Juvenile dermatomyositis at diagnosis

Clinical characteristics of 79 children

Lauren M. Pachman, Jennifer R. Hayford, Ahn Chung, Claire A. Daugherty, Mark A. Pallansch, Chester W. Fink, Harry L. Gewanter, Rita S Jerath, Bianca A. Lang, James Sinacore, Ilona S. Szer, Alan R. Dyer, Marc C. Hochberg

Research output: Contribution to journalArticle

147 Citations (Scopus)

Abstract

Objective: To evaluate demographic and clinical characteristics, duration of time between disease onset (date of first rash and/or weakness), and diagnosis/therapy, as well as socioeconomic status, of children with newly diagnosed juvenile dermatomyositis (JDM). Structured telephone interview of families of a cohort of 79 children with JDM: interval between onset of symptoms to diagnosis, median of 3 months (range 0.5-20.0). Results: At diagnosis, all the children had rash (100%) and proximal muscle weakness (100%); 58 (73%) had muscle pain; 51 (65%) fever; 35 (44%) dysphagia; 34 (43%) hoarsehess; 29 (37%) abdominal pain; 28 (35%) arthritis; 18 (23%) calcinosis, and 10 (13%) melena. Muscle derived enzymes were normal in 10% of the children. Of the 43 children who had an electromyogram (EMG), 8 (19%) had normal results. Fifty-one children had a muscle biopsy; the results were normal/nondiagnostic in 10 (20%). Median time from disease onset to diagnosis was different between racial groups: Caucasians (n=59) 2.0 months; for minorities (n=20), 6.5 months, (p=0.0008). The median time from disease onset to therapy was: Caucasians, 3.0 months; minorities, 7.2 months (p=0.002). Report of calcinosis was associated with increased time to diagnosis and therapy (p=0.04). In the 33 children whose first symptom occurred in June- September, rash preceded or accompanied onset of muscle weakness in 83% (n=27). Ninety-one percent of the children were given steroid therapy and 9% received methotrexate as well. Conclusion: The results of an undirected site for muscle biopsy or EMG may not be diagnostic. Minority children had a longer interval between first JDM symptom and diagnosis/therapy than Caucasian children. Delay in diagnosis/therapy was associated with calcinosis.

Original languageEnglish (US)
Pages (from-to)1198-1204
Number of pages7
JournalJournal of Rheumatology
Volume25
Issue number6
StatePublished - Jun 1 1998

Fingerprint

Calcinosis
Exanthema
Muscle Weakness
Electromyography
Muscles
Therapeutics
Juvenile dermatomyositis
Melena
Biopsy
Myalgia
Deglutition Disorders
Methotrexate
Social Class
Abdominal Pain
Arthritis
Fever
Steroids
Demography
Interviews
Enzymes

Keywords

  • Access to medical care
  • Clinical laboratory
  • Epidemiology
  • Juvenile dermatomyositis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

Pachman, L. M., Hayford, J. R., Chung, A., Daugherty, C. A., Pallansch, M. A., Fink, C. W., ... Hochberg, M. C. (1998). Juvenile dermatomyositis at diagnosis: Clinical characteristics of 79 children. Journal of Rheumatology, 25(6), 1198-1204.

Juvenile dermatomyositis at diagnosis : Clinical characteristics of 79 children. / Pachman, Lauren M.; Hayford, Jennifer R.; Chung, Ahn; Daugherty, Claire A.; Pallansch, Mark A.; Fink, Chester W.; Gewanter, Harry L.; Jerath, Rita S; Lang, Bianca A.; Sinacore, James; Szer, Ilona S.; Dyer, Alan R.; Hochberg, Marc C.

In: Journal of Rheumatology, Vol. 25, No. 6, 01.06.1998, p. 1198-1204.

Research output: Contribution to journalArticle

Pachman, LM, Hayford, JR, Chung, A, Daugherty, CA, Pallansch, MA, Fink, CW, Gewanter, HL, Jerath, RS, Lang, BA, Sinacore, J, Szer, IS, Dyer, AR & Hochberg, MC 1998, 'Juvenile dermatomyositis at diagnosis: Clinical characteristics of 79 children', Journal of Rheumatology, vol. 25, no. 6, pp. 1198-1204.
Pachman LM, Hayford JR, Chung A, Daugherty CA, Pallansch MA, Fink CW et al. Juvenile dermatomyositis at diagnosis: Clinical characteristics of 79 children. Journal of Rheumatology. 1998 Jun 1;25(6):1198-1204.
Pachman, Lauren M. ; Hayford, Jennifer R. ; Chung, Ahn ; Daugherty, Claire A. ; Pallansch, Mark A. ; Fink, Chester W. ; Gewanter, Harry L. ; Jerath, Rita S ; Lang, Bianca A. ; Sinacore, James ; Szer, Ilona S. ; Dyer, Alan R. ; Hochberg, Marc C. / Juvenile dermatomyositis at diagnosis : Clinical characteristics of 79 children. In: Journal of Rheumatology. 1998 ; Vol. 25, No. 6. pp. 1198-1204.
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