, additional, Hoppenreijs, EPAH, additional, Girschick, HJ, additional, Wouters, C, additional, Saurenmann, RK, additional, Houwing-Duistermaat, JJ, additional, Toes, REM, additional, Huizinga, TWJ, additional, ten Cate, R, additional, and Schilham, MW, additional
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- 2011
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15. Temporomandibular joint arthritis in patients with juvenile idiopathic arthritis: efficacy of intraarticular corticosteroid injection as measured by MRI and clinical examination
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Schroeder, S, primary, Cannizzaro, E, additional, Kellenberger, C, additional, Peltomäki, T, additional, and Saurenmann, RK, additional
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- 2008
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16. Association of the autoimmunity locus 4q27 with juvenile idiopathic arthritis.
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Albers HM, Kurreeman FA, Stoeken-Rijsbergen G, Brinkman DM, Kamphuis SS, van Rossum MA, Girschick HJ, Wouters C, Saurenmann RK, Hoppenreijs E, Slagboom P, Houwing-Duistermaat JJ, Verduijn W, Huizinga TW, Ten Cate R, Toes RE, and Schilham MW
- Abstract
OBJECTIVE: Juvenile idiopathic arthritis (JIA) is characterized by chronic arthritis and an autoimmune etiology. In several autoimmune diseases, including rheumatoid arthritis (RA), an association with the 4q27 locus has been reported. We undertook this study to investigate the possible role of the 4q27 locus in JIA. METHODS: A case-control association study was conducted, with a total of 655 Caucasian JIA patients and 791 healthy controls divided into 2 independent sample sets. The rs6822844 marker in the 4q27 locus was genotyped. RESULTS: In the first and larger sample set, a 5% decrease in T allele frequency was observed in patients compared with controls (allelic odds ratio [OR] 0.72 [95% confidence interval 0.55-0.95], P = 0.019), and in the second set, a 3% decrease was observed (allelic OR 0.81 [95% confidence interval 0.61-1.09], P = 0.169). The combined data set generated an OR of 0.76 (95% confidence interval 0.62-0.93, P = 7.08 x 10(-3)). When the different JIA subtypes were analyzed individually, significant decreases were seen in the subtypes with a polyarticular course of disease (extended oligoarthritis [P = 0.019] and rheumatoid factor-negative polyarthritis [P = 0.038]). CONCLUSION: Our findings suggest that the 4q27 locus, previously reported to be associated with RA, type 1 diabetes mellitus, celiac disease, and psoriatic arthritis, is also associated with susceptibility to JIA. [ABSTRACT FROM AUTHOR]
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- 2009
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17. Risk factors and longterm outcome of juvenile idiopathic arthritis-associated uveitis in Switzerland.
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Bolt IB, Cannizzaro E, Seger R, and Saurenmann RK
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- 2008
18. The provisional Paediatric Rheumatology International Trials Organisation/American College of Rheumatology/european League Against Rheumatism Disease activity core set for the evaluation of response to therapy in juvenile dermatomyositis: A prospective validation study.
- Author
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Ruperto N, Ravelli A, Pistorio A, Ferriani V, Calvo I, Ganser G, Brunner J, Dannecker G, Silva CA, Stanevicha V, Cate RT, van Suijlekom-Smit LW, Voygioyka O, Fischbach M, Foeldvari I, Hilario O, Modesto C, Saurenmann RK, Sauvain MJ, and Scheibel I
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- 2008
19. Epidemiology of juvenile idiopathic arthritis in a multiethnic cohort: ethnicity as a risk factor.
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Saurenmann RK, Rose JB, Tyrrell P, Feldman BM, Laxer RM, Schneider R, and Silverman ED
- Abstract
OBJECTIVE: To study the influence of ethnicity on the risk of developing juvenile idiopathic arthritis (JIA) in a multiethnic community of patients with unrestricted access to health care. METHODS: A questionnaire on ethnicity was distributed to all patients with JIA being followed up at the Hospital for Sick Children in Toronto, Ontario, Canada. Of 1,082 patients, 859 (79.4%) responded to the questionnaire. To calculate the relative risk (RR) of developing JIA in this study cohort, the results were compared with data from the age-matched general population of the Toronto metropolitan area (TMA) as provided in the 2001 census from Statistics Canada. RESULTS: European descent was reported by 69.7% of the patients with JIA compared with a frequency of 54.7% in the TMA general population, whereas a statistically significantly lower than expected percentage of the patients with JIA reported having black, Asian, or Indian subcontinent origin. Children of European origin had a higher RR for developing any of the JIA subtypes except polyarticular rheumatoid factor (RF)-positive JIA, and were particularly more likely to develop the extended oligoarticular and psoriatic subtypes. A higher frequency of enthesitis-related JIA was observed among patients of Asian origin, while those of black origin or native North American origin were more likely to develop polyarticular RF-positive JIA. CONCLUSION: In this multiethnic cohort, European descent was associated with a significantly increased risk of developing JIA, and the distribution of JIA subtypes differed significantly across ethnic groups. [ABSTRACT FROM AUTHOR]
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- 2007
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20. Tumor necrosis factor-alpha blocker in treatment of juvenile idiopathic arthritis-associated uveitis refractory to second-line agents: results of a multinational survey.
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Foeldvari I, Nielsen S, Kümmerle-Deschner J, Espada G, Horneff G, Bica B, Olivieri AN, Wierk A, and Saurenmann RK
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- 2007
21. Prevalence, risk factors, and outcome of uveitis in juvenile idiopathic arthritis: a long-term followup study.
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Saurenmann RK, Levin AV, Feldman BM, Rose JB, Laxer RM, Schneider R, and Silverman ED
- Abstract
OBJECTIVE: To assess the prevalence, risk factors, and long-term outcome of uveitis in patients with juvenile idiopathic arthritis (JIA). METHODS: An inception cohort of all 1,081 patients diagnosed as having JIA at a single tertiary care center was established. A questionnaire and followup telephone calls were used to confirm the diagnosis of uveitis. Ophthalmologists' records of patients with uveitis were collected. Kaplan-Meier and Cox regression analyses were used to assess risk factors for developing uveitis and for complications of uveitis. RESULTS: After a mean followup time of 6.9 years, 142 of 1,081 patients (13.1%) had developed uveitis. Risk factors were young age at diagnosis, female sex, antinuclear antibody positivity, and the subtype of JIA. The relative contribution of these risk factors was different for the different subtypes of JIA. Until the end of the study, uveitis complications had developed in 53 of 142 patients with uveitis (37.3%; 4.9% of the total cohort). Only 16 of 175 involved eyes (9.1%) in 14 of 108 patients (13%; 1.3% of the total cohort) for whom ophthalmology reports were available had best corrected visual acuity less than 20/40 (mean followup time for uveitis of 6.3 years). Abnormal vision was associated with synechiae or cataract. CONCLUSION: Risk factors for developing uveitis were different among subtypes of JIA. The long-term outcome of JIA-associated uveitis in our cohort was excellent despite the high rate of complications. [ABSTRACT FROM AUTHOR]
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- 2007
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22. Risk of new-onset uveitis in patients with juvenile idiopathic arthritis treated with anti-TNFalpha agents.
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Saurenmann RK, Levin AV, Feldman BM, Laxer RM, Schneider R, and Silverman ED
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- 2006
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23. Leflunomide or methotrexate for juvenile rheumatoid arthritis.
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Silverman E, Mouy R, Spiegel L, Jung LK, Saurenmann RK, Lahdenne P, Horneff G, Calvo I, Szer IS, Simpson K, Stewart JA, Strand V, and Leflunomide in Juvenile Rheumatoid Arthritis Investigator Group
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- 2005
24. Uncovering the hidden socioeconomic impact of juvenile idiopathic arthritis and paving the way for other rare childhood diseases: an international, cross-disciplinary, patient-centered approach (PAVE Consortium).
