New-onset juvenile dermatomyositis. Comparisons with a healthy cohort and children with juvenile rheumatoid arthritis
Article first published online: 12 DEC 2005
Copyright © 1997 American College of Rheumatology
Arthritis & Rheumatism
Volume 40, Issue 8, pages 1526–1533, August 1997
How to Cite
Pachman, L. M., Hayford, J. R., Hochberg, M. C., Pallansch, M. A., Chung, A., Daugherty, C. D., Athreya, B. H., Bowyer, S. L., Fink, C. W., Gewanter, H. L., Jerath, R., Lang, B. A., Szer, I. S., Sinacore, J., Christensen, M. L. and Dyer, A. R. (1997), New-onset juvenile dermatomyositis. Comparisons with a healthy cohort and children with juvenile rheumatoid arthritis. Arthritis & Rheumatism, 40: 1526–1533. doi: 10.1002/art.1780400822
- Issue published online: 12 DEC 2005
- Article first published online: 12 DEC 2005
- Manuscript Accepted: 21 MAR 1997
- Manuscript Received: 9 DEC 1996
- Clinical Sciences Grant from the National Arthritis Foundation
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.