New-onset juvenile dermatomyositis - Comparisons with a healthy cohort and children with juvenile rheumatoid arthritis
New-onset juvenile dermatomyositis - Comparisons with a healthy cohort and children with juvenile rheumatoid arthritis
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DOI：
10.1002/art.1780400822
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发表时间：
1997-08-01
影响因子：
--
通讯作者：
Dyer, AR
中科院分区：
文献类型：
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作者：
Pachman, LM;Hayford, JR;Dyer, AR
Objective.在病例对照研究中，确定与2个对照组相比，新发青少年皮肌炎（青少年DM）患者是否在发病前症状增加，暴露于某些环境条件，家族性自身免疫性疾病的频率或抗体滴度增加。对来自同一地理区域的80名青少年糖尿病儿童、40名青少年类风湿性关节炎（JRA）儿童或23名健康儿童的家庭进行了结构化访谈。所有患儿血清均检测弓形虫抗体、单纯疱疹病毒（HSV）抗体、柯萨奇病毒B抗体（CVB）。高比例的儿童与青少年糖尿病有体质症状3个月前发病日期（P = 0.013与对照组儿童）。与青少年DM或健康儿童相比，JRA儿童有更多的亲属患有类风湿性关节炎（P = 0.0001）和恶性贫血（P = 0.003）。在小于或等于7岁的儿童中，肠道病毒滴度升高在青少年DM（81%）和健康对照组（90%）中比JRA（64%）更常见，表明常见的环境暴露。弓形虫、HSV或CVB 1-6滴度正常。家族性自身免疫性疾病、暴露于环境因素或弓形虫、HSV或CVB抗体滴度升高的频率在青少年DM中并不增加。青少年糖尿病儿童在发病前3个月确实有疾病症状，年轻患者的肠道病毒滴度升高，年轻的地理对照组也是如此。
Objective. To determine, in a case-control study, if patients with new-onset juvenile dermatomyositis (juvenile DM) have increased symptoms prior to onset, exposure to certain environmental conditions, frequency of familial autoimmune diseases, or antibody titers, compared with 2 control groups.Methods. A structured interview with the families of 80 children with juvenile DM, 40 children with juvenile rheumatoid arthritis (JRA), or 23 healthy children, from the same geographic area as the children with juvenile DM, was conducted. All children's sera were tested for antibody to Toxoplasma gondii, herpes simplex virus (HSV), or coxsackievirus B (CVB).Results. A high proportion of children with juvenile DM had constitutional symptoms 3 months before the disease-onset date (P = 0.013 versus control children). Children with JRA had more relatives with rheumatoid arthritis (P = 0.0001) and pernicious anemia (P = 0.003) than did children with juvenile DM or healthy children. Among children less than or equal to 7 years of age, elevated enteroviral titers were more frequent in those with juvenile DM (81%) and in healthy controls (90%) than in those with JRA (64%), suggesting a common environmental exposure. Titers to T gondii, HSV, or CVB 1-6 were normal.Conclusion. Frequencies of familial autoimmune disease, exposure to environmental factors, or elevated antibody titers to T gondii, HSV, or CVB are not increased in juvenile DM. Children with juvenile DM do have symptoms of illness 3 months before the disease-onset date, and young patients have elevated enteroviral titers, as do young geographic controls.