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Marshall DA, Gerber B, Currie GR, Antón J, De Somer L, Dey M, Egert T, Egert Y, Henan L, Klotsche J, Mifsut LM, Minden K, Normand C, Porte D, Saurenmann RK, Swart JF, Uziel Y, Wilson J, Wouters C, Ziv A, and Benseler SM
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- Humans, Child, Cost of Illness, Europe, Arthritis, Juvenile economics, Patient-Centered Care economics, Rare Diseases economics
- Abstract
Background: Juvenile idiopathic arthritis (JIA) refers to a heterogeneous group of rheumatic conditions in children. Novel drugs have greatly improved disease outcomes; however, outcomes are impacted by limited awareness of the importance of early diagnosis and adequate treatment, and by differences in access across health systems. As a result, patients with JIA continue to be at risk for short- and long-term morbidity, as well as impacts on virtually all aspects of life of the child and family., Main Body: Literature on the socioeconomic burden of JIA is largely focused on healthcare costs, and the impact of JIA on patients, families, and communities is not well understood. High quality evidence on the impact of JIA is needed to ensure that patients are receiving necessary support, timely diagnostics, and adequate treatment, and to inform decision making and resource allocation. This commentary introduces the European Joint Programme on Rare Diseases: Producing an Arthritis Value Framework with Economic Evidence: Paving the Way for Rare Childhood Diseases (PAVE) project, which will co-develop a patient-informed value framework to measure the impact of JIA on individuals and on society. With a patient-centered approach, fundamental to PAVE is the involvement of three patient advocacy organizations from Canada, Israel, and Europe, as active research partners co-designing all project phases and ensuring robust patient and family engagement. The framework will build on the findings of projects from six countries: Canada, Germany, Switzerland, Spain, Israel, and Belgium, exploring costs, outcomes (health, well-being), and unmet needs (uveitis, mental health, equity)., Conclusion: This unique international collaboration will combine evidence on costs (from family to societal), outcomes (clinical, patient and family outcomes), and unmet needs, to co-design and build a framework with patients and families to capture the full impact of JIA. The framework will support the development of high-quality evidence, encompassing economic and clinical considerations, unmet needs, and patient perspectives, to inform equitable resource allocation, health system planning, and quality of care better aligned with the needs of children with JIA, their families, and communities. Knowledge gained from this novel approach may pave the way forward to be applied more broadly to other rare childhood diseases., (© 2024. The Author(s).)
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- 2024
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25. A practical approach to uveitis screening in children with juvenile idiopathic arthritis.
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Foeldvari I, Bohn M, Petrushkin H, Angeles Han S, Bangsgaard R, Calzada-Hernández J, Constantin T, de Boer JH, Díaz-Cascajosa J, Edelsten C, Glerup M, Ingels H, Kramer S, Miserocchi E, Nordal E, Saurenmann RK, Simonini G, Solebo AL, Titz J, and Anton J
- Abstract
Background: Juvenile idiopathic arthritis (JIA)-associated uveitis typically presents as a silent chronic anterior uveitis and can lead to blindness. Adherence to current screening guidelines is hampered by complex protocols which rely on the knowledge of specific JIA characteristics. The Multinational Interdisciplinary Working Group for Uveitis in Childhood identified the need to simplify screening to enable local eye care professionals (ECPs), who carry the main burden, to screen children with JIA appropriately and with confidence., Methods: A consensus meeting took place in January 2023 in Barcelona, Spain, with an expert panel of 10 paediatric rheumatologists and 5 ophthalmologists with expertise in paediatric uveitis. A summary of the current evidence for JIA screening was presented. A nominal group technique was used to reach consensus., Results: The need for a practical but safe approach that allows early uveitis detection was identified by the panel. Three screening recommendations were proposed and approved by the voting members. They represent a standardised approach to JIA screening taking into account the patient's age at the onset of JIA to determine the screening interval until adulthood., Conclusion: By removing the need for the knowledge of JIA categories, antinuclear antibody positivity or treatment status, the recommendations can be more easily implemented by local ECP, where limited information is available. It would improve the standard of care on the local level significantly. The proposed protocol is less tailored to the individual than the 'gold standard' ones it references and does not aim to substitute those where they are being used with confidence., Competing Interests: Competing interests: IF, MB and HP: no competing interest. SAH is supported by the National Institutes for Health (NIH) National Eye Institute under Award Numbers R01EY030521 and R01 EY034565. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the views or policies of the Department of Health and Human Services, nor does the mention of trade names, commercial products or organisations imply endorsement by the US government. RB, JC-H, TC, JHdB, JD-C, CE, MG, HI, SK, EM, EN, RKS, GS, ALS, JT and JA: no competing interest., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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26. New and Updated Recommendations for the Treatment of Juvenile Idiopathic Arthritis-Associated Uveitis and Idiopathic Chronic Anterior Uveitis.
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Foeldvari I, Maccora I, Petrushkin H, Rahman N, Anton J, de Boer J, Calzada-Hernández J, Carreras E, Diaz J, Edelsten C, Angeles-Han ST, Heiligenhaus A, Miserocchi E, Nielsen S, Saurenmann RK, Stuebiger N, Baquet-Walscheid K, Furst D, and Simonini G
- Subjects
- Child, Humans, Adolescent, Europe, Arthritis, Juvenile complications, Uveitis complications, Rheumatology, Uveitis, Anterior
- Abstract
Objective: The Multinational Interdisciplinary Working Group for Uveitis in Childhood identified the need to update the current guidelines, and the objective here was to produce this document to guide clinicians managing children with juvenile idiopathic arthritis-associated uveitis (JIAU) and idiopathic chronic anterior uveitis (CAU)., Methods: The group analyzed the literature published between December 2014 and June 2020 after a systematic literature review conducted by 2 clinicians. Pediatric rheumatologists were paired with ophthalmologists to review the eligible 37 publications. The search criteria were selected to reflect those used for the 2018 Single Hub and Access point for pediatric Rheumatology in Europe (SHARE) recommendations, in order to provide an update, rather than a replacement for that publication. The summary of the current evidence for each SHARE recommendation was presented to the expert committee. These recommendations were then discussed and revised during a video consensus meeting on January 22, 2021, with 14 voting participants, using a nominal group technique to reach consensus., Results: JIAU treatment was extended to include CAU. Fourteen recommendations regarding treatment of JIAU und CAU with >90% agreement were accepted., Conclusion: An update to the previous 2018 SHARE recommendations for the treatment of children with JIAU with the addition of CAU was created using an evidence-based consensus process. This guideline should help support clinicians to care for children and young people with CAU., (© 2022 American College of Rheumatology.)
- Published
- 2023
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27. Discrete Choice Experiment on a Magnetic Resonance Imaging Scoring System for Temporomandibular Joints in Juvenile Idiopathic Arthritis.
