History of infection before the onset of juvenile dermatomyositis: Results from the National Institute of Arthritis and Musculoskeletal and Skin Diseases Research Registry
History of infection before the onset of juvenile dermatomyositis: Results from the National Institute of Arthritis and Musculoskeletal and Skin Diseases Research Registry
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DOI：
10.1002/art.21068
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发表时间：
2005-04-15
期刊：
影响因子：
--
通讯作者：
Borzy, M
中科院分区：
文献类型：
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作者：
Pachman, LM;Lipton, R;Borzy, M
目标。目的：获取在发现与青少年皮肌炎（JDM）相关的典型虚弱和皮疹之前3个月内发生的感染史资料。登记研究护士对诊断为JDM的6个月内儿童的父母或看护人进行了访谈，内容涉及儿童的症状、环境、家庭背景和病史。审查了医生的医疗记录，确认了JDM的诊断。包括父母访谈和诊断时医生医疗记录均可获得的儿童（n = 286）。诊断如下：明确/可能的JDM (n = 234,82%)，可能的JDM (n = 43,15%)，或仅皮疹（n = 9.3%）。该群体以白人为主（71%），男女比例为2:1。虽然女孩的平均发病年龄为6.7岁，男孩为7.3岁，但25%的儿童在发病时为54岁。发病前3个月，57%的患儿有呼吸道症状，30%有胃肠道症状，有这些感染症状的患儿中有63%使用了抗生素。这项研究提供了JDM影响幼儿的证据。典型的皮疹和虚弱的症状通常是在呼吸道或胃肠道疾病史之后出现的。这些数据表明，对感染过程的反应可能与JDM的发病机制有关。
Objective. To obtain data concerning a history of infection occurring in the 3 months before recognition of the typical weakness and rash associated with juvenile dermatomyositis (JDM).Methods. Parents or caretakers of children within 6 months of JDM diagnosis were interviewed by the registry study nurse concerning their child's symptoms, environment, family background, and illness history. Physician medical records were reviewed, confirming the JDM diagnosis.Results. Children for which both a parent interview and physician medical records at diagnosis were available (n = 286) were included. Diagnoses were as follows: definite/probable JDM (n = 234, 82%), possible JDM (n = 43, 15%,), or rash only (n = 9, 3%). The group was predominantly white (71%) and had a girl:boy ratio of 2:1. Although the mean age at onset was 6.7 years for girls and 7.3 years for boys, 25% of the children were 54 years old at disease onset. In the 3 months before onset, 57% of the children had respiratory complaints, 30% had gastrointestinal symptoms, and 63% of children with these symptoms of infection were given antibiotics.Conclusion. This study provides evidence that JDM affects young children. The symptoms of the typical rash and weakness often follow a history of respiratory or gastrointestinal complaints. These data suggest that the response to an infectious process may be implicated in JDM disease pathogenesis.