uu.seUppsala University Publications
Change search
Refine search result
1 - 32 of 32
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1.
    Alberdi-Saugstrup, M.
    et al.
    Copenhagen University Hospital, Rigshospitalet, Department of Paediatrics and Adolescent Medicine; Naestved Hospital, Department of Paediatrics; Copenhagen University Hospital, Rigshospitalet, Institute for Inflammation Research.
    Enevold, C.
    Copenhagen University Hospital, Rigshospitalet, Institute for Inflammation Research.
    Zak, M.
    Copenhagen University Hospital, Rigshospitalet, Department of Paediatrics and Adolescent Medicine.
    Nielsen, S.
    Copenhagen University Hospital, Rigshospitalet, Department of Paediatrics and Adolescent Medicine.
    Nordal, E.
    University Hospital of North Norway, Department of Paediatrics.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Fasth, A.
    University of Gothenburg, Department of Paediatrics.
    Rygg, M.
    Norwegian University of Science and Technology, Department of Laboratory Medicine, Children’s and Women’s Health.
    Müller, K.
    Copenhagen University Hospital, Rigshospitalet, Department of Paediatrics and Adolescent Medicine; Copenhagen University Hospital, Rigshospitalet, Institute for Inflammation Research.
    Non-HLA gene polymorphisms in juvenile idiopathic arthritis: associations with disease outcome2017In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 46, no 5, p. 369-376Article in journal (Refereed)
    Abstract [en]

    Objective: To test the hypothesis that non-HLA single-nucleotide polymorphisms (SNPs) associated with the risk of juvenile idiopathic arthritis (JIA) are risk factors for an unfavourable disease outcome at long-term follow-up.

    Methods: The Nordic JIA cohort is a prospective multicentre study cohort of patients from the Nordic countries. In all, 193 patients met the inclusion criteria of having an 8year follow-up assessment and available DNA sample. Seventeen SNPs met the inclusion criteria of having significant associations with JIA in at least two previous independent study cohorts. Clinical endpoints were disease remission, actively inflamed joints and joints with limitation of motion (LOM), articular or extra-articular damage, and history of uveitis.

    Results: Evidence of associations between genotypes and endpoints were found for STAT4, ADAD1-IL2-IL21, PTPN2, and VTCN1 (p=0.003-0.05). STAT4_rs7574865 TT was associated with the presence of actively inflamed joints [odds ratio (OR) 20.6, 95% confidence interval (CI) 2.2->100, p=0.003] and extra-articular damage (OR 7.9, 95% CI 1-56.6, p=0.057). ADAD1_rs17388568 AA was associated with a lower risk of having joints with LOM (OR 0.1, 95% CI 0-0.55, p=0.016). PTPN2_rs1893217 CC was associated with a lower risk of having joints with LOM (OR 0.2, 95% CI 0-0.99, p=0.026), while VTCN1_rs2358820 GA was associated with uveitis (OR 3.5, 95% CI 1-12.1, p=0.029).

    Conclusion: This exploratory study, using a prospectively followed JIA cohort, found significant associations between long-term outcome and SNPs, all previously associated with development of JIA and involved in immune regulation and signal transduction in immune cells.

  • 2.
    Alberdi-Saugstrup, Mikel
    et al.
    Rigshosp, Dept Pediat & Adolescent Med, Copenhagen Univ Hosp, Copenhagen, Denmark.;Naestved Hosp, Dept Pediat, Naestved, Region Zealand, Denmark.;Rigshosp, Inst Inflammat Res, Copenhagen Univ Hosp, Copenhagen, Denmark..
    Zak, Marek
    Rigshosp, Dept Pediat & Adolescent Med, Copenhagen Univ Hosp, Copenhagen, Denmark..
    Nielsen, Susan
    Rigshosp, Dept Pediat & Adolescent Med, Copenhagen Univ Hosp, Copenhagen, Denmark..
    Herlin, Troels
    Aarhus Univ Hosp, Dept Pediat, Aarhus, Denmark..
    Nordal, Ellen
    Univ Hosp North Norway, Dept Pediat, Tromso, Norway..
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Fasth, Anders
    Univ Gothenburg, Dept Pediat, Gothenburg, Sweden..
    Rygg, Marite
    Norwegian Univ Sci & Technol, Dept Lab Med Childrens & Womens Hlth, Trondheim, Norway.;St Olavs Hosp, Dept Pediat, Trondheim, Norway..
    Müller, Klaus
    Rigshosp, Dept Pediat & Adolescent Med, Copenhagen Univ Hosp, Copenhagen, Denmark.;Rigshosp, Inst Inflammat Res, Copenhagen Univ Hosp, Copenhagen, Denmark..
    High-sensitive CRP as a predictive marker of long-term outcome in juvenile idiopathic arthritis2017In: Rheumatology International, ISSN 0172-8172, E-ISSN 1437-160X, Vol. 37, no 5, p. 695-703Article in journal (Refereed)
    Abstract [en]

    To evaluate whether C-reactive protein (CRP), including variation within the normal range, is predictive of long-term disease outcome in Juvenile Idiopathic Arthritis (JIA). Consecutive patients with newly diagnosed JIA were included prospectively from defined geographic areas of the Nordic countries from 1997 to 2000. Inclusion criteria were availability of a baseline serum sample within 12 months after disease onset and 8-year clinical assessment data. Systemic onset JIA was not included. CRP was measured by high-sensitive ELISA (detection limit of 0.2 mg/l). One hundred and thirty participants with a median follow-up time of 97 months (range 95-100) were included. At follow-up, 38% of the patients were in remission off medication. Absence of remission was associated with elevated level of CRP at baseline (odds ratio (OR) 1.33, confidence interval (CI) 1.08-1.63, p = 0.007). By applying a cutoff at the normal upper limit (> 10 mg/l), the risk of not achieving remission was increased to an OR of 8.60 (CI 2.98-24.81, p < 0.001). Variations of CRP within the normal range had no predictive impact on disease activity at follow-up. Baseline levels of ESR were available in 80 patients (61%) and elevated ESR was associated with absence of remission in a multivariable logistic regression analysis (OR 2.32, CI 1.35-4.00, p = 0.002). This results of this study indicate that baseline CRP concentrations above 10 mg/l are predictive of a poor outcome at 8-year follow-up. We could not demonstrate any predictive value of CRP variations within the normal range.