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Tolend M, Junhasavasdikul T, Cron RQ, Inarejos Clemente EJ, von Kalle T, Kellenberger CJ, Koos B, Miller E, van Rossum MA, Saurenmann RK, Spiegel L, Stimec J, Twilt M, Tzaribachev N, Abramowicz S, Appenzeller S, Arvidsson LZ, Guleria S, Jaremko JL, Kirkhus E, Larheim TA, Meyers AB, Panwar J, Resnick CM, Shelmerdine SC, Feldman BM, and Doria AS
- Subjects
- Humans, Arthritis, Juvenile diagnostic imaging, Magnetic Resonance Imaging, Severity of Illness Index, Temporomandibular Joint diagnostic imaging
- Abstract
Objective: To determine the relative importance weights of items and grades of a newly developed additive outcome measure called the juvenile idiopathic arthritis (JIA) magnetic resonance imaging (MRI) scoring system for the temporomandibular joint (TMJ) (JAMRIS-TMJ)., Methods: An adaptive partial-profile, discrete choice experiment (DCE) survey using the 1000Minds platform was independently completed by members of an expert group consisting of radiologists and non-radiologist clinicians to determine the group-averaged relative weights for the JAMRIS-TMJ. Subsequently, an image-based vignette ranking exercise was done, during which experts individually rank ordered 14 patient vignettes for disease severity while blinded to the weights and unrestricted to JAMRIS-TMJ assessment criteria. Validity of the weighted JAMRIS-TMJ was tested by comparing the consensus-graded, DCE-weighted JAMRIS-TMJ score of the vignettes with their unrestricted image-based ranks provided by the experts., Results: Nineteen experts completed the DCE survey, and 21 completed the vignette ranking exercise. Synovial thickening and joint enhancement showed higher weights per raw score compared to bone marrow items and effusion in the inflammatory domain, while erosions and condylar flattening showed nonlinear and higher weights compared to disk abnormalities in the damage domain. The weighted JAMRIS-TMJ score of the vignettes correlated highly with the ranks from the unrestricted comparison method, with median Spearman's ρ of 0.92 (interquartile range [IQR] 0.87-0.95) for the inflammation and 0.93 (IQR 0.90-0.94) for the damage domain., Conclusion: A DCE survey was used to quantify the importance weights of the items and grades of the JAMRIS-TMJ. The weighted score showed high convergent validity with an unrestricted, holistic vignette ranking method., (© 2021, American College of Rheumatology.)
- Published
- 2022
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28. Magnetic Resonance Imaging Followup of Temporomandibular Joint Inflammation, Deformation, and Mandibular Growth in Juvenile Idiopathic Arthritis Patients Receiving Systemic Treatment.
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Bollhalder A, Patcas R, Eichenberger M, Müller L, Schroeder-Kohler S, Saurenmann RK, and Kellenberger CJ
- Subjects
- Child, Female, Humans, Inflammation diagnostic imaging, Longitudinal Studies, Magnetic Resonance Imaging, Temporomandibular Joint diagnostic imaging, Arthritis, Juvenile diagnostic imaging, Arthritis, Juvenile drug therapy
- Abstract
Objective: To investigate the course of temporomandibular joint (TMJ) inflammation, osseous deformation, and mandibular ramus growth in children with juvenile idiopathic arthritis (JIA) during systemic therapy., Methods: Longitudinal study of 38 consecutive patients with JIA (29 female, median age 9.0 yrs, interquartile range 6.2-10.7 yrs) receiving systemic therapy with TMJ involvement, with 2 TMJ magnetic resonance imaging (MRI) examinations ≥ 2 years apart and no TMJ corticosteroid injection. Clinical and MRI findings were compared between initial and followup examinations and between TMJ with and without active inflammation at baseline., Results: Over a median period of 3.6 years (range, 2.0-8.7 yrs), MRI grade of TMJ inflammation improved (p = 0.009) and overall osseous deformity tended to become less severe (p = 0.114). In TMJ with arthritis at baseline (46 TMJ), both the grades of inflammation (p < 0.001) and deformity (p = 0.011) improved. In TMJ with no arthritis at baseline (30 TMJ), the frequency and grade of condylar deformation remained stable. Mandibular ramus growth rates were not significantly different between TMJ with and without arthritis at baseline (1.3 mm/yr vs 1.5 mm/yr, p = 0.273), and were not correlated with the degree of inflammation at baseline or followup. The frequency of facial asymmetry tended to be lower at followup than at initial examination (24% vs 45%, p = 0.056)., Conclusion: Our results suggest that systemic treatment of TMJ arthritis in children with JIA decreases the degree of inflammation seen on MRI, preserves osseous TMJ morphology, and maintains normal mandibular ramus growth.
- Published
- 2020
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29. Temporomandibular joint magnetic resonance imaging findings in adolescents with anterior disk displacement compared to those with juvenile idiopathic arthritis.
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Kellenberger CJ, Bucheli J, Schroeder-Kohler S, Saurenmann RK, Colombo V, and Ettlin DA
- Subjects
- Adolescent, Arthritis, Juvenile physiopathology, Female, Humans, Inflammation physiopathology, Male, Retrospective Studies, Temporomandibular Joint Disc pathology, Temporomandibular Joint Disorders physiopathology, Arthritis, Juvenile diagnostic imaging, Inflammation diagnostic imaging, Magnetic Resonance Imaging, Temporomandibular Joint Disc diagnostic imaging, Temporomandibular Joint Disorders diagnostic imaging
- Abstract
Background: Deformation of the mandibular condyle can be associated with anterior disk displacement (ADD) or involvement of the temporomandibular joint (TMJ) by juvenile idiopathic arthritis (JIA). Diagnostic differentiation is critical for proper management., Objectives: To compare morphology and inflammation between TMJs with ADD and JIA., Methods: Retrospective assessment of contrast-enhanced TMJ MRI in 18 adolescents (15 female, mean age 15.1 ± 1.9 years) with ADD and age- and gender-matched patients with JIA. Articular disk findings, inflammatory signs and osseous morphology were compared., Results: In the ADD group, 31 of 36 disks were displaced. In total, 28 of 31 displaced disks showed thickening of the bilaminar zone. In JIA patients, the disks were mainly flattened (19/36), centrally perforated (12/36) and/or anteriorly displaced (2/36). In total, 19 of 31 TMJs with ADD showed various degrees of inflammation, with joint effusion, synovial thickening and joint enhancement not significantly different from JIA patients. Osseous deformity was present in 27 of 31 TMJs with ADD, with frequent erosions in both groups (ADD 25/31; JIA 32/36, P = 0.55) but lower grades of condylar and temporal bone flattening than in JIA (P ≤ 0.001). Glenoid fossa depth was preserved in 28 of 31 joints with ADD and decreased in 26 of 36 joints with JIA (P < 0.0001). Mandibular ramus height was decreased in both groups., Conclusion: In adolescents, inflammatory signs are common MRI findings in symptomatic TMJs with ADD and thus should not be considered diagnostic for JIA involvement. In this cohort, both entities had high rates of condylar deformity, while TMJs with ADD showed a better-preserved and often normal shape of the glenoid fossa., (© 2018 John Wiley & Sons Ltd.)
- Published
- 2019
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30. Identification of an Amino Acid Motif in HLA-DRβ1 That Distinguishes Uveitis in Patients With Juvenile Idiopathic Arthritis.
