TY - JOUR
T1 - Duration of illness is an important variable for untreated children with juvenile dermatomyositis
AU - Pachman, Lauren M.
AU - Abbott, Kathy
AU - Sinacore, James M.
AU - Amoruso, Lisa
AU - Dyer, Alan
AU - Lipton, Rebecca
AU - Ilowite, Norman
AU - Hom, Christine
AU - Cawkwell, Gail
AU - White, Andrew
AU - Rivas-Chacon, Rafael
AU - Kimura, Yukiko
AU - Ray, Linda
AU - Ramsey-Goldman, Rosalind
PY - 2006/2
Y1 - 2006/2
N2 - Objective: To evaluate the impact of duration of untreated symptoms in children with juvenile dermatomyositis (JDM) on clinical and laboratory status at diagnosis. Study design: We examined physical and laboratory data from the first physician visit for 166 untreated children with JDM. Disease activity scores (DASs) assessed skin and muscle involvement. Height and weight were compared with the National Health and Nutrition Examination Survey III dataset. Duration of untreated illness was designated as the time from first sign of rash or weakness to diagnostic visit. Results: Boys and girls with untreated JDM were shorter and lighter than national norms (P > .0005 for both), and nonwhite children were weaker than white children (P > .0005). Older children had more dysphagia (P = .017) and arthritis (P > .001). Duration of untreated JDM was negatively associated with DAS weakness (P > .0005), unrelated to DAS skin, and positively associated with pathological calcifications (P = .006). With untreated disease < 4.7 months, serum levels of 4 muscle enzymes (aldolase, lactic dehydrogenase, creatine kinase, serum glutamic-oxaloacetic transaminase/aspartate aminotransferase) tended toward normal (P > .01 for each). Conclusions: Duration of untreated symptoms is an important variable and should be included in decisions concerning both diagnostic criteria and intensity of therapy for children with JDM.
AB - Objective: To evaluate the impact of duration of untreated symptoms in children with juvenile dermatomyositis (JDM) on clinical and laboratory status at diagnosis. Study design: We examined physical and laboratory data from the first physician visit for 166 untreated children with JDM. Disease activity scores (DASs) assessed skin and muscle involvement. Height and weight were compared with the National Health and Nutrition Examination Survey III dataset. Duration of untreated illness was designated as the time from first sign of rash or weakness to diagnostic visit. Results: Boys and girls with untreated JDM were shorter and lighter than national norms (P > .0005 for both), and nonwhite children were weaker than white children (P > .0005). Older children had more dysphagia (P = .017) and arthritis (P > .001). Duration of untreated JDM was negatively associated with DAS weakness (P > .0005), unrelated to DAS skin, and positively associated with pathological calcifications (P = .006). With untreated disease < 4.7 months, serum levels of 4 muscle enzymes (aldolase, lactic dehydrogenase, creatine kinase, serum glutamic-oxaloacetic transaminase/aspartate aminotransferase) tended toward normal (P > .01 for each). Conclusions: Duration of untreated symptoms is an important variable and should be included in decisions concerning both diagnostic criteria and intensity of therapy for children with JDM.
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U2 - 10.1016/j.jpeds.2005.10.032
DO - 10.1016/j.jpeds.2005.10.032
M3 - Article
C2 - 16492437
AN - SCOPUS:33344455589
SN - 0022-3476
VL - 148
SP - 247
EP - 253
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 2
ER -