  • 3.
    Arnstad, Ellen Dalen
    et al.
    Nord Trondelag Hosp Trust, Levanger Hosp, Levanger, Norway;Norwegian Univ Sci & Technol, Trondheim, Norway.
    Rypdal, Veronika
    Univ Hosp North Norway, Tromso, Norway;Arctic Univ Norway, Tromso, Norway.
    Peltoniemi, Suvi
    Univ Helsinki, Hosp Children & Adolescents, Helsinki, Finland.
    Herlin, Troels
    Aarhus Univ Hosp, Aarhus, Denmark.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Fasth, Anders
    Univ Gothenburg, Gothenburg, Sweden.
    Nielsen, Susan
    Copenhagen Univ Hosp, Rigshosp, Copenhagen, Denmark.
    Glerup, Mia
    Ekelund, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research. Ryhov Cty Hosp, Jonkoping, Sweden.
    Zak, Marek
    Copenhagen Univ Hosp, Rigshosp, Copenhagen, Denmark.
    Aalto, Kristiina
    Univ Helsinki, Hosp Children & Adolescents, Helsinki, Finland.
    Nordal, Ellen
    Univ Hosp North Norway, Tromso, Norway;Arctic Univ Norway, Tromso, Norway.
    Romundstad, Pal Richard
    Norwegian Univ Sci & Technol, Trondheim, Norway.
    Rygg, Marite
    Norwegian Univ Sci & Technol, Trondheim, Norway;St Olavs Hosp, Trondheim, Norway.
    Marhaug, Gudmund
    Anderson-Gare, Boel
    Pedersen, Freddy Karup
    Lahdenne, Pekka
    Pelkonen, Pirkko
    Early Self-Reported Pain in Juvenile Idiopathic Arthritis as Related to Long-Term Outcomes: Results From the Nordic Juvenile Idiopathic Arthritis Cohort Study2019In: Arthritis care & research, ISSN 2151-464X, E-ISSN 2151-4658, Vol. 71, no 7, p. 961-969Article in journal (Refereed)
    Abstract [en]

    Objective To study self-reported pain early in the disease course of juvenile idiopathic arthritis (JIA) as a predictor of long-term disease outcomes. Methods Consecutive cases of JIA with disease onset from 1997 to 2000 from defined geographical areas of Norway, Sweden, Finland, and Denmark were prospectively enrolled in this population-based cohort study. Self-reported, disease-related pain was measured on a 10-cm visual analog scale (VAS pain). Inclusion criteria were a baseline visit with a pain score 6 months after disease onset, followed by an 8-year study visit. Remission was defined according to Wallace et al (2004) preliminary criteria. Functional disability was measured by the Childhood Health Assessment Questionnaire and the Child Health Questionnaire Parent Form if the child was age <18 years and by the Health Assessment Questionnaire if age >= 18 years. Damage was scored using the Juvenile Arthritis Damage Index. Results The final study cohort consisted of 243 participants, and 120 participants (49%) had oligoarticular onset. At baseline, 76% reported a VAS pain score >0 compared to 57% reporting at 8 years. Half of those who reported baseline pain also reported pain at 8 years but at a lower intensity. Compared to no pain, higher pain intensity at baseline predicted more pain at 8 years, more functional disability, more damage, and less remission without medication. Baseline pain predicted more use of disease-modifying antirheumatic drugs/biologics during the disease course. Participants with oligoarticular JIA reporting pain at baseline were more likely to develop extended oligoarticular JIA or other JIA categories with an unfavorable prognosis. Conclusion Early self-reported, disease-related pain among children and adolescents with JIA is common and seems to predict persistent pain and unfavorable long-term disease outcomes.

  • 4.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Anti-inflammatory effect by exclusive enteral nutrition (EEN) in a patient with juvenile idiopathic arthritis (JIA): brief report2014In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 33, no 8, p. 1173-1175Article in journal (Refereed)
    Abstract [en]

    There is extensive evidence for influence of gut microbiota on health. Exclusive enteral nutrition (EEN) possibly changes gut microbiota, but the exact pathophysiological role is unknown. EEN has been shown to have an anti-inflammatory effect in children with Mb Crohn, an inflammatory bowel disease. The intestinal tract is very scarcely studied in children with juvenile idiopathic arthritis (JIA), but data points to an immunologically important role. The aim of this study was to explore if EEN had any anti-inflammatory effect in children with JIA. The first patient enrolled in the study was followed for 1 year. She had onset of severe polyarticular disease at 3.2 years of age, negative in RF, anti-CCP, ANA, and HLA-B27. She was included in the study at 7.4 years of age. Exclusive enteral nutrition was given in two periods of almost 7 weeks each, several months apart, during the year of the study. Clinical and laboratory status were assessed before, during, and after treatment periods. In this patient, EEN had remarkable anti-inflammatory effect that was sustained for months after each of two separate treatment periods. Exclusive enteral nutrition is a possible anti-inflammatory treatment in patients with JIA, but to what extent EEN is effective in other children with JIA needs to be explored, as well as the possible pathophysiological role of EEN in those children.

  • 5.
    Berntson, Lillemor
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Univ Uppsala Hosp, Dept Pediat, Unit Pediat Rheumatol, S-75185 Uppsala, Sweden..
    Agback, Peter
    Swedish Univ Agr Sci, Dept Chem & Biotechnol, Uppsala, Sweden..
    Dicksved, Johan
    Swedish Univ Agr Sci, Dept Anim Nutr & Management, Uppsala, Sweden..
    Changes in fecal microbiota and metabolomics in a child with juvenile idiopathic arthritis (JIA) responding to two treatment periods with exclusive enteral nutrition (EEN)2016In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 35, no 6, p. 1501-1506Article in journal (Refereed)
    Abstract [en]

    The microbiome and immune system of the digestive tract are highly important in both health and disease. Exclusive enteral nutrition (EEN) is a common anti-inflammatory treatment in children with Crohn's disease in the European countries, and the mechanism is most likely linked to changes in the intestinal microbiome. In the present study, EEN was given in two treatment periods several months apart to a patient with very severe, disabling juvenile idiopathic arthritis (JIA), with a remarkable clinical response as the result. The aim of the present study was to study how the EEN treatment influenced the microbiome and metabolome of this patient. Fecal samples from before, during, and between treatments with EEN were studied. The microbiome was analyzed by sequencing of 16S rRNA amplicons using Illumina MiSeq, and the metabolome was analyzed using nuclear magnetic resonance. The microbiome changed markedly from treatment with EEN, with a strong reduction of the Bacteroidetes phylum. Metabolic profiles showed clear differences before, during, and between treatment with EEN, where butyrate, propionate, and acetate followed a cyclic pattern with the lowest levels at the end of each treatment period. This patient with JIA showed remarkable clinical improvement after EEN treatment, and we found corresponding changes in both the fecal microbiome and the metabolome. Further studies are needed to explore the pathophysiological role of the intestinal canal in children with JIA.

  • 6.
    Berntson, Lillemor
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Damgard, Michael
    Department of Pediatrics, Falun Hospital.
    Andersson-Gare, Boel
    Department of Pediatrics, Ryhov County Hospital.
    Herlin, Troels
    Århus University Hospital.
    Nielsen, Susan
    University Clinic of Pediatrics II, Rigshospitalet.
    Nordal, Ellen
    Institute of Clinical Medicine/Institute of Community Medicine, University of Tromsø.
    Rygg, Marite
    Department of Laboratory Medicine, Children’s and Women’s Health, Faculty of Medicine, Norwegian University of Science and Technology.
    Zak, Marek
    University Clinic of Pediatrics II, Rigshospitalet.
    Fasth, Anders
    Department of Pediatrics, Göteborg University.
    HLA-B27 predicts a more extended disease with increasing age at onset in boys with juvenile idiopathic arthritis2008In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 35, no 10, p. 2055-2061Article in journal (Refereed)
    Abstract [en]