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Haasnoot AJW, Schilham MW, Kamphuis S, Hissink Muller PCE, Heiligenhaus A, Foell D, Minden K, Ophoff RA, Radstake TRDJ, Den Hollander AI, Reinards THCM, Hiddingh S, Schalij-Delfos NE, Hoppenreijs EPAH, van Rossum MAJ, Wouters C, Saurenmann RK, van den Berg JM, Wulffraat NM, Ten Cate R, de Boer JH, Pulit SL, and Kuiper JJW
- Subjects
- Adolescent, Alleles, Child, Child, Preschool, Cohort Studies, Female, Genetic Association Studies, Genetic Loci, Genotype, Humans, Male, Odds Ratio, Amino Acid Motifs genetics, Arthritis, Juvenile genetics, Genetic Predisposition to Disease genetics, HLA-DRB1 Chains genetics, Uveitis genetics
- Abstract
Objective: Uveitis is a visually debilitating disorder that affects up to 30% of children with the most common forms of juvenile idiopathic arthritis (JIA). The disease mechanisms predisposing only a subgroup of children to uveitis are unknown. This study was undertaken to identify genetic susceptibility loci for uveitis in JIA, using a genome-wide association study in 522 children with JIA., Methods: Two cohorts of JIA patients with ophthalmologic follow-up data were genotyped. Data were then imputed using a genome-wide imputation reference panel, and an HLA-specific reference panel was used for imputing amino acids and HLA types in the major histocompatibility complex (MHC). After imputation, genome-wide and MHC-specific analyses were performed, and a reverse immunology approach was utilized to model antigen presentation at 13 common HLA-DRβ1 alleles., Results: Presence of the amino acid serine at position 11 (serine 11) in HLA-DRβ1 was associated with an increased risk of uveitis in JIA patients (odds ratio [OR] 2.60, P = 5.43 × 10
-10 ) and was specific to girls (Pfemales = 7.61 × 10-10 versus Pmales = 0.18). Serine 11 resides in the YST motif in the peptide-binding groove of HLA-DRβ1; all 3 amino acids in this motif are in perfect linkage disequilibrium and show identical association with disease. Quantitative prediction of binding affinity revealed that HLA-DRβ1 alleles with the YST motif could be distinguished on the basis of discernable peptide-binding preferences., Conclusion: These findings highlight a genetically distinct, sexually dimorphic feature of JIA with uveitis as compared to JIA without uveitis. The association could be indicative of the potential involvement of antigen presentation by HLA-DRβ1 in the development of uveitis in JIA. The results of this study may advance our progress toward improved treatments for, and possible prevention of, the sight-threatening complications of uveitis in children with JIA., (© 2018, American College of Rheumatology.)- Published
- 2018
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31. The Swiss French version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR).
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Hofer M, von Scheven-Gête A, Santos M, Quartier P, Wouters C, Vanoni F, Saurenmann RK, Consolaro A, Bovis F, and Ruperto N
- Subjects
- Adolescent, Age of Onset, Arthritis, Juvenile physiopathology, Arthritis, Juvenile psychology, Arthritis, Juvenile therapy, Case-Control Studies, Child, Child, Preschool, Cultural Characteristics, Female, Health Status, Humans, Male, Parents psychology, Patients psychology, Predictive Value of Tests, Prognosis, Psychometrics, Quality of Life, Reproducibility of Results, Switzerland, Translating, Arthritis, Juvenile diagnosis, Disability Evaluation, Patient Reported Outcome Measures, Rheumatology methods
- Abstract
The Juvenile Arthritis Multidimensional Assessment Report (JAMAR) is a new parent/patient reported outcome measure that enables a thorough assessment of the disease status in children with juvenile idiopathic arthritis (JIA). We report the results of the cross-cultural adaptation and validation of the parent and patient versions of the JAMAR in the Swiss French language. The reading comprehension of the questionnaire was tested in ten JIA parents and patients. Each participating centre was asked to collect demographic, clinical data, and the JAMAR in 100 consecutive JIA patients or all consecutive patients seen in a 6-month period and to administer the JAMAR to 100 healthy children and their parents. The statistical validation phase explored descriptive statistics and the psychometric issues of the JAMAR: the three Likert assumptions, floor/ceiling effects, internal consistency, Cronbach's alpha, interscale correlations, test-retest reliability, and construct validity (convergent and discriminant validity). A total of 98 JIA patients (3.1% systemic, 43.9% oligoarticular, 16.3% RF negative polyarthritis, 36.7% other categories), and 64 healthy children were enrolled in a paediatric rheumatology centre. The JAMAR components discriminated well healthy subjects from JIA patients. All JAMAR components revealed good psychometric performances. In conclusion, the Swiss French version of the JAMAR is a valid tool for the assessment of children with JIA and is suitable for use both in routine clinical practice and clinical research.
- Published
- 2018
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32. [Toxic Shock Syndrome caused by Fingertip Injury Management with semi-occlusive Dressing].
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Sproedt J, Jandali AR, Saurenmann RK, and Zucol F
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- Bandages, Humans, Finger Injuries therapy, Occlusive Dressings adverse effects, Shock, Septic etiology
- Abstract
Competing Interests: Interessenkonflikt: Die Autoren geben an, dass kein Interessenkonflikt besteht.
- Published
- 2017
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33. Parameters affecting length of stay in a pediatric emergency department: a retrospective observational study.
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Hofer KD and Saurenmann RK
- Subjects
- Adolescent, Child, Child, Preschool, Female, Gastroenteritis epidemiology, Hospitalization statistics & numerical data, Humans, Infant, Infant, Newborn, Logistic Models, Male, Quality of Health Care, Respiratory Tract Infections epidemiology, Retrospective Studies, Triage statistics & numerical data, Emergency Service, Hospital statistics & numerical data, Hospitals, Pediatric statistics & numerical data, Length of Stay statistics & numerical data
- Abstract
Prolonged emergency department (ED) length of stay (LOS) is used as a proxy for ED overcrowding and is associated with adverse outcomes of patients requiring therapy and reduced patient satisfaction. Our aim was to identify and quantify variables which affect ED-LOS. Patients admitted to the pediatric ED of a large regional Swiss hospital during a 1-year period were analyzed for LOS (in minutes). Predictor variables included patient-associated parameters (time of admission and discharge, ED occupancy, triage score, diagnosis, and demographic data) and external factors (weekday, time, and season). A total of 4885 visits were included in a multivariable logistic regression analysis. Median LOS was 124 min. The most important factors associated with prolonged LOS were physician referral (adjusted odds ratio [OR], 1.97; 95% confidence interval [CI], 1.47-2.62); morning admissions, especially before noon (OR, 1.92; 95% CI, 1.23-3.07); and gastrointestinal infections (OR, 1.38; 95% CI, 1.08-1.76). Upper airway infections (OR, 0.37; 95% CI, 0.27-0.49) and triage level 5 (OR, 0.18; 95% CI, 0.06-0.61) were inversely associated with ED-LOS. Together with ED occupancy, these factors did significantly contribute to log LOS in a stepwise backward multiple regression model (p < 0.001)., Conclusion: Several parameters are associated with prolonged ED-LOS. Notably, morning arrivals represent possible targets for strategies to reduce LOS. What is Known: • Prolonged length of stay (LOS) may affect care delivered to admitted patients in the emergency department (ED) and is well studied in the setting of adult patients with high acuity conditions. • Little is known about parameters which impact LOS in European pediatric EDs. What is New: • Several predictors of prolonged LOS could be identified in a European pediatric setting. • Our results indicate that prolonged LOS is associated with modifiable factors like morning and summer admission, which have the potential to be addressed by modification in staffing, infrastructure, and higher attention to faster processing.
- Published
- 2017
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34. Temporomandibular Joint Involvement in Association With Quality of Life, Disability, and High Disease Activity in Juvenile Idiopathic Arthritis.
