GI involvement linked to relapse of vasculitis in kids

GI involvement linked to relapse of vasculitis in kids
In the largest single-center study of polyarteritis nodosa in childhood, fever, myalgia, and skin involvement were found to be the most common symptoms, and cumulative dose of cyclophosphamide was associated with lower risk of relapse, while gastrointestinal involvement was linked to increased relapse risk. The study has been published online June 10 in Arthritis & Rheumatism.

(HealthDay)—In the largest single-center study of polyarteritis nodosa (PAN) in childhood, fever, myalgia, and skin involvement were found to be the most common symptoms, and cumulative dose of cyclophosphamide was associated with lower risk of relapse, while gastrointestinal (GI) involvement was linked to increased relapse risk. The study has been published online June 10 in Arthritis & Rheumatism.

Despina Eleftheriou, Ph.D., from Great Ormond Street Hospital for Children National Health Service Foundation Trust in London, and colleagues retrospectively reviewed data from children with PAN seen over a 32-year period. The Pediatric Vasculitis Activity Score (PVAS) was used to assess disease activity.

The researchers identified 69 children (55 percent male) with PAN, with a median age of 8.5 years. At presentation, clinical features included (86 percent), myalgia (82 percent), skin involvement (88 percent), renal involvement (19 percent), severe GI involvement (10 percent), and neurological involvement (10 percent), and the PVAS was 9/63. In 40 of 50 biopsies, skin histopathology showed necrotizing vasculitis. In 94 percent of patients, selective visceral arteriography suggested PAN. Cyclophosphamide and corticosteroids (82 percent); plasma exchange (8 percent); and biologic agents (after 2002, 11 percent) were used for treatment. Thirty-four percent of patients experienced relapse and mortality was 4 percent. There was a significantly increased risk of relapse associated with GI involvement, while a significantly lower risk of was associated with longer time to induce remission and increased cumulative cyclophosphamide dose.

"Childhood PAN is a severe inflammatory disease of insidious onset, and variable clinical presentation," the authors write.

More information: Abstract
Full Text (subscription or payment may be required)

add to favorites email to friend print save as pdf

Related Stories

Cognitive health info from doctors found to be lacking

May 14, 2013

(HealthDay)—Communication between patients and physicians regarding activities that may be beneficial to maintaining cognitive functioning during aging may be lacking, according to a study published online ...

Recommended for you

Prompt diagnosis of psoriatic arthritis crucial

13 hours ago

Research led by Conway Fellow, Professor Oliver FitzGerald in St Vincent's University Hospital shows that a delay of more than 6 months from initial symptoms to a diagnosis of psoriatic arthritis leads to poorer outcomes ...

Mummy remains refute antiquity of ankylosing spondylitis

Oct 20, 2014

Ankylosing spondylitis is a systemic disease that causes inflammation in the spinal joints and was thought to have affected members of the ancient Egyptian royal families. Now a new study published in Arthritis & Rheumatology, a jour ...

Arthritis sufferers excluded from everyday life

Oct 13, 2014

Arthritis is the second leading cause of disability in Australia with many sufferers so severely disabled they cannot engage in basic everyday activities, new UNSW research has found.

User comments