    Objective. Juvenile idiopathic arthritis (JIA) is a heterogeneous condition with very few clinical and laboratory signs that can help predict the course and severity of the disease in the individual patient. The cell-surface antigen HLA-1327 is well known to be associated with spondyloarthropathies, reactive arthritis, and enthesitis. HLA-1327 plays all important role in the classification of JIA, since evidence of sacroiliitis most often evolves after years of arthritis in other Joints. We investigated the associations of HLA-B27 and the clinical manifestations of JIA using a method as close to a poplulation-based study as possible. Methods. We studied,in incidence-based cohort of 305 patients collected prospectively ill 3 Nordic countries (Sweden, Norway, Denmark). Clinical and serological data of the first 3),cars of the disease were collected. Results. HLA-B27 was found to be positive in 25.5% of the Patients, and We found a higher proportion of HLA-B27-positive boys with older age at disease onset (p = 0.034). Regression analysis showed a correlation of 0.7 in the HLA-B27-positive boys. pointing to a higher risk of more Joint involvement with older a,,e at disease onset. By Fisher's exact test, involvement of small joints in the lower extremities was associated with HLA-B27 in boys (p = 0.011) but not in girls (p = 0.687). HLA-B27 was associated with inflammatory back pain in both sexes (1) = 0.041 in boys, p 0.042 in girls), but with enthesitis only in boys (p < 0.001 in boys. p = 0.708 in girls). Conclusion. HLA-B27 is of increasing importance with older age at disease onset in boys with JIA, predicting more active joints within the first 3 years of disease, and also involving small joints in the lower extremity, to a greater degree than in HLA-B27-negative boys. During the first 3 years of disease the occurrence of HLA-B27 is associated with inflammatory back pain ill both sexes, bill with enthesitis only in boys. Our data present new challenges for file ILAR classification of JIA.

  • 7.
    Berntson, Lillemor
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Nordal, Ellen
    Aalto, Kristiina
    Peltoniemi, Suvi
    Herlin, Troels
    Zak, Marek
    Nielsen, Susan
    Rygg, Marite
    HLA-B27 Predicts a More Chronic Disease Course in an 8-year Followup Cohort of Patients with Juvenile Idiopathic Arthritis2013In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 40, no 5, p. 725-731Article in journal (Refereed)
    Abstract [en]

    Objective. We investigated associations of HLA-B27 with clinical manifestations and longterm outcome in a near population-based setting among patients with juvenile idiopathic arthritis (JIA). Methods. We studied clinical and serological data from 410 patients with HLA-B27 results among 440 prospectively collected patients with JIA with 8-year followup data in a Nordic database. The study was structured to be as close to a population-based study as possible. Results. HLA-B27 was analyzed in 93% of patients, and was positive in 21% of the cohort, in 18.4% of the girls and in 25.9% of the boys. Boys who were HLA-B27-positive had significantly higher age at onset compared to HLA-B27-negative boys and compared to both HLA-B27-negative and positive girls. This difference in onset age in relation to HLA-B27 was not found in girls. HLA-B27 was associated with clinical signs of sacroiliitis, enthesitis, and tenosynovitis in boys, but not in girls. After 8 years of disease, 46 children (11.2%) were classified as having enthesitis-related arthritis (ERA). Boys with ERA had clinical signs of sacroiliitis more often than girls with ERA. HLA-B27-positive children, as well as children with clinical signs of sacroiliitis, enthesitis, and hip arthritis, had higher odds of not being in remission off medication after 8 years of disease. Conclusion. In this near population-based Nordic JIA cohort we found significant differences between HLA-B27-positive boys and girls in age at disease onset, clinical signs of sacroiliitis, and ERA classification. HLA-B27 was negatively associated with longterm remission status, possibly because of its association with clinical disease characteristics, such as sacroiliitis, rather than being a general marker of persistent disease.

  • 8.
    Berntson, Lillemor
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Nordal, Ellen
    Fasth, Anders
    Aalto, Kristiina
    Herlin, Troels
    Nielsen, Susan
    Rygg, Marite
    Zak, Marek
    Rönnelid, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.
    Anti-type II collagen antibodies, anti-CCP, IgA RF and IgM RF are associated with joint damage, assessed eight years after onset of juvenile idiopathic arthritis (JIA)2014In: Pediatric Rheumatology, ISSN 1546-0096, E-ISSN 1546-0096, Vol. 12, p. 22-Article in journal (Refereed)
    Abstract [en]

    Background: Early appearance of antibodies specific for native human type II collagen (anti-CII) characterizes an early inflammatory and destructive phenotype in adults with rheumatoid arthritis (RA). The objective of this study was to investigate the occurrence of anti-CII, IgM RF, IgA RF and anti-CCP in serum samples obtained early after diagnosis, and to relate the occurrence of autoantibodies to outcome after eight years of disease in children with juvenile idiopathic arthritis (JIA). Methods: The Nordic JIA database prospectively included JIA patients followed for eight years with data on remission and joint damage. From this database, serum samples collected from 192 patients, at a median of four months after disease onset, were analysed for IgG anti-CII, IgM RF, IgA RF and IgG anti-CCP. Joint damage was assessed based on Juvenile Arthritis Damage Index for Articular damage (JADI-A), a validated clinical instrument for joint damage. Results: Elevated serum levels of anti-CII occurred in 3.1%, IgM RF in 3.6%, IgA RF in 3.1% and anti-CCP in 2.6% of the patients. Occurrence of RF and anti-CCP did to some extent overlap, but rarely with anti-CII. The polyarticular and oligoarticular extended categories were overrepresented in patients with two or more autoantibodies. Anti-CII occurred in younger children, usually without overlap with the other autoantibodies and was associated with high levels of C-reactive protein (CRP) early in the disease course. All four autoantibodies were significantly associated with joint damage, but not with active disease at the eight-year follow up. Conclusions: Anti-CII, anti-CCP, IgA RF and IgM RF detected early in the disease course predicted joint damage when assessed after eight years of disease. The role of anti-CII in JIA should be further studied.

  • 9.
    Berntson, Lillemor
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Wernroth, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research center.
    Fasth, Anders
    Aalto, Kristiina
    Herlin, Troels
    Nielsen, Susan
    Nordal, Ellen
    Rygg, Marite
    Zak, Marek
    Assessment of disease activity in juvenile idiopathic arthritis. The number and the size of joints matter2007In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 34, no 10, p. 2106-2111Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Variables for assessment of disease activity of juvenile idiopathic arthritis (JIA) were studied, in order to develop a disease activity score for children with JIA. METHODS: One randomly chosen hospital visit was studied for each of 312 patients with JIA, with regard to disease activity variables. The physician global assessment score visual analog scale (physician GA) was used as a dependent variable in comparisons between potential disease activity variables. Previous studies have shown this variable to be the most sensitive to changes in JIA disease activity and to be comparable between patients. RESULTS: Based on Spearman's rank order correlation the number of active joints had a strong association with the physician GA. The median physician GA score rose markedly for each active large joint, but less for small joints, although small joints were also statistically important in assessing disease activity. Among the laboratory data, the erythrocyte sedimentation rate, C-reactive protein level, and platelet count showed weak correlations to the physician GA. CONCLUSION: In preparation of a disease activity score for children with JIA the importance of both the number and size of joints involved needs further evaluation.

