Assessment of an infectious disease history preceding juvenile dermatomyositis symptom onset
Assessment of an infectious disease history preceding juvenile dermatomyositis symptom onset
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DOI：
10.1093/rheumatology/ken038
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发表时间：
2008-04-01
期刊：
影响因子：
5.5
通讯作者：
Feldman, B. M.
中科院分区：
文献类型：
--
作者：
Manlhiot, C.;Liang, L.;Feldman, B. M.
目标。许多研究探讨了传染病在引发青少年皮肌炎 (JDM) 中的作用。先前的研究发现，在疾病发作之前，感染症状的出现频率较高；然而，无法识别出具体的病原体。我们试图将先前的感染症状与 JDM 的发病和结果相关联。方法。我们研究了 1988 年至 2006 年间在医院箔病儿童 (SickKids) 诊断的所有 JDM 病例的初始队列。提取了有关发病症状、诊断和疾病结果的数据。两名独立的儿科传染病专家审查了有感染症状或检测结果的患者的所有记录。总共对110名油患者进行了审查；其中，78 人拥有足够的有关疾病发作的信息可供纳入。在 55/78 (71%) 的患者中发现了 JDM 发病前的潜在迹象，并进一步评估了与症状发作暂时相关的感染证据。 40/55 的人发现在 JDM 症状出现之前存在暗示感染的特征[可能 (30/40) 或可能 (10/40)]。大多数可能感染的儿童患有呼吸道疾病[24/30 (80%)]。夏季发病的患者数量少于预期。未发现发病时艺术感染的存在与诊断时特征或疾病结果的差异相关。结论。大量 JDM 患者的临床病史与发病前的感染一致。新诊断的患者应接受全面的传染病评估，作为初步检查的一部分；应特别注意呼吸道感染。
Objectives. A number of studies have looked at the role of infectious diseases in triggering juvenile dermatomyositis (JDM). Previous studies have found a moderately high frequency of infectious symptoms prior to disease onset; however, no specific pathogens could be identified. We sought to correlate preceding infectious symptoms with onset and outcomes of JDM.Methods. We studied an inception cohort of all JDM cases diagnosed at The Hospital foil Sick Children (SickKids) between 1988 and 2006. Data pertaining to symptoms at onset, diagnosis and disease outcomes were abstracted. Two independent paediatric infectious disease specialists reviewed all records of patients with symptoms or tests suggestive of infection.Results. A total oil 110 patients were reviewed; of these, 78 had sufficient information about disease onset for inclusion. Potential indications clan infectious process prior to JDM onset were found in 55/78 (71%) patients and were further evaluated for evidence of infection temporally associated with symptom onset. Features suggestive of infection prior to JDM symptom onset were found in 40/55 [probable (30/40) or possible (10/40)]. Most children with probable infections had respiratory illnesses [24/30 (80%)]. Fewer patients than expected had disease onset during summer months. The presence of art infection at onset was not found to be associated with differences in characteristics at diagnosis or disease outcomes.Conclusion. A substantial number of JDM patients hove a clinical history consistent with an infection prior to onset. Newly diagnosed patients should undergo a full infectious disease assessment as part of their initial work-up; specific attention should be given to respiratory infections.