New-onset juvenile dermatomyositis. Comparisons with a healthy cohort and children with juvenile rheumatoid arthritis |
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| Authors: | Lauren M. Pachman MD Jennifer R. Hayford RN Marc C. Hochberg Md Mph Mark A. Pallansch PhD Ahn Chung BS Claire D. Daugherty MS Balu H. Athreya MD Suzanne L. Bowyer MD Chester W. Fink MD Harry L. Gewanter MD Rita Jerath MD Bianca A. Lang MD Ilona S. Szer MD James Sinacore PhD Mary L. Christensen PhD Alan R. Dyer PhD |
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| Affiliation: | 1. Children's Memorial Hospital, Chicago, Illinois;2. University of Maryland, Baltimore;3. Centers for Disease Control and Prevention, Atlanta, Georgia;4. Northwestern University Medical School, Chicago, Illinois;5. Alfred I. Dupont Institute, Wilmington, Delaware;6. James Whitcomb Riley Hospital, Indianapolis, Indiana;7. University of Texas, Dallas;8. Redmont Pediatric Associates, Richmond, Virginia;9. Medical College of Georgia, Augusta;10. Dalhousie University, Halifax, Nova Scotia, Canada;11. Children's Hospital of San Diego, San Diego, California;12. University of Illinois, Chicago |
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| Abstract: | 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 ⩽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. |
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