  • 10.
    Beukelman, Timothy
    et al.
    Univ Alabama Birmingham, 1600 7th Ave South,CPP 210, Birmingham, AL 35233 USA.;Univ Alabama Birmingham, Div Pediat Rheumatol, 1600 7th Ave South,CPP 210, Birmingham, AL 35233 USA..
    Anink, Janneke
    Erasmus MC, Rotterdam, Netherlands..
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Uppsala Univ Hosp, Uppsala, Sweden..
    Duffy, Ciaran
    Childrens Hosp Eastern Ontario, Ottawa, ON, Canada..
    Ellis, Justine A.
    Murdoch Childrens Res Inst, Genes Environm & Complex Dis, Parkville, Vic, Australia..
    Glerup, Mia
    Aarhus Univ Hosp, Aarhus, Denmark..
    Guzman, Jaime
    Univ British Columbia, Vancouver, BC, Canada..
    Horneff, Gerd
    Asklepios Klin Sankt Augsutin, St Augustin, Germany..
    Kearsley-Fleet, Lianne
    Univ Manchester, Manchester, Lancs, England..
    Klein, Ariane
    Asklepios Klin Sankt Augsutin, St Augustin, Germany..
    Klotsche, Jens
    German Rheumatism Res Ctr, Berlin, Germany..
    Magnusson, Bo
    Karolinska Univ Hosp, Stockholm, Sweden..
    Minden, Kirsten
    German Rheumatism Res Ctr, Berlin, Germany..
    Munro, Jane E.
    Royal Childrens Hosp, Melbourne, Vic, Australia..
    Niewerth, Martina
    German Rheumatism Res Ctr, Berlin, Germany..
    Nordal, Ellen
    Univ Hosp North Norway, Tromso, Norway..
    Ruperto, Nicolino
    Ist Giannina Gaslini, Genoa, Italy..
    Santos, Maria Jose
    Hosp Garcia de Orta, Almada, Portugal..
    Schanberg, Laura E.
    Duke Univ, Durham, NC 27706 USA..
    Thomson, Wendy
    Univ Manchester, Manchester, Lancs, England..
    van Suijlekom-Smit, Lisette
    Erasmus MC, Rotterdam, Netherlands..
    Wulffraat, Nico
    Univ Med Ctr Utrecht, Utrecht, Netherlands..
    Hyrich, Kimme
    Univ Manchester, Manchester, Lancs, England.;Cent Manchester Fdn Trust, Manchester, Lancs, England..
    A survey of national and multi-national registries and cohort studies in juvenile idiopathic arthritis: challenges and opportunities2017In: Pediatric Rheumatology, ISSN 1546-0096, E-ISSN 1546-0096, Vol. 15, article id 31Article in journal (Refereed)
    Abstract [en]

    Background: To characterize the existing national and multi-national registries and cohort studies in juvenile idiopathic arthritis (JIA) and identify differences as well as areas of potential future collaboration.

    Methods: We surveyed investigators from North America, Europe, and Australia about existing JIA cohort studies and registries. We excluded cross-sectional studies. We captured information about study design, duration, location, inclusion criteria, data elements and collection methods.

    Results: We received survey results from 18 studies, including 11 national and 7 multi-national studies representing 37 countries in total. Study designs included inception cohorts, prevalent disease cohorts, and new treatment cohorts (several of which contribute to pharmacosurveillance activities). Despite numerous differences, the data elements collected across the studies was quite similar, with most studies collecting at least 5 of the 6 American College of Rheumatology core set variables and the data needed to calculate the 3-variable clinical juvenile disease activity score. Most studies were collecting medication initiation and discontinuation dates and were attempting to capture serious adverse events.

    Conclusion: There is a wide-range of large, ongoing JIA registries and cohort studies around the world. Our survey results indicate significant potential for future collaborative work using data from different studies and both combined and comparative analyses.

  • 11. Cedstromer, Anna-Lena
    et al.
    Ahlqwist, Margareta
    Andlin-Sobocki, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Hedenberg-Magnusson, Britt
    Dahlstrom, Lars
    Temporomandibular condylar alterations in juvenile idiopathic arthritis most common in longitudinally severe disease despite medical treatment2014In: Pediatric Rheumatology, ISSN 1546-0096, E-ISSN 1546-0096, Vol. 12, p. 43-Article in journal (Refereed)
    Abstract [en]

    Background: Juvenile idiopathic arthritis (JIA) is an autoimmune, heterogeneous disease and the temporomandibular joint (TMJ) can be affected, with consequences for mandibular growth and function. The aim of this study was to evaluate the importance of longitudinal medical treatment and the burden of disease activity on the development of temporomandibular condylar alterations as judged on panoramic radiographs. Methods: The study was a retrospective evaluation of dental and medical records in consecutive JIA patients referred to three specialist dental clinics in Sweden during an eight-year period. Data on the total pharmacological treatment and disease activity were evaluated longitudinally from disease onset to the time of the panoramic examination, during a median observation period of 2.5 years. The radiographs were analysed in terms of structural and shape alterations in the condyles and judged dichotomously. Results: Panoramic examinations were analysed in 158 patients from 266 referrals diagnosed with JIA. Condylar alterations (shape or structural) were seen in 68 patients (43%). Patients with condylar alterations were more extensively treated over time compared with those without condylar alterations. Powerful disease activity and/or potent medication at any time during the course of the disease implied an increased risk of alterations. Conclusions: Patients with JIA who require more intensive medication over time run the greatest risk of condylar alterations. As yet, current medical programmes have not been specified for the TMJ and more knowledge in this area is needed.

  • 12.
    Cedströmer, Anna-Lena
    et al.
    Department of Behavioral and Community Dentistry, University of Gothenburg, Sweden.
    Andlin-Sobocki, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery. Department of Orthodontics, Eastman Institutet, Stockholm, Sweden.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Hedenberg-Magnusson, Britt
    Department of Dental Medicine, Section for Orofacial Pain and Jaw Function, Karolinska Institutet, Huddinge, Sweden.
    Dahlström, Lars
    Department of Behavioral and Community Dentistry, University of Gothenburg, Sweden.
    Temporomandibular signs, symptoms, joint alterations and disease activity in juvenile idiopathic arthritis - an observational study2013In: Pediatric Rheumatology, ISSN 1546-0096, E-ISSN 1546-0096, Vol. 11, no 1, p. 37-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Juvenile idiopathic arthritis (JIA) is a heterogeneous disease that frequently affects also the temporomandibular joint (TMJ) and associated structures. The main aim of this observational study was to describe systematically orofacial clinical signs and subjective symptoms in JIA patients, classified according to the International League of Associations for Rheumatology (ILAR) criteria, and to relate the findings to disease activity and radiological TMJ condyle lesions.

    METHODS: The study was a retrospective evaluation of dental and medical records in consecutive JIA patients referred to one of three dental specialist clinics in Sweden during an eight-year period. Data concerning temporomandibular signs, symptoms and general disease activity were collected and condylar alterations were judged on panoramic radiographs.

    RESULTS: All ILAR categories of JIA were represented among the 266 referrals included in the study. The distribution of patients among categories resembled the pattern seen in epidemiological studies. Persistent oligoarthritis was the largest category with 36.5 % of the patients. Temporomandibular clinical signs (mild, moderate or severe) occurred in 57.7 % to 92.0 %, and subjective symptoms (mild or severe) in 32.0 % to 76.0 % of the patients in all categories. Patients in the juvenile psoriatic arthritis category had the largest number of orofacial signs and symptoms, and patients in the persistent oligoarthritis category had the fewest signs and symptoms. There were significant associations between clinical signs as well as subjective symptoms and overall disease activity. Half of all the patients had undergone panoramic examinations and 37.9 % of those were judged to have condylar alterations after a mean of 2.9 years after onset. No associations between radiological findings and variables, such as signs, symptoms or disease activity, were found.

