Symptomatic cardiac involvement in juvenile rheumatoid arthritis

Goldenberg, J; Ferraz, Marcos Bosi; Pessoa, Angela Pinto; Fonseca, Antonio S.M.; Carvalho, Antônio Carlos; Hilário, Maria Odete Esteves; Atra, E

doi:10.1016/0167-5273(92)90082-e

Cited by 81 publications

(35 citation statements)

References 9 publications

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“…In a retrospective study of 172 patients with juvenile RA, symptomatic cardiac involvement occurred in 7.6% of patients and included pericarditis, perimyocarditis, and myocarditis. 309 In a population study in Rochester, MN, of 575 patients with RA with a mean of 46 years of follow-up, the presence of RA was associated with a 2-fold increased risk of HF compared with a non-RA population; this was in the absence of traditional risk factors, with a greater risk for women than men. 310 Both myocarditis and pericarditis are regarded as poor prognostic factors in RA.…”

Section: Epidemiology and Prognosismentioning

confidence: 99%

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

600

663

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CLINICAL STATEMENTS AND GUIDELINEST he intent of this American Heart Association (AHA) scientific statement is to summarize our current understanding of dilated cardiomyopathies. There is special emphasis on recent developments in diagnostic approaches and therapies for specific cardiomyopathies. Recommendations in this document are based on published studies, published practice guidelines from the American College of Cardiology (ACC)/AHA 1 and other organizations, 2,3 and the multidisciplinary expertise of the writing group. Existing evidence in epidemiology, classification, diagnosis, and management of specific cardiomyopathies is usually derived from nonrandomized observational studies, registries, case reports, or expert opinion based on clinical experience, not large-scale randomized clinical trials or systematic reviews. Therefore, in this document, rather than using the standard ACC/AHA classification schema of recommendations and level of evidence, 4 we have included key management strategies at the end of each section and categorized our recommendations according to the level of consensus. Although the format of our recommendations might resemble the ACC/AHA classification of recommendations used in the ACC/AHA practice guidelines, because of the preponderance of expert opinion or level of evidence C evidence in our document, we elected to use different terminology to provide a distinction from the practice guidelines, in which stronger levels and quality of evidence with randomized clinical trials or meta-analyses are usually present. 4 The levels of evidence follow the AHA and ACC methods of classifying the level of certainty of the treatment effect. 4 DEfINITIoN of DILATED CArDIoMyopAThyThe term dilated cardiomyopathy (DCM) refers to a spectrum of heterogeneous myocardial disorders that are characterized by ventricular dilation and depressed myocardial performance in the absence of hypertension, valvular, congenital, or ischemic heart disease. 5 In clinical practice, the pathogenesis of heart failure (HF) has often been placed into 2 categories: ischemic and nonischemic cardiomyopathy. The term nonischemic cardiomyopathy has been interchangeably used with DCM. Although this approach might be practical, it fails to recognize that nonischemic cardiomyopathy can include cardiomyopathies caused by volume or pressure overload (such as hypertension or valvular heart disease) that are not conventionally accepted under the definition of DCM. 1,5 Again, in general practice and clinical research trials, the term ischemic cardiomyopathy is defined as cardiomyopathy caused by ischemic heart disease. Current use of ischemic cardiomyopathy terminology implies ventricular dilation and depressed myocardial contractility caused by ischemia or infarction. CLASSIfICATIoN of CArDIoMyopAThIESThe first classification on this topic categorized cardiomyopathies as heart muscle diseases with dilated (DCM), hypertrophic, restrictive, arrhythmogenic right ventricular (ARVC), or nonclassifiable cardiomyopathy in 1980. 5 Subse...

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Section: Epidemiology and Prognosismentioning

confidence: 99%

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

600

663

View full text Add to dashboard Cite

show abstract

“…Reported cardiac complications of SoJIA include pericarditis, pericardial effusion, myocarditis, and rarely endocarditis. [3][4][5] Diagnosis of SoJIA is often challenging, especially before children have had symptoms for 6 weeks (as required by International League of Associations for Rheumatology criteria for SoJIA and American College of Rheumatology criteria for systemic-onset juvenile rheumatoid arthritis) or 3 months (as required by European League Against Rheumatism criteria for systemic-onset juvenile chronic arthritis). 1,6,7 Infectious diseases and other inflammatory conditions, including childhood vasculitides, may mimic SoJIA.…”

mentioning

confidence: 99%

Coronary Artery Dilation Among Patients Presenting With Systemic-Onset Juvenile Idiopathic Arthritis

et al. 2005

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ABSTRACT. Objective. To evaluate coronary artery diameters among patients presenting with systemic-onset juvenile idiopathic arthritis (SoJIA).Methods. Fifty cases of SoJIA were reviewed. At the time of initial presentation with fever, 12 patients had echocardiograms that included a complete evaluation of the coronary arteries. A single reviewer measured the diameters of the left main, proximal left anterior descending, and proximal right coronary arteries. Body surface area-adjusted z scores were calculated with respect to a normative population.Results. Coronary artery dilation (z score: >2) was observed for 5 of the 12 patients with SoJIA who had echocardiograms performed at the time of presentation with fever. No patient developed a coronary artery aneurysm, and all of the coronary artery z scores normalized within 4 months. Only 2 of the 5 patients with coronary artery z scores of >2 fulfilled the clinical criteria for Kawasaki disease, the most commonly recognized cause of coronary artery dilation among children.Conclusions. Children presenting with SoJIA may have coronary artery dilation similar to that observed for children with Kawasaki disease. These data suggest that the presence of coronary artery dilation on initial echocardiograms for patients with fever does not exclude the diagnosis of SoJIA. Pediatrics 2005;116:e89-e93. URL: www.pediatrics.org/cgi

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“…[11] Semptomatik kardiyak tutulum özellikle sistemik bafllang›çl› J‹A'l› hastalar›n %3-9'unda görülebilmektedir. [12] Asemptomatik hastalarda ekokardiyografi bulgusu ya da post-mortem serilerde bu oran vakalar›n %36-45'inde bildirilmektedir. [13,14] Perikardit en s›k bildirilen tutulum flekli olup genellikle iyi seyirlidir.…”

Section: öYkünün Devam›unclassified

“…[15] Miyokardit vakalar› s›kl›kla sistemik bafllang›çl› J‹A'da bildirilmifltir ve s›kl›kla perikarditle birliktedir. [12] Öykünün Devam› Mart 2014 tarihinde 3 haftad›r devam eden bacaklarda flifllik, nefes darl›¤› ve hafif çarp›nt› flikayeti ile hasta yeniden baflvurdu. 2010 y›l›ndan beri steroid tedavisi kullanmamaktayd›.…”

Section: öYkünün Devam›unclassified

Clinicopathologic case discussion: systemic onset juvenil idiopathic arthritis and acut-subacute heart failure

Kılıç¹,

Torğutalp²,

Erden³

et al. 2014

RAED Derg

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Symptomatic cardiac involvement in juvenile rheumatoid arthritis

Cited by 81 publications

References 9 publications

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Coronary Artery Dilation Among Patients Presenting With Systemic-Onset Juvenile Idiopathic Arthritis

Clinicopathologic case discussion: systemic onset juvenil idiopathic arthritis and acut-subacute heart failure

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