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Frid P, Nordal E, Bovis F, Giancane G, Larheim TA, Rygg M, Pires Marafon D, De Angelis D, Palmisani E, Murray KJ, Oliveira S, Simonini G, Corona F, Davidson J, Foster H, Steenks MH, Flato B, Zulian F, Baildam E, Saurenmann RK, Lahdenne P, Ravelli A, Martini A, Pistorio A, and Ruperto N
- Subjects
- Adolescent, Arthritis, Juvenile physiopathology, Arthritis, Juvenile psychology, Case-Control Studies, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Infant, Logistic Models, Male, Odds Ratio, Randomized Controlled Trials as Topic, Temporomandibular Joint physiopathology, Temporomandibular Joint Disorders etiology, Temporomandibular Joint Disorders physiopathology, Arthritis, Juvenile complications, Disability Evaluation, Quality of Life, Severity of Illness Index, Temporomandibular Joint Disorders psychology
- Abstract
Objective: To evaluate the demographic, disease activity, disability, and health-related quality of life (HRQOL) differences between children with juvenile idiopathic arthritis (JIA) and their healthy peers, and between children with JIA with and without clinical temporomandibular joint (TMJ) involvement and its determinants., Methods: This study is based on a cross-sectional cohort of 3,343 children with JIA and 3,409 healthy peers, enrolled in the Pediatric Rheumatology International Trials Organisation HRQOL study or in the methotrexate trial. Potential determinants of TMJ involvement included demographic, disease activity, disability, and HRQOL measures selected through univariate and multivariable logistic regression., Results: Clinical TMJ involvement was observed in 387 of 3,343 children with JIA (11.6%). Children with TMJ involvement, compared to those without, more often had polyarticular disease course (95% versus 70%), higher Juvenile Arthritis Disease Activity Score (odds ratio [OR] 4.6), more disability, and lower HRQOL. Children with TMJ involvement experienced clearly more disability and lower HRQOL compared to their healthy peers. The multivariable analysis showed that cervical spine involvement (OR 4.6), disease duration >4.4 years (OR 2.8), and having more disability (Childhood Health Assessment Questionnaire Disability Index >0.625) (OR 1.6) were the most important determinants for TMJ involvement., Conclusion: Clinical TMJ involvement in JIA is associated with higher disease activity, higher disability, and impaired HRQOL. Our findings indicate the need for dedicated clinical and imaging evaluation of TMJ arthritis, especially in children with cervical spine involvement, polyarticular course, and longer disease duration., (© 2016, American College of Rheumatology.)
- Published
- 2017
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35. Prevalence of Anti-infliximab Antibodies and Their Associated Co-factors in Children with Refractory Arthritis and/or Uveitis: A Retrospective Longitudinal Cohort Study.
- Author
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Aeschlimann FA, Angst F, Hofer KD, Cannizzaro Schneider E, Schroeder-Kohler S, Lauener R, van der Kleij D, Rispens T, and Saurenmann RK
- Subjects
- Antirheumatic Agents therapeutic use, Arthritis, Juvenile blood, Arthritis, Juvenile drug therapy, Child, Child, Preschool, Female, Humans, Infant, Infliximab therapeutic use, Longitudinal Studies, Male, Retrospective Studies, Seroepidemiologic Studies, Uveitis blood, Uveitis drug therapy, Antibodies blood, Arthritis, Juvenile immunology, Infliximab immunology, Uveitis immunology
- Abstract
Objective: Infliximab (IFX) is a monoclonal tumor necrosis factor-α-inhibiting antibody used in children with refractory arthritis and uveitis. Immunogenicity is associated with a lack of clinical response and infusion reactions in adults; data on immunogenicity in children treated with IFX for rheumatic diseases are scarce. We aimed to describe the prevalence of anti-IFX antibodies and determine co-factors associated with anti-IFX antibodies in children with inflammatory rheumatic and ocular diseases., Methods: Consecutive children treated between August 2009 and August 2012 with IFX at our department were included. Blood samples were collected every 6 months before IFX infusion and tested for anti-IFX antibodies by radioimmunoassay. Patients' charts were retrospectively reviewed for clinical features and analyzed for associations with anti-IFX antibodies., Results: Anti-IFX antibodies occurred in 14/62 children (23%) and 32/253 blood samples (12.6%) after a mean treatment time of 1084 days (range 73-3498). Infusion reactions occurred in 10/62 (16%) children during the treatment period. With continuation of IFX, anti-IFX antibodies disappeared in 7/14 children. In the bivariate analysis, the occurrence of anti-IFX antibodies was associated with younger age at IFX treatment start (mean age 7.01 vs 9.88 yrs, p = 0.003) and infusion reactions (OR 15.0), while uveitis as treatment indication was protective against development of anti-IFX antibodies (OR 0.17), likely because of higher IFX doses. In the multivariate logistic regression, all 3 covariates remained highly significant., Conclusion: Anti-IFX antibodies occurred commonly at any time during IFX treatment. Anti-IFX antibodies were associated with younger age at IFX start, infusion reactions, and arthritis as treatment indication.
- Published
- 2017
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36. Clinical Orofacial Examination in Juvenile Idiopathic Arthritis: International Consensus-based Recommendations for Monitoring Patients in Clinical Practice and Research Studies.
- Author
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Stoustrup P, Twilt M, Spiegel L, Kristensen KD, Koos B, Pedersen TK, Küseler A, Cron RQ, Abramowicz S, Verna C, Peltomäki T, Alstergren P, Petty R, Ringold S, Nørholt SE, Saurenmann RK, and Herlin T
- Subjects
- Arthritis, Juvenile physiopathology, Humans, Physical Examination, Temporomandibular Joint Disorders complications, Temporomandibular Joint Disorders physiopathology, Arthritis, Juvenile complications, Temporomandibular Joint Disorders diagnosis
- Abstract
Objective: To develop international consensus-based recommendations for the orofacial examination of patients with juvenile idiopathic arthritis (JIA), for use in clinical practice and research., Methods: Using a sequential phased approach, a multidisciplinary task force developed and evaluated a set of recommendations for the orofacial examination of patients with JIA. Phase 1: A Delphi survey was conducted among 40 expert physicians and dentists with the aim of identifying and ranking the importance of items for inclusion. Phase 2: The task force developed consensus about the domains and items to be included in the recommendations. Phase 3: A systematic literature review was performed to assess the evidence supporting the consensus-based recommendations. Phase 4: An independent group of orofacial and JIA experts were invited to assess the content validity of the task force's recommendations., Results: Five recommendations were developed to assess the following 5 domains: medical history, orofacial symptoms, muscle and temporomandibular joint function, orofacial function, and dentofacial growth. After application of data search criteria, 56 articles were included in the systematic review. The level of evidence for the 5 recommendations was derived primarily from descriptive studies, such as cross-sectional and case-control studies., Conclusion: Five recommendations are proposed for the orofacial examination of patients with JIA to improve the clinical practice and aid standardized data collection for future studies. The task force has formulated a future research program based on the proposed recommendations.
- Published
- 2017
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37. Is early TMJ involvement in children with juvenile idiopathic arthritis clinically detectable? Clinical examination of the TMJ in comparison with contrast enhanced MRI in patients with juvenile idiopathic arthritis.
- Author
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Keller H, Müller LM, Markic G, Schraner T, Kellenberger CJ, and Saurenmann RK
- Subjects
- Adolescent, Arthritis, Juvenile pathology, Child, Child, Preschool, Female, Humans, Infant, Magnetic Resonance Imaging methods, Male, Physical Examination, Temporomandibular Joint pathology, Temporomandibular Joint Disorders etiology, Temporomandibular Joint Disorders pathology, Arthritis, Juvenile complications, Temporomandibular Joint Disorders diagnosis
- Abstract
Background: To test clinical findings associated with early temporomandibular joint (TMJ) arthritis in comparison to the current gold standard contrast enhanced magnetic resonance imaging (MRI) in children with juvenile idiopathic arthritis (JIA)., Methods: Seventy-six consecutive JIA patients were included in this study. Rheumatological and orthodontic examinations were performed blinded to MRI findings. Joint effusion and/or increased contrast enhancement of synovium or bone as well as TMJ deformity were assessed on MRI and compared to clinical findings. The maximal mouth opening capacity (MOC) of the JIA patients was compared to normative values obtained from a cohort of 20719 school children from Zürich, Switzerland., Results: On MRI a total of 54/76 (71%) patients and 92/152 (61%) joints had signs of TMJ involvement. MRI showed enhancement in 85/152 (56%) and deformity in 39/152 (26%) joints. MOC, asymmetry and restriction in condylar translation showed significant correlation to TMJ enhancement and deformity, whereas antegonial notching was correlated with TMJ deformity only. When joints with deformity were excluded, enhancement alone did not show a significant correlation with any clinical factor., Conclusions: Clinical findings in affected TMJs are correlated with structural damage only. Therefore clinical assessment of TMJs does not allow to diagnose early arthritis accurately and will still depend on contrast enhanced MRI.
