Objective:To evaluate the impact of duration of untreated symptoms in childre n with juvenile dermatomyositis(JDM)on clinical and laboratory status at diagn osis.Study design:We examined physical and laboratory data f...Objective:To evaluate the impact of duration of untreated symptoms in childre n with juvenile dermatomyositis(JDM)on clinical and laboratory status at diagn osis.Study design:We examined physical and laboratory data from the first phys ician visit for 166 untreated children with JDM.Disease activity scores(DASs)assessed skin and muscle involvement.Height and weight were compared with the N ational Health and Nutrition Examination Survey III dataset.Duration of untreat ed illness was designated as the time from first sign of rash or weakness to dia gnostic visit.Results:Boys and girls with untreated JDM were shorter and light er than national norms(P >.0005 for both),and nonwhite children were weaker than wh ite children(P >.0005).Older children had more dysphagia(P =.017)and arthr itis(P >.001).Duration of untreated JDM was negatively associated with DAS we akness(P >.0005),unrelated to DAS skin,and positively associated with pathol ogical calcifications(P =.006).With untreated disease < 4.7 months,serum lev els of 4 muscle enzymes(aldolase,lactic dehydrogenase,creatine kinase,serum glutamic-oxaloacetic transaminase/aspartate aminotransferase)tended toward nor mal(P >.01 for each).Conclusions:Duration of untreated symptoms is an import ant variable and should be included in decisions concerning both diagnostic crit eria and intensity of therapy for children with JDM.展开更多
文摘Objective:To evaluate the impact of duration of untreated symptoms in childre n with juvenile dermatomyositis(JDM)on clinical and laboratory status at diagn osis.Study design:We examined physical and laboratory data from the first phys ician visit for 166 untreated children with JDM.Disease activity scores(DASs)assessed skin and muscle involvement.Height and weight were compared with the N ational Health and Nutrition Examination Survey III dataset.Duration of untreat ed illness was designated as the time from first sign of rash or weakness to dia gnostic visit.Results:Boys and girls with untreated JDM were shorter and light er than national norms(P >.0005 for both),and nonwhite children were weaker than wh ite children(P >.0005).Older children had more dysphagia(P =.017)and arthr itis(P >.001).Duration of untreated JDM was negatively associated with DAS we akness(P >.0005),unrelated to DAS skin,and positively associated with pathol ogical calcifications(P =.006).With untreated disease < 4.7 months,serum lev els of 4 muscle enzymes(aldolase,lactic dehydrogenase,creatine kinase,serum glutamic-oxaloacetic transaminase/aspartate aminotransferase)tended toward nor mal(P >.01 for each).Conclusions:Duration of untreated symptoms is an import ant variable and should be included in decisions concerning both diagnostic crit eria and intensity of therapy for children with JDM.
