History of infection before the onset of juvenile dermatomyositis: Results from the National Institute of Arthritis and Musculoskeletal and Skin diseases research registry

Lauren M. Pachman, Rebecca Lipton, Rosalind Ramsey-Goldman, Eli Shamiyeh, Kathy Abbott, Eduardo P. Mendez, Alan Dyer, Deborah Mc Curdy, Larry Vogler, Ann Reed, Gail Cawkwell, Lawrence Zemel, Christy Sandborg, Rafael Rivas-Chacon, Christine Hom, Norman Ilowite, Abraham Gedalia, Jonathan Gitlin, Michael Borzy

Research output: Contribution to journalReview article

91 Scopus citations

Abstract

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 ≤4 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.

Original languageEnglish (US)
Pages (from-to)166-172
Number of pages7
JournalArthritis Care and Research
Volume53
Issue number2
DOIs
StatePublished - Apr 15 2005

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Keywords

  • Epidemiology
  • History of infection
  • Juvenile dermatomyositis

ASJC Scopus subject areas

  • Rheumatology

Cite this

Pachman, L. M., Lipton, R., Ramsey-Goldman, R., Shamiyeh, E., Abbott, K., Mendez, E. P., Dyer, A., Mc Curdy, D., Vogler, L., Reed, A., Cawkwell, G., Zemel, L., Sandborg, C., Rivas-Chacon, R., Hom, C., Ilowite, N., Gedalia, A., Gitlin, J., & Borzy, M. (2005). History of infection before the onset of juvenile dermatomyositis: Results from the National Institute of Arthritis and Musculoskeletal and Skin diseases research registry. Arthritis Care and Research, 53(2), 166-172. https://doi.org/10.1002/art.21068