Browsing by Subject "Pediatric rheumatology"

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    Childhood Sjögren syndrome: features of an international cohort and application of the 2016 ACR/EULAR classification criteria
    (Oxford University Press, 2021) Basiaga, Matthew L.; Stern, Sara M.; Mehta, Jay J.; Edens, Cuoghi; Randell, Rachel L.; Pomorska, Anna; Irga-Jaworska, Ninela; Ibarra, Maria F.; Bracaglia, Claudia; Nicolai, Rebecca; Susic, Gordana; Boneparth, Alexis; Srinivasalu, Hemalatha; Dizon, Brian; Kamdar, Ankur A.; Goldberg, Baruch; Knupp-Oliveira, Sheila; Antón, Jordi; Mosquera, Juan M.; Appenzeller, Simone; O'Neil, Kathleen M.; Protopapas, Stella A.; Saad-Magalhães, Claudia; Akikusa, Jonathan D.; Thatayatikom, Akaluck; Cha, Seunghee; Nieto-González, Juan Carlos; Lo, Mindy S.; Brennan Treemarcki, Erin; Yokogawa, Naoto; Lieberman, Scott M.; Childhood Arthritis and Rheumatology Research Alliance and the International Childhood Sjögren Syndrome Workgroup; Pediatrics, School of Medicine
    Objective: Sjögren syndrome in children is a poorly understood autoimmune disease. We aimed to describe the clinical and diagnostic features of children diagnosed with Sjögren syndrome and explore how the 2016 ACR/EULAR classification criteria apply to this population. Methods: An international workgroup retrospectively collected cases of Sjögren syndrome diagnosed under 18 years of age from 23 centres across eight nations. We analysed patterns of symptoms, diagnostic workup, and applied the 2016 ACR/EULAR classification criteria. Results: We identified 300 children with Sjögren syndrome. The majority of patients n = 232 (77%) did not meet 2016 ACR/EULAR classification criteria, but n = 110 (37%) did not have sufficient testing done to even possibly achieve the score necessary to meet criteria. Even among those children with all criteria items tested, only 36% met criteria. The most common non-sicca symptoms were arthralgia [n = 161 (54%)] and parotitis [n = 140 (47%)] with parotitis inversely correlating with age. Conclusion: Sjögren syndrome in children can present at any age. Recurrent or persistent parotitis and arthralgias are common symptoms that should prompt clinicians to consider the possibility of Sjögren syndrome. The majority of children diagnosed with Sjögren syndromes did not meet 2016 ACR/EULAR classification criteria. Comprehensive diagnostic testing from the 2016 ACR/EULAR criteria are not universally performed. This may lead to under-recognition and emphasizes a need for further research including creation of paediatric-specific classification criteria.
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    Depression And Anxiety In Patients With Juvenile Idiopathic Arthritis: Current Insights And Impact On Quality Of Life, A Systematic Review
    (Dove Medical Press, 2019-11-01) Fair, Danielle C.; Rodriguez, Martha; Knight, Andrea M.; Rubinstein, Tamar B.; Pediatrics, School of Medicine
    Depression and anxiety are prevalent in children with rheumatologic diseases, including juvenile idiopathic arthritis (JIA). However, prevalence rates and the relationship with disease outcomes, including quality of life are conflicting in the early literature. To review the current literature, determine gaps in our knowledge, and identify areas in need of further investigation, we conducted a systematic review of studies examining depression and anxiety symptoms among children with JIA and the impact these symptoms may have on disease outcomes and quality of life. Six electronic databases were searched up until January 2019. Of 799 potential articles, 60 articles were included with the main focus on 28 articles from 2009 to 2019, to concentrate on the most current evidence. We found that JIA patients experience symptoms of depression and anxiety similar to other childhood chronic diseases and at higher rates than in healthy children. Patients who experience these symptoms have worse quality of life, with some evidence pointing to depression and anxiety symptoms having a greater impact on quality of life than other disease features, such as active joint count. Family members of JIA patients experience high rates of anxiety and depression symptoms which may impact their child’s mental health and pain symptoms related to JIA. Conflicting reports of associations between depression/anxiety symptoms and disease features/disease outcomes and a paucity of longitudinal studies investigating the impact of treatment on mental health symptoms indicate areas in need of further research to effectively identify patients at greatest risk of depression and anxiety and to better understand how to treat and prevent these symptoms in youth with JIA. Family mental health should also be considered in investigations concerning mental health and disease outcomes of children with JIA.