Juvenile dermatomyositis and other idiopathic inflammatory myopathies of childhood

@article{Feldman2008JuvenileDA,
  title={Juvenile dermatomyositis and other idiopathic inflammatory myopathies of childhood},
  author={Brian M. Feldman and Lisa G. Rider and Ann M Reed and Lauren M. Pachman},
  journal={The Lancet},
  year={2008},
  volume={371},
  pages={2201-2212}
}
Juvenile dermatomyositis, the most common inflammatory myopathy of childhood, is a rare systemic autoimmune vasculopathy that is characterised by weakness in proximal muscles and pathognomonic skin rashes. The length of time before the initiation of treatment affects presenting symptoms, laboratory measures, and pathophysiology. It also affects disease outcomes, including the development of pathological calcifications, which are associated with increased morbidity. Both genetic and… Expand
Treatment of Juvenile Dermatomyositis: An Update
TLDR
This review summarises the newer and possible future therapies of juvenile inflammatory myopathies, including evidence supporting their efficacy and safety. Expand
The Vasculopathy of Juvenile Dermatomyositis
TLDR
The vasculopathy of JDM is described in the context of pathophysiology, clinical features, and treatment of disease in a bid to better understanding of the essential pathogenic mechanisms. Expand
Juvenile Dermatomyositis
TLDR
Current treatment is with corticosteroids, frequently in combination with other medications such as methotrexate or intravenous gammaglobulin, and newer therapies are currently being evaluated; it is not clear what role these medications will have in the future. Expand
Juvenile dermatomyositis.
TLDR
Ongoing clinical trials are assessing the effect of several immunosuppressive and immunomodulatory drugs, which may help to control the disease and possibly demonstrate a corticosteroid-sparing effect. Expand
Juvenile dermatomyositis: advances in clinical presentation, myositis-specific antibodies and treatment
TLDR
The authors need to better understand recent advances of JDM in the context of clinical features including skin manifestations, muscle weakness and organ damage, myositis-specific antibodies and their associated outcomes and the treatment of disease. Expand
Actuality of juvenile dermatomyositis.
TLDR
The standardisation and the generalisation of clinical assessment tools will make it possible to carry out the clinical trials required to determine the relevance of the new therapeutic options available for children, including corticosteroid and immunosuppressor treatment. Expand
Juvenile dermatomyositis: new developments in pathogenesis, assessment and treatment.
TLDR
Aggressive treatment approaches, including multiple initial therapies, as well as new drugs and biological therapies for refractory disease, offer promise of improved outcomes and less corticosteroid-related toxicity. Expand
Dermatomyositis Leading to Necrotizing Vasculitis: A Perfect Response to Applied Therapy
TLDR
The patient was a 30 years old woman who got involved with dermatomyositis for 10 years and has been under therapy with Methotrexate, Prednisolon and Azathioprine until she came to us suffering from progressive skin lesions, and because of immune cells infiltration and observations necrotizing vasculitis was diagnosed. Expand
Juvenile dermatomyositis: new insights and new treatment strategies
TLDR
This review will focus on recent insights into pathogenesis, the assessment of the disease in children and the modern approach to its treatment. Expand
[Lung is also involved in juvenile dermatomyositis].
TLDR
Juvenile dermatomyositis is the leading cause of chronic idiopathic inflammatory myopathy of auto-immune origin in children and careful assessment of the treatments risk-benefit ratio is necessary, especially in growing children. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 151 REFERENCES
The heterogeneity of juvenile myositis.
  • L. Rider
  • Biology, Medicine
  • Autoimmunity reviews
  • 2007
TLDR
The current therapy of juvenile DM consists of corticosteroids and other immunosuppressive agents, with the adjunctive treatment of cutaneous manifestations and rehabilitation, and therapeutic trials of biologic agents, including anti-TNFalpha and anti-CD20, may aid in developing promising new therapies for these disorders. Expand
International consensus guidelines for trials of therapies in the idiopathic inflammatory myopathies.
TLDR
It has been difficult to compare results from any two myositis trials even when the same agent is being studied, resulting in the current uncertainty regarding the safety and efficacy of most agents. Expand
Clinical features and outcomes of juvenile dermatomyositis and other childhood onset myositis syndromes.
The childhood myositis syndromes, primarily JDM, are relatively homogeneous diseases that have a good outcome in most cases, but are chronic, with poor outcomes, in a substantial number of cases.Expand
Rituximab for the treatment of juvenile dermatomyositis: a report of four pediatric patients.
TLDR
These cases highlight the potential for anti-B cell therapies in the treatment of juvenile DM in both myositis-specific autoantibody-positive and -negative patients. Expand
Intravenous immunoglobulin in juvenile dermatomyositis--four year review of nine cases.
TLDR
This clinical trial in some of the more refractory cases of juvenile dermatomyositis showed clinical improvement at some point in their treatment with intravenous immunoglobulin, prompted by the reported benefit in a number of childhood illnesses. Expand
Polymyositis and dermatomyositis
TLDR
Early initiation of therapy is essential, since both polymyositis and dermatomyositis respond to immunotherapeutic agents and new immunomodulatory agents currently being tested in controlled trials may prove promising for difficult cases. Expand
Clinical and pathogenetic implications of histopathology in childhood polydermatomyositis.
TLDR
Observations support a central role for endothelial cell injury in the pathogenesis of childhood dermatomyositis, suggest a basis for assessing the efficacy of therapy, and provide a focus for investigation of basic mechanisms. Expand
Childhood dermatomyositis: factors predicting functional outcome and development of dystrophic calcification.
TLDR
A subgroup of children with dermatomyositis who appear to do poorly despite optimal therapeutic regimens is identified, distinguished by a severe disease course responding minimally to corticosteroid therapy and manifested by persistent muscle weakness, elevations of muscle enzyme activity, and severe generalized cutaneous vasculitis. Expand
Gene Expression Profiling in DQA1*0501+ Children with Untreated Dermatomyositis: A Novel Model of Pathogenesis1
TLDR
Compared gene expression profiles in muscle biopsies of four untreated DQA1*0501+ JDM children with profiles from children with a known necrotizing myopathy (Duchenne muscular dystrophy), as well as an in vitro antiviral model (NF90), and healthy pediatric controls support a model of Ag (?viral) induction of an apparent autoimmune disease based on dynamic interaction between the muscle, vascular, and immune systems in the genetically susceptible child. Expand
Late-onset gastrointestinal pain in juvenile dermatomyositis as a manifestation of ischemic ulceration from chronic endarteropathy.
TLDR
Two patients with severe gastrointestinal ulceration that resulted in surgery are reported, and the pathologic findings and risk factors for the development of these serious, often life-threatening manifestations of juvenile DM are reviewed. Expand
...
1
2
3
4
5
...