    CONCLUSIONS: Temporomandibular signs and symptoms can be expected to a varying degree, including severe cases, in all JIA categories. Clinical and subjective orofacial involvement appears to be related to disease activity but not to condylar lesions.

  • 13.
    Dahlbom, Ingrid
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Nyberg, Britt-Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Hansson, Tony
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology.
    Simultaneous detection of IgA and IgG antibodies against tissue transglutaminase: The preferred pre-biopsy test in childhood celiac disease2016In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 76, no 3, p. 208-216Article in journal (Refereed)
    Abstract [en]

    Objectives: IgA antibodies against tissue transglutaminase (anti-TG2) is a reliable marker of celiac disease (CD). However, IgA-deficient patients are not identified and young children may lack IgA anti-TG2. Combined detection of IgA and IgG (IgA/IgG) against deamidated gliadin peptides (DGP) has shown a high diagnostic performance for untreated CD. Here we examined the utility of IgA/IgG anti-TG2, IgA/IgG anti-DGP and IgA/IgG against a mix of TG2 and DGP (anti-TG2/DGP) in finding CD among children.

    Methods: Serum antibodies against TG2, DGP, and TG2/DGP were determined with ELISA in 242 children referred to a paediatric gastroenterologist. Fifty had untreated CD verified by an intestinal biopsy and 192/242 children had other diseases than CD.

    Results: Forty-eight untreated CD children had increased IgA/IgG anti-TG2, 47/50 had increased IgA/IgG anti-DGP and 46/50 had increased IgA/IgG anti-TG2/DGP. One control subject had increased IgA/IgG anti-TG2 and IgA/IgG anti-TG2/DGP, whereas 7/192 control subjects had increased IgA/IgG anti-DGP. The IgA/IgG anti-TG2 assay had the best performance with a sensitivity of 96%, a specificity of 99.5% and the area under the ROC-curve was 0.996 (95% CI 0.992-1, p < 0.0001).

    Conclusions: Detection of one antibody is not sufficient when screening for untreated CD among children due to cases of IgA deficiency. The inclusion of DGP antigens in the IgA/IgG combination assays seems to affect the sensitivity and specificity negatively, whereas detection of IgA/IgG anti-TG2 has the potential of finding most untreated CD patients, including those with IgA deficiency.

  • 14.
    Ekelund, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Ryhov Cty Hosp, Dept Pediat, Jonkoping, Sweden..
    Aalto, Kristiina
    Univ Helsinki Hosp, Childrens Hosp, Dept Pediat, Helsinki, Finland..
    Fasth, Anders
    Gothenburg Univ, Sahlgrenska Acad, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden..
    Herlin, Troels
    Arhus Univ Hosp, Dept Pediat, Aarhus, Denmark..
    Nielsen, Susan
    Rigshosp, Copenhagen Univ Hosp, Pediat Rheumatol Dept, Pediat Clin 2, Copenhagen, Denmark..
    Nordal, Ellen
    Univ Hosp North Norway, Dept Pediat, Tromso, Norway.;UIT Arctic Univ Norway, Dept Clin Med, Tromso, Norway..
    Peltoniemi, Suvi
    Univ Helsinki Hosp, Childrens Hosp, Dept Pediat, Helsinki, Finland..
    Rygg, Marite
    Norwegian Univ Sci & Technol, Dept Lab Med Childrens & Womens Hlth, Trondheim, Norway.;St Olavs Hosp, Dept Pediat, Trondheim, Norway..
    Zak, Marek
    Pediatric Rheumatology Department, Pediatric Clinic II, Copenhagen University Hospital.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Psoriasis and associated variables in classification and outcome of juvenile idiopathic arthritis - an eight-year follow-up study2017In: Pediatric Rheumatology, ISSN 1546-0096, E-ISSN 1546-0096, Vol. 15, article id 13Article in journal (Refereed)
    Abstract [en]

    Background: To study the impact of psoriasis and features associated with psoriasis on classification and outcome in a population-based follow-up cohort of children with juvenile idiopathic arthritis (JIA). Methods: In all, 440 children with JIA were followed for a median of 8 years in a prospective Nordic population-based cohort study. Data for remission was available for 427 of these children. The presence of psoriasis, psoriasis-like rash, dactylitis, nail pitting, enthesitis, tenosynovitis and heredity was assessed in relation to ILAR classification and remission. Results: Clinical findings associated with psoriasis developed consecutively during the 8-year period. Six of 14 children with psoriasis were not classified as juvenile psoriatic arthritis according to the ILAR criteria at 8 year follow-up. Dactylitis was more common in children with early onset of JIA. After 8 years we found a cumulative median number of eleven arthritic joints in children with psoriasis or psoriasis- like rash compared with six in the rest of the cohort (p = 0.02). Also, the chance for not being in remission after 8 years increased significantly in patients with psoriasis, psoriasis-like rash or at least two of: 1) first-degree heredity for psoriasis or psoriatic arthritis, 2) dactylitis or 3) nail pitting, compared with the rest of the group (OR 3.32, p = 0.010). Conclusions: Our results indicate a more severe disease over time in psoriasis- associated JIA, as features of psoriasis develop during the disease course. This group is a major challenge to encompass in a future JIA classification in order to facilitate early tailored treatment.

  • 15.
    Ekelund, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Ryhov Cty Hosp, Dept Pediat, Jönköping, Sweden. .
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Consolaro, Alessandro
    Ist Giannina Gaslini, Paediat Rheumatol Int Trials Org PRINTO, Clin Pediat & Reumatol, Via Gaslini 5, I-16147 Genoa, Italy;Univ Genoa, Dipartimento Pediat, Genoa, Italy.
    Bovis, Francesca
    Ist Giannina Gaslini, Paediat Rheumatol Int Trials Org PRINTO, Clin Pediat & Reumatol, Via Gaslini 5, I-16147 Genoa, Italy.
    Ruperto, Nicolino
    Ist Giannina Gaslini, Paediat Rheumatol Int Trials Org PRINTO, Clin Pediat & Reumatol, Via Gaslini 5, I-16147 Genoa, Italy.
    The Swedish version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR)2018In: Rheumatology International, ISSN 0172-8172, E-ISSN 1437-160X, Vol. 38, no Suppl. 1, p. 371-377Article in journal (Refereed)
    Abstract [en]

    The Juvenile Arthritis Multidimensional Assessment Report (JAMAR) is a new parent/patient-reported outcome measure that enables a thorough assessment of the disease status in children with juvenile idiopathic arthritis (JIA). We report the results of the cross-cultural adaptation and validation of the parent and patient versions of the JAMAR in the Swedish language. The reading comprehension of the questionnaire was tested in 10 JIA parents and patients. Each participating centre was asked to collect demographic, clinical data and the JAMAR in 100 consecutive JIA patients or all consecutive patients seen in a 6-month period and to administer the JAMAR to 100 healthy children and their parents. The statistical validation phase explored descriptive statistics and the psychometric issues of the JAMAR: the 3 Likert assumptions, floor/ceiling effects, internal consistency, Cronbach's alpha, interscale correlations, test-retest reliability and construct validity (convergent and discriminant validity). A total of 68 JIA patients (8.8% systemic, 44.1% oligoarticular, 13.2% RF negative polyarthritis, 33.9% other categories) and 76 healthy children, were enrolled in two centres. The JAMAR components discriminated well healthy subjects from JIA patients. All JAMAR components revealed good psychometric performances. In conclusion, the Swedish version of the JAMAR is a valid tool for the assessment of children with JIA and is suitable for use both in routine clinical practice and clinical research.