- Published
- 2015
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38. CD226 (DNAM-1) is associated with susceptibility to juvenile idiopathic arthritis.
- Author
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Reinards TH, Albers HM, Brinkman DM, Kamphuis SS, van Rossum MA, Girschick HJ, Wouters C, Hoppenreijs EP, Saurenmann RK, Hinks A, Ellis JA, Bakker E, Verduijn W, Slagboom P, Huizinga TW, Toes RE, Houwing-Duistermaat JJ, ten Cate R, and Schilham MW
- Subjects
- Antigens, Differentiation, T-Lymphocyte metabolism, Arthritis, Juvenile metabolism, Female, Genetic Association Studies, Genotype, Humans, Male, Middle Aged, Antigens, Differentiation, T-Lymphocyte genetics, Arthritis, Juvenile genetics, DNA genetics, Genetic Predisposition to Disease, Polymorphism, Genetic
- Abstract
Objectives: Juvenile idiopathic arthritis (JIA) is considered a complex genetic autoimmune disease. We investigated the association of genetic variants previously implicated in JIA, autoimmunity and/or immunoregulation, with susceptibility to JIA., Methods: A genetic association study was performed in 639 JIA patients and 1613 healthy controls of northwest European descent. Ninety-three single nucleotide polymorphisms (SNP) were genotyped in a candidate gene approach. Results of the entire JIA patient group (all subtypes) were compared with results obtained, alternatively, with a clinically homogeneous patient group including only oligoarticular and rheumatoid factor (RF) negative polyarticular JIA patients (n=493). Meta-analyses were performed for all SNPs that have been typed in other Caucasian JIA cohorts before., Results: SNPs in or near PTPN22, VTCN1, the IL2-IL21 region, ANKRD55 and TNFA were confirmed to be associated with JIA (p<0.05), strengthening the evidence for involvement of these genes in JIA. In the majority of these replicated SNPs, effect sizes were larger when analysing a homogeneous patient cohort than when analysing all subtypes. We identified two novel associations with oligoarticular and RF-negative polyarticular JIA: CD226 rs763361 (OR 1.30, 95% CI 1.12 to 1.51, p=0.0006) and CD28 rs1980422 (OR 1.29, 95% CI 1.07 to 1.55, p=0.008). Meta-analyses including reported studies confirmed the association of both SNPs with susceptibility to JIA (OR 1.16, p=0.001 and OR 1.18, p=0.001, for rs763361 and rs1980422, respectively)., Conclusions: The CD226 gene has been identified as novel association with JIA, and a SNP near CD28 as a suggestive association. Both genes are probable candidate risk factors, since they are involved in costimulation of T cells., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)
- Published
- 2015
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39. Assessing Arthritis in the Temporomandibular Joint.
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Saurenmann RK and Kellenberger CJ
- Subjects
- Female, Humans, Male, Arthritis, Juvenile epidemiology, Infliximab administration & dosage, Temporomandibular Joint Disorders drug therapy, Temporomandibular Joint Disorders epidemiology
- Published
- 2015
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40. Contrast-enhanced MRI of the temporomandibular joint: findings in children without juvenile idiopathic arthritis.
- Author
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Kottke R, Saurenmann RK, Schneider MM, Müller L, Grotzer MA, and Kellenberger CJ
- Subjects
- Adolescent, Arthritis, Juvenile pathology, Child, Child, Preschool, Contrast Media, Female, Gadolinium, Gadolinium DTPA, Heterocyclic Compounds, Humans, Image Interpretation, Computer-Assisted, Infant, Male, Organometallic Compounds, Temporomandibular Joint pathology, Magnetic Resonance Imaging methods, Temporomandibular Joint anatomy & histology
- Abstract
Background: Contrast-enhanced magnetic resonance imaging (MRI) is highly sensitive for assessing temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA), but only sparse data exist on normal TMJ appearance in children., Purpose: To determine normal MRI appearance and enhancement pattern of pediatric TMJ as basis for diagnosing early arthritis., Material and Methods: In 27 children (age range, 1.2-16.8 years) without TMJ pathology undergoing head MRI, fat-saturated T2-weighted (T2W) and postcontrast fat-saturated T1-weighted (T1W) images sagittally aligned to the 54 TMJs, besides standard T1W and T2W images, were assessed for bony and soft tissue signal intensity (SI), the amount of perceptible joint fluid, and contrast enhancement (CE)., Results: Bone marrow SI and CE of the mandible were consistent with varying degrees of residual red marrow in 96% of joints. The mandibular condyles were mostly isointense to the ramus, but in 9% showed mild edema-like bone marrow SI and CE. Small amounts of intraarticular fluid were detected in 31% on T2W images without fat saturation and in 83% on T2W images with fat saturation as fine lines in the upper or lower joint compartment or as small dots in an articular recess. Seventy-nine percent of all TMJs showed intense joint enhancement on early images restricted to areas of intraarticular fluid., Conclusion: Small amounts of joint fluid with intense CE are a common MRI finding in TMJs of children without JIA and therefore should not be considered diagnostic for early arthritis., (© The Foundation Acta Radiologica 2014.)
- Published
- 2015
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41. Magnetic Resonance Imaging Assessment of Temporomandibular Joint Involvement and Mandibular Growth Following Corticosteroid Injection in Juvenile Idiopathic Arthritis.
- Author
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Lochbühler N, Saurenmann RK, Müller L, and Kellenberger CJ
- Subjects
- Arthritis, Juvenile pathology, Child, Child, Preschool, Female, Humans, Injections, Intra-Articular, Magnetic Resonance Imaging, Male, Retrospective Studies, Adrenal Cortex Hormones therapeutic use, Arthritis, Juvenile drug therapy, Mandibular Condyle growth & development, Temporomandibular Joint pathology
- Abstract
Objective: To assess whether intraarticular corticosteroid injection (CSI) reduces inflammation of the temporomandibular joint (TMJ), prevents growth disturbances of the mandibular condyle, and restores normal growth of the mandibular ramus., Methods: Retrospective longitudinal magnetic resonance imaging (MRI) evaluation of inflammatory activity, TMJ deformity, and mandibular ramus height in 33 children (23 girls, median age 5.2 yrs) over a median period of 5 years following repetitive CSI to the TMJ., Results: Intraarticular location of CSI led to inflammatory grade improvement in 53% at first MRI followup compared to 20% with extraarticular location (p = 0.005), with more improvement of the mean inflammatory grade after intraarticular CSI (p = 0.001). Rate of osseous deformities of the TMJ deteriorated from 51% at study inclusion to 62% at end of observation period, with progression to severe condylar destruction in 26% of joints including 24% with development of intraarticular calcifications/ossifications. Mean short-term growth rates of the mandibular ramus were negative for intraarticular CSI while positive for extraarticular CSI (p = 0.036). Mean longterm mandibular ramus growth rate (0.7 ± 0.8 mm/yr) after CSI was significantly lower than reported normal mean age- and sex-matched growth rate (1.4 ± 0.1 mm/yr, p < 0.0001)., Conclusion: Despite improving the inflammatory activity as seen on MRI, repetitive CSI to the TMJ does not reach the treatment goals to prevent progressive osseous deformation and to normalize mandibular ramus growth in children with juvenile idiopathic arthritis.
