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Biomedical subjects

L Aramini

Publications and source records attributed to L Aramini.

4 recordsLinked to original sources

Frequency of relapse after discontinuation of methotrexate therapy for clinical remission in juvenile rheumatoid arthritis.

OBJECTIVE: To investigate the outcome of children with juvenile rheumatoid arthritis (JRA) who discontinued taking methotrexate (MTX) therapy after the achievement of clinical remission. METHODS: We conducted a retrospective review of the clinical course of all consecutive patients with JRA treated with MTX at our department. RESULTS: Seventeen of the 30 patients who responded to treatment entered clinical remission 6 to 30 mo after beginning MTX therapy. All patients were discontinued from MTX within 2 to 5 mo. Five patients relapsed within 9 mo, whereas 12 patients had sustained remission for 12 mo or longer. Four of 5 children with extended pauciarticular JRA relapsed early after MTX discontinuation. These patients were less responsive to a further cycle of MTX, and 3 showed progression of radiographic joint lesions. CONCLUSION: These findings suggest that MTX should be continued in patients with extended pauciarticular JRA even after the achievement of clinical remission.

Adolescent↗

Correlation of serum neopterin concentrations with disease activity in juvenile dermatomyositis.

Serum neopterin concentrations were measured in 15 patients with juvenile dermatomyositis and their correlation with the severity of muscle impairment was evaluated. Neopterin concentrations were measured by radioimmunoassay. When compared with controls (median 0.75 ng/ml; range 0.33-1.18), serum neopterin concentrations were increased in patients with active juvenile dermatomyositis (median 3.21 ng/ml; range 0.95-13.81), but not in patients during remission (median 0.81 ng/ml; range 0.55-1.34). In horizontal and longitudinal studies, serum neopterin was significantly correlated with the severity of muscle strength impairment, whereas serum muscle enzyme values were not. These data suggest that measurement of serum neopterin may be used, together with clinical examination, to guide the treatment of patients with juvenile dermatomyositis.

Adolescent↗

Frequency and complications of chronic iridocyclitis in ANA-positive pauciarticular juvenile chronic arthritis.

Chronic iridocyclitis (CI) is among the most important extra-articular manifestations of juvenile chronic arthritis (JCA) and is most often observed in young girls with pauciarticular JCA and circulating antinuclear antibodies (ANAs). The frequency of CI found in 39 children with ANA-positive pauciarticular JCA was 56%. None of the patients developed ocular complications during follow-up. We think that this favourable outcome was primarily due to the early diagnosis and to our choice of using atropine as a mydriatic agent and to prolong atropine, after having spaced its administration further apart, up to one year or longer after the remission of ocular manifestations.

Administration, Topical↗

[Juvenile dermatomyositis].

Juvenile dermatomyositis (JDM) is a chronic multisystem inflammatory disease that primarily involves skin and muscles. The clinical picture is mainly characterized by the typical cutaneous rash and by skeletal muscle weakness. Nevertheless the vasculitic process may extend in some cases to other organs such as lung, joints or gastrointestinal system. Calcinosis represents a relatively frequent complication of JDM and occurs in most cases during the late stage of the disease. Usually serum levels of muscle enzymes are elevated and electromyography shows signs of myositis. Muscle biopsy is generally performed only in doubtful cases. JDM should be differentiated from the muscle involvement of other diffuse inflammatory connective tissue diseases and from non inflammatory myopathies. The treatment is mainly based on steroids, whose dosage and regimen depend on disease severity. Steroid therapy has greatly improved the prognosis of JDM.

Adolescent↗