Calcinose na infância, um desafio terapêutico

Castro, Tânia Caroline Monteiro de; Yamashita, Edson; Terreri, Maria Teresa; Len, Cláudio Arnaldo; Hilário, Maria Odete Esteves

doi:10.1590/s0482-50042007000100013

Cited by 8 publications

(5 citation statements)

References 25 publications

(43 reference statements)

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“…The treatment of calcinosis is itself controversial, since spontaneous involution of the condition can even occur. 10,29 Reports exist of good efficacy and absent or rare adverse events being obtained with EDTA, diltiazem and bisphosphonates (alendronate or pamidronate), and also with surgical excision and localized infiltration of triamcinolone hexacetonide, 18,[26][27][28][29][30][31][32][33] as was used with some of the patients studied here.…”

Section: Resultsmentioning

confidence: 99%

Fatores de risco associados à calcinose na dermatomiosite juvenil

Sallum

Pivato

Doria-Filho

et al. 2008

J. Pediatr. (Rio J.)

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Objective: To identify risk factors associated with calcinosis in children and adolescents with juvenile dermatomyositis. Methods:A review was carried out of the medical records of 54 patients with juvenile dermatomyositis. Data were collected on demographic characteristics, clinical features: muscle strength (stages I to V of the Medical Research Council scale), pulmonary involvement (restrictive pulmonary disease with presence or absence of anti-Jo1 antibodies), gastrointestinal problems (gastroesophageal reflux) and/or heart disease (pericarditis and/or myocarditis); laboratory tests: elevated muscle enzyme levels in serum (creatine phosphokinase, aspartate aminotransferase, alanine aminotransferase and/or lactate dehydrogenase); and on the treatments given: corticoid therapy in isolation or associated with hydroxychloroquine and/or immunosuppressants. The patients were divided into two groups, depending on presence or absence of calcinosis and data were evaluated by both univariate and multivariate analyses. Conclusions:Calcinosis was a frequent development among these juvenile dermatomyositis cases, generally emerging as the disease progressed. Calcinosis was associated with the more severe cases that also had cardiac involvement and where immunosuppressors had to be included in the treatment.

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Section: Resultsmentioning

confidence: 99%

Fatores de risco associados à calcinose na dermatomiosite juvenil

Sallum

Pivato

Doria-Filho

et al. 2008

J. Pediatr. (Rio J.)

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“…Calcinosis is known to result from persistent disease activity, poor treatment adherence, and therapy refractoriness. 3,9,22,28 It is worth emphasizing that calcinosis manifested in 10 patients during disease course even after six months of beginning therapy and in patients with good adherence to treatment, and no association was observed between non-adherence and the appearance of that complication. The association of age and higher frequency of calcinosis has neither been reported in other studies, nor found in ours.…”

Section: Discussionmentioning

confidence: 99%

Frequência elevada de calcinose em dermatomiosite juvenil: estudo de fatores de risco

Clemente¹,

Piotto²,

Barbosa³

et al. 2012

Rev. Bras. Reumatol.

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Objective: To assess the frequency of calcinosis in patients with juvenile dermatomyositis, and the possible risk factors for that manifestation. Methods: Medical record review of 34 patients, with an emphasis on the following characteristics: demographic, clinical and laboratory data; type of treatment; adherence to treatment; disease course (monocyclic, chronic and polycyclic); and disease severity. Patients were divided into two groups as follows: those who developed calcinosis (up to the sixth month of follow-up and after six months of follow-up) and those who did not develop calcinosis. Twentyseven patients underwent two nailfold capillaroscopies (NFC), which were considered altered when the scleroderma pattern was found. Results: The mean age of symptom onset of the 34 patients was 6.5 years, the time until diagnosis was 1.2 years, and 70% were females. Half of the patients had a monocyclic disease course, and only 14.7% had severe vasculitis. Almost 90% of the patients undergoing NFC showed a change on the fi rst assessment, 74% showed a change on the second assessment, and the mean interval between both assessments was 1.6 year. Calcinosis was evidenced in 16 (47.1%) patients. No association was observed between the variables analyzed and the development of calcinosis. Conclusion: No risk factors for calcinosis were identifi ed in this study, although that complication was found in half of the patients with juvenile dermatomyositis studied.

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“…A patogênese é desconhecida, mas parece envolver a ação de células inflamatórias, citocinas e proteínas da matriz mineralizada, como osteocalcina. Atraso no início do tratamento, vasculopatia e doença grave são fatores de risco para o aparecimento de calcinose nesses pacientes 15 .…”

Section: Discussionunclassified

“…Em nosso estudo, a paciente apresentou calcificações, dado concordante com outros trabalhos nos quais a frequencia de calcificações é alta 17,18. A paciente descrita apresentou limitações importantes em AVD'S devido encurtamentos, fraquezas musculares e quadro álgico à movimentação articular, caracteristicas próprias desta afecção 15,19 .…”

Section: Discussionunclassified

Facilitação neuromuscular proprioceptiva na dermatomiosite juvenil: relato de caso

Dias

Tini

Martins

et al. 2009

Rev. Med. (São Paulo)

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Rev Med (São Paulo). 2009 jul.-dez.;88(3/4):186-90. MT. Facilitação neuromuscular proprioceptiva na dermatomiosite juvenil: relato de caso. Rev Med (São Paulo). 2009 jul.dez.;88(3/4):186-90. REsuMo: INTRODuçãO: Dermatomiosite Juvenil (DMJ) é uma doença muscular inflamatória de etiologia desconhecida, auto-imune, e que se manifesta nos pequenos vasos sanguíneos dos músculos e pele. A incidência varia entre 0,8 e 4,1 por milhão de crianças nascidas por ano, com prevalência do sexo feminino. São cinco os critérios de diagnóstico: fraqueza simétrica proximal progressiva, enzimas musculares elevadas, anormalidades no eletromiograma, padrão inflamatório na amostra da biópsia muscular, e associação com distúrbios cutâneos. OBJETIVO: Relatar a Facilitação Neuromuscular Proprioceptiva (FNP) em um caso de DMJ. MÉTODO:Foi avaliada uma paciente do sexo feminino, nove anos de idade, com quadro de DMJ e com sintomas de: fraqueza muscular, dificuldade em atividades de vida diária e quedas freqüentes, que se encontra em acompanhamento médico ambulatorial no Hospital Foram realizadas três avaliações, antes (AV-1), durante (AV-2) e após (AV-3) a intervenção fisioterapêutica. Após a primeira avaliação, foi aplicado um tratamento com 24 sessões, com duração de uma hora cada sessão, durante 12 semanas, que constou de Facilitação Neuromuscular Proprioceptiva (FNP) com técnicas de estímulo de estiramento e reversões lentas nas diagonais primitiva e funcional, bem como alongamentos associados. RESULTADOS: Aumento da força muscular em membros inferiores, diminuição de contraturas, ganho de amplitude de movimento articular e melhor qualidade de vida para a paciente. CONCLuSãO: Em vista dos resultados expostos, a utilização da FNP foi satisfatória, e estudos longitudinais são necessários para que se comprove a eficácia a longo prazo.

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Calcinose na infância, um desafio terapêutico

Cited by 8 publications

References 25 publications

Fatores de risco associados à calcinose na dermatomiosite juvenil

Fatores de risco associados à calcinose na dermatomiosite juvenil

Frequência elevada de calcinose em dermatomiosite juvenil: estudo de fatores de risco

Facilitação neuromuscular proprioceptiva na dermatomiosite juvenil: relato de caso

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