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- 2015
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42. Infliximab in pediatric rheumatology patients: a retrospective analysis of infusion reactions and severe adverse events during 2246 infusions over 12 years.
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Aeschlimann FA, Hofer KD, Cannizzaro Schneider E, Schroeder S, Lauener R, and Saurenmann RK
- Subjects
- Adolescent, Antibodies, Monoclonal therapeutic use, Antirheumatic Agents therapeutic use, Child, Child, Preschool, Dyspnea chemically induced, Exanthema chemically induced, Female, Humans, Infliximab, Infusions, Intravenous adverse effects, Nausea chemically induced, Respiratory Sounds, Retrospective Studies, Urticaria chemically induced, Antibodies, Monoclonal adverse effects, Antirheumatic Agents adverse effects, Arthritis drug therapy, Uveitis drug therapy
- Abstract
Objective: To describe infusion reactions (IR) and severe adverse events (SAE) associated with infliximab (IFX) in pediatric patients with rheumatologic and ocular inflammatory diseases in a real-world setting., Methods: This is a retrospective chart review of all patients treated with IFX at the pediatric rheumatology division of a university hospital between October 2000 and December 2012., Results: A total of 2446 IFX infusions were given to 82 patients (72% female). IR occurred in 46 infusions (2%) of 14 patients (17%) after a mean IFX treatment time of 340 days (range 41-780); 9/14 patients (64%) experienced repeated IR. IR were classified as mild (26%), moderate (74%), or severe (0%). Indications for IFX were arthritis (60%), uveitis (20%), arthritis and uveitis (13%), and other inflammatory diseases (5%). The most common clinical symptoms were respiratory signs (72%), cutaneous manifestations (69%), and malaise (61%). In 6/14 patients (43%) with IR, IFX was discontinued: 4 patients because of repeated IR and 2 patients wished to stop treatment immediately following a mild IR. The other 8/14 patients (57%) received premedication with high-dose antihistamine (100%), corticosteroids (75%), and IFX dose increase (75%) and continued IFX treatment for a mean followup period of 146 weeks (range 26-537) after the first IR. We observed severe infections in 5/82 patients (6%); other SAE were rare., Conclusion: Mild and moderate IR occurred in 17% of our patients. Treatment with antihistamines and methylprednisolone, and increasing the IFX dose, allowed continued treatment despite IR in > 50% of patients. Other SAE were infrequent.
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- 2014
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43. Genetic variation in VTCN1 (B7-H4) is associated with course of disease in juvenile idiopathic arthritis.
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Albers HM, Reinards TH, Brinkman DM, Kamphuis SS, van Rossum MA, Hoppenreijs EP, Girschick HJ, Wouters C, Saurenmann RK, Bakker E, Verduijn W, Slagboom P, Huizinga TW, Toes RE, Houwing-Duistermaat JJ, ten Cate R, and Schilham MW
- Subjects
- Adolescent, Arthritis, Juvenile physiopathology, Child, Child, Preschool, Cohort Studies, Disease Progression, Female, Humans, Infant, Logistic Models, Male, Multivariate Analysis, Polymorphism, Single Nucleotide, Arthritis, Juvenile genetics, Cyclin-Dependent Kinase 6 genetics, V-Set Domain-Containing T-Cell Activation Inhibitor 1 genetics
- Abstract
Objective: The course of disease in juvenile idiopathic arthritis (JIA) is unpredictable with episodes of activity and remission. In order to identify predictive factors, 93 SNPs, JIA subtype, age at onset and ANA status were studied in relation to disease course., Methods: Genetic and clinical parameters were analysed in a cohort of 272 Caucasian patients with persistent oligoarthritis (n=129), extended oligoarthritis (n=57) and rheumatoid factor negative polyarthritis (n=86). Categories of disease course (remitting (n=65), intermediate (n=96) and unremitting (n=111)) were designed based on the cumulative time spent in active disease in the first 2 years., Results: Univariate analysis revealed association of the course of disease with JIA subtype (p=5.7*10(-5)) and three SNPs; VTCN1 rs10 923 223 (p=4.4*10(-5)), VTCN1 rs12 046 117 (p=0.017) and CDK6 rs42 041 (p=0.038). In a subsequent multivariate ordinal logistic regression analysis, VTCN1 rs10 923 223 (OR 0.41, 95%-CI 0.26 to 0.63) and JIA subtype (OR 3.8, 95%-CI 2.0 to 7.2; OR 2.5, 95%-CI 1.4 to 4.2, for extended oligoarthritis and RF-negative polyarthritis vs persistent oligoarthritis, respectively) were the strongest independent factors for course of disease., Conclusions: This study provides evidence that VTCN1, encoding B7-H4, is associated with course of disease in selected subtypes of JIA. VTCN1 might be useful in predicting the course of disease.
- Published
- 2014
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44. [Back pain in children and adolescents].
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Saurenmann RK
- Subjects
- Adolescent, Child, Child, Preschool, Diagnosis, Differential, Diagnostic Imaging methods, Female, Humans, Male, Physical Examination methods, Back Pain diagnosis, Back Pain etiology, Spinal Cord Diseases diagnosis, Spinal Cord Diseases etiology, Spinal Diseases complications, Spinal Diseases diagnosis
- Abstract
The differential diagnosis of back pain in children and adolescents is wide. The prevalence of low back pain is increasing with age and after puberty is similar to what is known from the adult population, but in smaller children a structural cause for the pain is more common. Careful history taking and physical examination will help with the decision of when to perform further investigations. This article lists the most common differential diagnoses of back pain in children.
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- 2013
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45. Maximal mouth opening capacity: percentiles for healthy children 4-17 years of age.
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Müller L, van Waes H, Langerweger C, Molinari L, and Saurenmann RK
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Background: A reduced mouth opening capacity may be one of the first clinical signs of pathological changes in the masticatory system. The aim of this retrospective cross-sectional study was to create age related percentiles for unassisted maximal mouth opening capacity (MOC) of healthy children., Methods: All recordings of MOC as measured at the yearly dental examinations of school children in the city of Zurich, Switzerland, between August 2009 and August 2010 were extracted from the database. The program LMSchartMaker Pro Version 2.43, Huiqi Pan and Tim Cole, Medical Research Council, 1997-2010 was used to calculate age and sex related reference centiles., Results: Records from 22(')060 dental examinations were found during the study period. In 1286 (5.8%) the maximal interincisal measurement was missing. Another 55 examinations were excluded because of missing data for sex (7), age at examination (11) or because the value was deemed to be pathologically low (37). Thus, a total of 20(')719 measurements (10(')060 girls, 10(')659 boys) were included in the analysis. The median age (range) was 9.9 years (3.3-18.3) for girls and 10.0 years (2.8-18.7) for boys. The mean MOC (range) was 45 mm (25-69) for girls and 45 mm (25-70) for boys. Age related percentiles were created for girls and boys separately, showing the 3(rd), 10(th), 25(th), 50(th), 75(th), 90(th), and 97(th) percentile from 3 through 18 years of age., Conclusions: In these 20(')719 unselected school children MOC increased with age but showed a wide range within children of the same age.
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- 2013
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46. Juvenile Psoriatic Arthritis (JPsA): juvenile arthritis with psoriasis?
