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 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; 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, R, 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 ; 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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