  • 16. Esbjornsson, A-C
    et al.
    Aalto, K.
    Univ Helsinki, Childrens Hosp, Dept Paediat, FIN-00014 Helsinki, Finland.;Univ Helsinki, Cent Hosp, FIN-00014 Helsinki, Finland..
    Brostrom, E. W.
    Karolinska Inst, Dept Womens & Children Hlth, Stockholm, Sweden..
    Fasth, A.
    Univ Gothenburg, Dept Pediat, Gothenburg, Sweden..
    Herlin, T.
    Aarhus Univ Hosp, Dept Paediat, DK-8000 Aarhus, Denmark..
    Nielsen, S.
    Copenhagen Univ Hosp, Rigshosp, Dept Pediat Rheumatol, Copenhagen, Denmark..
    Nordal, E.
    Univ Hosp North Norway, Dept Paediat, Tromso, Norway.;Arctic Univ Norway, UIT, Inst Clin Med, Tromso, Norway..
    Peltoniemi, S.
    Univ Helsinki, Childrens Hosp, Dept Paediat, FIN-00014 Helsinki, Finland.;Univ Helsinki, Cent Hosp, FIN-00014 Helsinki, Finland..
    Rygg, M.
    Norwegian Univ Sci & Technol, Dept Lab Med Childrens & Womens Hlth, N-7034 Trondheim, Norway.;St Olavs Hosp, Dept Paediat, Trondheim, Norway..
    Zak, M.
    Copenhagen Univ Hosp, Rigshosp, Dept Pediat Rheumatol, Copenhagen, Denmark..
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Ankle arthritis predicts polyarticular disease course and unfavourable outcome in children with juvenile idiopathic arthritis2015In: Clinical and Experimental Rheumatology, ISSN 0392-856X, E-ISSN 1593-098X, Vol. 33, no 5, p. 751-757Article in journal (Refereed)
    Abstract [en]

    Objective To evaluate the occurrence, clinical characteristics and prognostic factors associated with ankle arthritis in children with juvenile idiopathic arthritis (JIA). Methods 440 children with JIA were followed for eight years in a prospective Nordic population-based cohort study. Data on remission was available for 427 of these children. Occurrence of clinically assessed ankle arthritis was analysed in relation to JIA category, clinical characteristics and remission data eight years after disease onset. Results In 440 children with JIA, 251 (57%) experienced ankle arthritis during the first eight years of disease. Ankle arthritis was least common in the persistent oligoarticular category (25%) and most common in children with extended oligoarticular (83%) and polyarticular RF-negative (85%) JIA. Children who developed ankle arthritis during the first year of disease were younger at disease onset (median age 4.9 (IQR 2.1-8.8) vs. 6.6 (IQR 2.8-10.1) years, p<0.003) and had more cumulative affected joints at 8-year follow-up (median involved joints 10 (IQR 6-16) vs. 3 (IQR 2-9), p<0.001). The odds ratio for not achieving remission eight years after disease onset, if the ankle joint was involved during the first year of disease was 2.0 (95 %.0, p<0.001). Hind-, mid- and forefoot involvements were more common compared to patients without ankle arthritis. Conclusion In this Nordic population-based 8-year follow-up study, occurrence of ankle arthritis during the first year was associated with an unfavourable disease outcome. We suggest that ankle arthritis should be recognised in the assessment of prognosis and choice of treatment strategy in JIA.

