Persistent association of nailfold capillaroscopy changes and skin involvement over thirty-six months with duration of untreated disease in patients with juvenile dermatomyositis.

Détails

ID Serval
serval:BIB_CBB1DF1F2285
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Persistent association of nailfold capillaroscopy changes and skin involvement over thirty-six months with duration of untreated disease in patients with juvenile dermatomyositis.
Périodique
Arthritis and Rheumatism
Auteur(s)
Christen-Zaech S., Seshadri R., Sundberg J., Paller A.S., Pachman L.M.
ISSN
0004-3591
Statut éditorial
Publié
Date de publication
2008
Peer-reviewed
Oui
Volume
58
Numéro
2
Pages
571-576
Langue
anglais
Résumé
OBJECTIVE: To determine the association of changes on nailfold capillaroscopy with clinical findings and genotype in children with juvenile dermatomyositis (DM), in order to identify potential differences in disease course over 36 months. METHODS: At diagnosis of juvenile DM in 61 children prior to the initiation of treatment, tumor necrosis factor alpha (TNFalpha) -308 allele and DQA1*0501 status was determined, juvenile DM Disease Activity Scores (DAS) were obtained, and nailfold capillaroscopy was performed. The disease course was monitored for 36 months. Variations within and between patients were assessed by regression analysis. RESULTS: At diagnosis, shorter duration of untreated disease (P = 0.05) and a lower juvenile DM skin DAS (P = 0.035) were associated with a unicyclic disease course. Over 36 months, end-row loop (ERL) regeneration was associated with lower skin DAS (P < 0.001) but not muscle DAS (P = 0.98); ERL regeneration and decreased bushy loops were associated with a shorter duration of untreated disease (P = 0.04 for both). At 36 months, increased ERL regeneration (P = 0.007) and improvement of skin DAS (P < 0.001) and muscle DAS (P = 0.025) were associated with a unicyclic disease course. CONCLUSION: Early treatment of juvenile DM may lead to a unicyclic disease course. The non-unicyclic disease course usually involves continuing skin manifestations with persistent nailfold capillaroscopy changes. The correlation of nailfold capillaroscopy results with cutaneous but not with musculoskeletal signs of juvenile DM over a 36-month period suggests that the cutaneous and muscle vasculopathies have different pathophysiologic mechanisms. These findings indicate that efforts to identify the optimal treatment of cutaneous features in juvenile DM require greater attention.
Mots-clé
Adolescent, Capillaries, Child, Child, Preschool, Dermatomyositis, Disease Progression, Female, Genotype, HLA-DQ Antigens, Humans, Infant, Male, Nails, Predictive Value of Tests, Regional Blood Flow, Skin, Tumor Necrosis Factor-alpha
Pubmed
Web of science
Open Access
Oui
Création de la notice
16/02/2009 12:15
Dernière modification de la notice
09/05/2019 1:18
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