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Butbul Aviel Y, Tyrrell P, Schneider R, Dhillon S, Feldman BM, Laxer R, Saurenmann RK, Spiegel L, Cameron B, Tse SM, and Silverman E
- Abstract
Background: Following the introduction of the ILAR criteria for juvenile idiopathic arthritis, juvenile psoriatic arthritis (JPsA) has become a better recognized category within the inflammatory arthritides of childhood. There are fewer reports describing the characteristics and long-term outcome of patients with JPsA than other subtypes of JIA.The aim of our study was to determine the long-term outcome and clinical course of patients with juvenile psoriatic arthritis (JPsA) and to define subgroups of JPsA., Methods: Clinical records of all patients meeting criteria for JPsA were reviewed and divided into 4 groups depending on their clinical features and onset type. Patient characteristics and clinical features at onset and during follow-up were determined., Results: The cohort consisted of 119 patients: 65 with oligoarticular-onset (55%; persistent 44 and extended 21), 34 (29%) with RF(-) and 4 (3%) RF(+) polyarticular and 16 (13%) enthesitis-related arthritis (ERA). At diagnosis patients with ERA were oldest and more commonly male (p=0.001 and =0.01 respectively). Patients with a polyarticular course had more involvement of small joints of the hands and wrist when compared to patients with persistent oligoarticular and ERA (p<0.001) while patients with ERA had more hip and sacroiliac arthritis (p<0.001 for both). Nail changes were seen in 66 patients (57%) and were associated with DIP involvement (p=0.0034)., Outcome: Time to first inactive disease on, but not off, therapy was significantly longer among patients with polyarticular course when compared to oligoarticular and ERA (p=0.016 and p=0.48 respectively). Patients with polyarticular course more frequently had contractures during follow-up than other groups (p=0.01)., Conclusion: The long-term outcome of with JPsA was generally good. Patients with JPsA did not appear to form distinct sub-group of patients but rather resembled JIA patients with onset types without psoriasis.
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- 2013
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47. A 12-year-old girl with absent radial pulse: arterial thoracic outlet syndrome with subclavian artery aneurysm and thrombosis of the brachial artery.
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Schroeder S, Cannizzaro E, Kellenberger CJ, and Saurenmann RK
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- Aneurysm diagnostic imaging, Child, Female, Humans, Pulse, Radiography, Raynaud Disease etiology, Ribs abnormalities, Thoracic Outlet Syndrome complications, Thrombosis diagnostic imaging, Aneurysm etiology, Brachial Artery diagnostic imaging, Subclavian Artery diagnostic imaging, Thoracic Outlet Syndrome diagnosis, Thrombosis etiology
- Abstract
Brachial arterial occlusion is rare in children and adolescents. Once a traumatic cause is excluded, the differential diagnosis consists of a variety of rare conditions. We report the case of a 12-year-old girl whose presenting symptoms--an absent radial pulse and Raynaud's phenomenon of the right hand--could be easily mistaken for a vasculitis. She was found to have arterial thoracic outlet syndrome with right subclavian artery compression and aneurysm formation caused by an anomalous first rib and consecutive thromboembolic occlusion of the brachial artery. The diagnosis and differential diagnosis of this condition are reviewed.
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- 2012
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48. Proposed outcome measures for prospective clinical trials in juvenile idiopathic arthritis-associated uveitis: a consensus effort from the multinational interdisciplinary working group for uveitis in childhood.
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Heiligenhaus A, Foeldvari I, Edelsten C, Smith JR, Saurenmann RK, Bodaghi B, de Boer J, Graham E, Anton J, Kotaniemi K, Mackensen F, Minden K, Nielsen S, Rabinovich EC, Ramanan AV, and Strand V
- Subjects
- Age Factors, Consensus, Cooperative Behavior, Delphi Technique, Endpoint Determination, Humans, Interdisciplinary Communication, International Cooperation, Longitudinal Studies, Predictive Value of Tests, Prospective Studies, Reproducibility of Results, Severity of Illness Index, Treatment Outcome, Uveitis diagnosis, Uveitis etiology, Arthritis, Juvenile complications, Randomized Controlled Trials as Topic standards, Uveitis therapy
- Abstract
Objective: To develop a set of core outcome measures for use in randomized controlled trials (RCTs) and longitudinal observational studies in juvenile idiopathic arthritis (JIA)-associated uveitis., Methods: The literature relating to outcome measures used in studies of uveitis in childhood and adolescence was reviewed. A set of core outcomes and domains was established using the Delphi process. This was reviewed by a representative multinational interdisciplinary working group. Nominal group technique consensus was reached on face and content validity of the range and content of the domains. The outcomes and the appropriate instruments for uveitis trials were adapted to the age ranges of patients with JIA-associated uveitis., Results: Consensus was reached that data should be reported at defined time points in longitudinal studies with patients stratified by prognostic markers. Visual acuity testing should be age appropriate. The severity of uveitis (measured as anterior chamber cell grade) and duration of active inflammation should be documented. Visually significant structural complications should be recorded and quantified with standard measures. The responses to treatment and corticosteroid-sparing effects of treatment should be documented. Patient-reported disease activity and age-specific uveitis-related quality of life should be reported using appropriate questionnaires., Conclusion: The proposed outcome measures in JIA-associated uveitis should aid in the standardization and comparison of future RCTs of the treatment regimens for this disease. The proposed outcome measures will be verified in a prospective validation study., (Copyright © 2012 by the American College of Rheumatology.)
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- 2012
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49. Cataract and juvenile arthritis.
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Sabri K, Saurenmann RK, Silverman ED, and Levin AV
- Subjects
- Female, Humans, Male, Arthritis, Juvenile drug therapy, Cataract chemically induced, Glucocorticoids adverse effects, Lens, Crystalline drug effects, Uveitis, Anterior drug therapy
- Published
- 2011
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50. Temporomandibular joint involvement in children with juvenile idiopathic arthritis.
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Cannizzaro E, Schroeder S, Müller LM, Kellenberger CJ, and Saurenmann RK
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- Adolescent, Arthritis, Juvenile pathology, Child, Child, Preschool, Female, Humans, Infant, Magnetic Resonance Imaging, Male, Retrospective Studies, Temporomandibular Joint Disorders pathology, Arthritis, Juvenile complications, Temporomandibular Joint pathology, Temporomandibular Joint Disorders etiology
- Abstract
Objective: To determine the rate of temporomandibular joint (TMJ) involvement and find factors associated with TMJ arthritis in a single-center cohort of patients with juvenile idiopathic arthritis (JIA)., Methods: Retrospective analysis of all patients with JIA visiting the rheumatology clinic between January 1, 2005, and December 31, 2006. Followup information was included until August 2008. A diagnosis of TMJ arthritis was based on clinical rheumatological and/or radiological findings., Results: After a mean followup time for JIA of 4.6 years (range 0.08-14.17), 86/223 patients (38.6%) had developed TMJ arthritis. The rate of TMJ involvement differed significantly among JIA subtypes (p = 0.0016), with 61% in extended oligoarticular, 52% in polyarticular rheumatoid factor (RF)-negative, 50% in psoriatic, 36% in systemic, 33% in polyarticular RF-positive, 33% in persistent oligoarticular, 30% in unclassified JIA, and 11% in enthesitis-related arthritis. The rate of TMJ involvement in our cohort was statistically significantly lower for patients who were HLA-B27-positive (p = 0.0002). In a multivariate analysis, the association of the following factors was confirmed: JIA subtype (p = 0.0001), a higher erythrocyte sedimentation rate (ESR) at diagnosis (p = 0.0038), involvement of joints of the upper extremity (p = 0.011), the absence of HLA-B27 (p = 0.023), and younger age at onset of JIA (p = 0.050)., Conclusion: In our cohort of children with JIA, the overall rate of TMJ involvement was 38.6%. Patients with certain JIA subtypes, a higher ESR at disease onset, involvement of upper extremity joints, and younger age at diagnosis were more likely to develop TMJ arthritis. The presence of HLA-B27 seemed to be protective.
- Published
- 2011
- Full Text
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