  • 17.
    Foeldvari, Ivan
    et al.
    Hamburg Ctr Pediat & Adolescent Rheumatol, Hamburg, Germany.
    Klotsche, Jens
    German Rheumatism Res Ctr, Program Area Epidemiol, Berlin, Germany.
    Kasapcopur, Ozgur
    Istanbul Univ, Cerrahpasa Med Sch, Dept Pediat Rheumatol, Istanbul, Turkey.
    Adrovic, Amra
    Istanbul Univ, Cerrahpasa Med Sch, Dept Pediat Rheumatol, Istanbul, Turkey.
    Torok, Kathryn S.
    UPMC, Childrens Hosp Pittsburgh, Scleroderma Ctr Pittsburgh, Pediat Rheumatol, Pittsburgh, PA USA.
    Stanevicha, Valda
    Riga Stradins Univ, Pediat Cathedra, Riga, Latvia.
    Sztajnbok, Flavio
    Univ Fed Rio de Janeiro, Rio De Janeiro, Brazil.
    Terreri, Maria Teresa
    UNIFESP Univ Fed Sao Paulo, Fed Univ Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, Brazil.
    Alexeeva, Ekaterina
    Natl Med Res Ctr Childrens Hlth, Moscow, Russia;Sechenov First Moscow State Med Univ, Minist Hlth Russian Federat, Moscow, Russia.
    Anton, Jordi
    Hosp St Joan de Deu, Barcelona, Spain.
    Katsicas, Maria M.
    Hosp Pediat Prof Dr JP Garrahan, Serv Immunol & Rheumatol, Buenos Aires, DF, Argentina.
    Smith, Vanessa
    Univ Ghent, Dept Internal Med, Ghent Univ Hosp, Dept Internal Med,Dept Rheumatol, Ghent, Belgium.
    Avcin, Tadey
    Univ Childrens Hosp, Ljubljana, Slovenia.
    Cimaz, Rolando
    Osped Pediat Anna Meyer, Pediat, Florence, Italy.
    Kostik, Mikhail
    St Petersburg State Pediat Med Univ, St Petersburg, Russia.
    Lehman, Thomas J. A.
    Weill Cornell Med Coll, Hosp Special Surg, Pediat Rheumatol, New York, NY USA.
    Sifuentes-Giraldo, Walter A.
    Univ Hosp Ramon y Cajal, Dept Rheumatol, Madrid, Spain.
    Appenzeller, Simone
    State Univ Campinas UNICAMP, Fac Med Sci, Sao Paulo, Brazil.
    Janarthanan, Mahesh
    Nemkova, Dana
    Gen Univ Hosp Prague, Dept Pediat & Adolescent Med, Pediat Rheumatol Unit, Prague, Czech Republic.
    Santos, Maria Jose
    Reuma Pt, Almada, Portugal.
    Battagliotti, Cristina
    Hosp Ninos Dr Orlando Alasia, Santa Fe, Argentina.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Bica, Blanca
    Univ Fed Rio de Janeiro, HUCFF, Serv Reumatol, Rio De Janeiro, Brazil.
    Brunner, Juergen
    Med Univ Innsbruck, Div Pediat Rheumatol, Innsbruck, Austria.
    Reis, Patricia Costa
    Hosp Santa Maria, Pediat, Lisbon, Portugal.
    Eleftheriou, Despina
    UCL Inst Child Hlth, Infect Inflammat & Rheumatol, London, England.
    Harel, Liora
    Tel Aviv Univ, Sackler Sch Med, Schneider Childrens Med Ctr Israel, Tel Aviv, Israel.
    Horneff, Gerd
    Asklepios Kinderklin St Augustin GmbH, St Augustin, Germany.
    Kallinich, Tilmann
    Charite Berlin Campus Virchow, Berlin, Germany.
    Lazarevic, Dragana
    Clin Ctr Nis, Dept Pediat Rheumatol & Immunol, Nish, Serbia.
    Minden, Kirsten
    Childrens Univ Hosp Charite, German Rheumatism Res Ctr Berlin, Berlin, Germany.
    Nielsen, Susan Mary
    Rigshosp, Copenhagen, Denmark.
    Uziel, Yosef
    Meir Med Ctr, Kefar Sava, Israel.
    Helmus, Nicola
    Hamburg Ctr Pediat & Adolescent Rheumatol, Hamburg, Germany.
    Update from the Juvenile Scleroderma Inception Cohort2018In: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 70Article in journal (Other academic)
  • 18.
    Foeldvari, Ivan
    et al.
    Hamburg Ctr Pediat & Adolescent Rheumatol, Hamburg, Germany.
    Klotsche, Jens
    German Rheumatism Res Ctr, Program Area Epidemiol, Berlin, Germany.
    Kasapcopur, Ozgur
    Istanbul Univ, Cerrahpasa Med Sch, Dept Pediat Rheumatol, Istanbul, Turkey.
    Terreri, Maria Teresa
    UNIFESP Univ Fed Sao Paulo, Fed Univ Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, Brazil.
    Avcin, Tadey
    Univ Childrens Hosp, Ljubljana, Slovenia.
    Cimaz, Rolando
    Osped Pediat Anna Meyer, Pediat, Florence, Italy.
    Kostik, Mikhail
    St Petersburg State Pediat Med Univ, St Petersburg, Russia.
    Katsicas, Maria M.
    Hosp Pediat Prof Dr JP Garrahan, Serv Immunol & Rheumatol, Buenos Aires, DF, Argentina.
    Nemkova, Dana
    Gen Univ Hosp Prague, Dept Pediat & Adolescent Med, Pediat Rheumatol Unit, Prague, Czech Republic.
    Battagliotti, Cristina
    Hosp Ninos Dr Orlando Alasia, Santa Fe, Argentina.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Brunner, Juergen
    Med Univ Innsbruck, Div Pediat Rheumatol, Innsbruck, Austria.
    Harel, Liora
    Tel Aviv Univ, Sackler Sch Med, Schneider Childrens Med Ctr Israel, Tel Aviv, Israel.
    Kallinich, Tilmann
    Charite Berlin Campus Virchow, Berlin, Germany.
    Minden, Kirsten
    Charite Univ Med Berlin, Berlin, Germany.
    Santos, Maria Jose
    Reuma Pt, Almada, Portugal.
    Torok, Kathryn S.
    Univ Pittsburgh, Med Ctr, Pediat Rheumatol, Pittsburgh, PA USA.
    Helmus, Nicola
    Hamburg Ctr Pediat & Adolescent Rheumatol, Hamburg, Germany.
    After 24 Months Observation Period the Patients Related Outcomes Improve Significantly in the Juvenile Scleroderma Inceptions Cohorte2018In: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 70Article in journal (Other academic)
  • 19.
    Glerup, Mia
    et al.
    Aarhus Univ Hosp, Dept Pediat, Aarhus N, Denmark.
    Rypdal, Veronika
    UIT Arctic Univ Norway, Dept Clin Med, Tromso, Norway;Univ Hosp North Norway, Dept Pediat, Tromso, Norway.
    Arnstad, Ellen Dalen
    NTNU, Dept Clin & Mol Med, Trondheim, Norway;Levanger Hosp, Dept Pediat, Nord Trondelag, Norway.
    Ekelund, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Ryhov Cty Hosp, Dept Pediat, Jonkoping, Sweden.
    Peltoniemi, Suvi
    Univ Helsinki, Hosp Children & Adolescents, Helsinki, Finland.
    Aalto, Kristiina
    Univ Helsinki, Hosp Children & Adolescents, Helsinki, Finland.
    Rygg, Marite
    NTNU, Dept Clin & Mol Med, Trondheim, Norway;St Olays Hosp, Dept Pediat, Trondheim, Norway.
    Toftedal, Peter
    Copenhagen Univ Hosp, Dept Pediat, Copenhagen, Denmark.
    Nielsen, Susan
    Copenhagen Univ Hosp, Dept Pediat, Copenhagen, Denmark.
    Fasth, Anders
    Univ Gothenburg, Sahlgrenska Acad, Gothenburg, Sweden.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Nordal, Ellen
    UIT Arctic Univ Norway, Dept Clin Med, Tromso, Norway;Univ Hosp North Norway, Dept Pediat, Tromso, Norway.
    Herlin, Troels
    Aarhus Univ Hosp, Dept Pediat, Aarhus N, Denmark.
    Remission Status after 18 Years of Follow-up in the Population-Based Nordic Juvenile Idiopathic Arthritis (JIA) Cohort2018In: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 70Article in journal (Other academic)
  • 20.
    Glerup, Mia
    et al.
    Aarhus Univ Hosp, Dept Pediat, Aarhus N, Denmark.
    Stoustrup, Peter
    Aarhus Univ, Sect Orthodont, Aarhus, Denmark.
    Matzen, Louise Hauge
    Aarhus Univ, Dept Oral Radiol, Aarhus, Denmark.
    Rypdal, Veronika
    Univ Hosp North Norway, Dept Pediat, Tromso, Norway;UIT Arctic Univ Norway, Dept Clin Med, Tromso, Norway.
    Nordal, Ellen
    Univ Hosp North Norway, Dept Pediat, Tromso, Norway;UIT Arctic Univ Norway, Dept Clin Med, Tromso, Norway.
    Frid, Paula
    UIT Arctic Univ Norway, Dept Clin Med, Tromso, Norway;Univ Hosp North Norway, ENT Dept, Div Oral & Maxillofacial Surg, Tromso, Norway;Univ Hosp North Norway, Div Oral & Maxillofacial Surg, Tromso, Norway;Publ Dent Serv Competence Ctr North Norway, Tromso, Norway.
    Arnstad, Ellen Dalen
    NTNU, Dept Clin & Mol Med, Trondheim, Norway;Levanger Hosp, Dept Pediat, Nord Trondelag, Norway.
    Rygg, Marite
    NTNU, Dept Clin & Mol Med, Trondheim, Norway;St Olavs Hosp, Dept Pediat, Trondheim, Norway.
    Thorarensen, Olafur
    NTNU, St Olavs Hosp, Dept Oral & Craniomaxillofacial Surg, Trondheim, Norway.
    Ekelund, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Ryhov Cty Hosp, Dept Pediat, Jonkoping, Sweden.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Fasth, Anders
    Univ Gothenburg, Sahlgrenska Acad, Gothenburg, Sweden.
    Nilsson, Hakan
    Inst Postgrad Dent Educ, Dept Oral & Maxillofacial Surg, Jonkoping, Sweden.
    Peltoniemi, Suvi
    Univ Helsinki, Hosp Children & Adolescents, Helsinki, Finland.
    Aalto, Kristiina
    Univ Helsinki, Hosp Children & Adolescents, Helsinki, Finland.
    Arte, Sirpa
    Univ Helsinki, Dept Oral & Maxillofacial Dis, Helsinki, Finland.
    Toftedal, Peter
    Copenhagen Univ Hosp, Dept Pediat, Copenhagen, Denmark.
    Nielsen, Susan
    Copenhagen Univ Hosp, Dept Pediat, Copenhagen, Denmark.
    Kreiborg, Sven
    Univ Copenhagen, Dept Paediat Dent & Clin Genet, Copenhagen, Denmark.
    Herlin, Troels
    Aarhus Univ Hosp, Dept Pediat, Aarhus N, Denmark.
    Pedersen, Thomas Klit
    Aarhus Univ, Sect Orthodont, Aarhus, Denmark;Aarhus Univ Hosp, Dept Oral & Maxillofacial Surg, Aarhus, Denmark.
    Long-Term Outcome of Temporomandibular Joint Arthritis in Juvenile Idiopathic Arthritis: Results of 18-Year Follow-up in the Population-Based Nordic JIA Cohort2018In: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 70Article in journal (Other academic)
  • 21.
    Glerup, Mia
    et al.
    Aarhus Univ Hosp, Dept Pediat, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark.
    Thiel, Steffen
    Aarhus Univ, Dept Biomed, Aarhus, Denmark.
    Rypdal, Veronika
    Univ Hosp North Norway, Dept Pediat, Tromso, Norway;UiT Arctic Univ Norway, Dept Clin Med, Tromso, Norway.
    Arnstad, Ellen Dalen
    NTNU Norwegian Univ Sci & Technol, Dept Clin & Mol Med, Trondheim, Norway;Nord Trondelag Hosp Trust, Levanger Hosp, Dept Pediat, Levanger, Norway.
    Ekelund, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research. Ryhov Cty Hosp, Dept Pediat, Jonkoping, Sweden.
    Peltoniemi, Suvi
    Univ Helsinki, Helsinki Univ Cent Hosp, New Childrens Hosp, Pediat Res Ctr, Helsinki, Finland.
    Aalto, Kristiina
    Univ Helsinki, Helsinki Univ Cent Hosp, New Childrens Hosp, Pediat Res Ctr, Helsinki, Finland.
    Rygg, Marite
    NTNU Norwegian Univ Sci & Technol, Dept Clin & Mol Med, Trondheim, Norway;St Olavs Hosp, Dept Pediat, Trondheim, Norway.
    Nielsen, Susan
    Copenhagen Univ Hosp, Rigshosp, Dept Pediat, Copenhagen, Denmark.
    Fasth, Anders
    Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Nordal, Ellen
    Univ Hosp North Norway, Dept Pediat, Tromso, Norway;UiT Arctic Univ Norway, Dept Clin Med, Tromso, Norway.
    Herlin, Troels
    Aarhus Univ Hosp, Dept Pediat, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark.
    Complement lectin pathway protein levels reflect disease activity in juvenile idiopathic arthritis: a longitudinal study of the Nordic JIA cohort2019In: Pediatric Rheumatology, ISSN 1546-0096, E-ISSN 1546-0096, Vol. 17, no 1, article id 63Article in journal (Refereed)
    Abstract [en]

    Background

    To determine the serum levels of the lectin pathway proteins early in the disease course and 17 years after disease onset and to correlate the protein levels to markers of disease activity in participants from a population-based Nordic juvenile idiopathic arthritis (JIA) cohort. Additionally, to assess the predictive value of lectin pathway proteins with respect to remission status.

    Methods

    A population-based cohort study of consecutive cases of JIA with a disease onset from 1997 to 2000 from defined geographical areas of Finland, Sweden, Norway and Denmark with 17 years of follow-up was performed. Clinical characteristics were registered and H-ficolin, M-ficolin, MASP-1, MASP-3, MBL and CL-K1 levels in serum were analyzed.

    Results

    In total, 293 patients with JIA were included (mean age 23.7 ± 4.4 years; mean follow-up 17.2 ± 1.7 years). Concentrations of the lectin protein levels in serum were higher at baseline compared to the levels 17 years after disease onset (p ≤ 0.006, n = 164). At baseline, the highest level of M-ficolin was observed in systemic JIA. Further, high M-ficolin levels at baseline and at 17-year follow-up were correlated to high levels of ESR. In contrast, high MASP-1 and MASP-3 tended to correlate to low ESR. CL-K1 showed a negative correlation to JADAS71 at baseline.

    None of the protein levels had prognostic abilities for remission status 17 years after disease onset.

    Conclusion

    We hypothesize that increased serum M-ficolin levels are associated with higher disease activity in JIA and further, the results indicate that MASP-1, MASP-3 and CL-K1 are markers of inflammation.

  • 22.
    Kazamia, Kalliopi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Holmquist, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Fagerlund, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Children with juvenile idiopathic arthritis frequently experience interruptions to their medical therapy2014In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 5, p. 529-536Article in journal (Refereed)
    Abstract [en]

    AimTo study real-life experiences of drug treatment discontinuations and safety in a well-defined cohort of patients with juvenile idiopathic arthritis (JIA), over an eleven-year period in Uppsala County, Sweden. MethodsClinical charts of all incident and prevalent cases of juvenile arthritis were reviewed prospectively by an experienced paediatric rheumatologist. Each patient file was supplemented retrospectively regarding hereditary diseases, clinical data and aspects of pharmacological treatment. ResultsSevere adverse events from methotrexate or biological agents were rare, but 84 occasions of interrupted therapy due to adverse events or inefficacy were identified within 225 treatment periods (37.3%) in the 156 patients (108 girls and 48 boys) studied. The median observation period was 8.6years after disease onset (minimum 1.33, maximum 17.5years). Oral and subcutaneous methotrexate caused adverse events in 22.6% of the treatment periods and biological agents in 19.2% (p=0.71). Discontinuation of treatment periods was equally common for methotrexate (38.7%) and biological agents (33.3%) (p=0.53). ConclusionOur study shows a high percentage of interrupted medical therapies, due to adverse events or inefficacy, in children with JIA. Adverse events from methotrexate and biological agents were seldom severe. The results highlight the need for better predictive factors to guide therapy.

  • 23.
    Klotsche, Jens
    et al.
    German Rheumatism Res Ctr, Epidemiol Unit, Berlin, Germany..
    Foeldvari, Ivan
    Hamburg Ctr Pediat & Adolescent Rheumatol, Hamburg, Germany..
    Kasapcopur, Ozgur
    Istanbul Univ, Cerrahpasa Med Sch, Dept Pediat Rheumatol, Pediat Rheumatol, Istanbul, Turkey..
    Smith, Vanessa
    Univ Ghent, Fac Internal Med, Ghent, Belgium..
    Sztajnbok, Flavio
    Univ Fed Rio de Janeiro, Rio De Janeiro, Brazil..
    Katsicas, Maria M.
    Hosp Pediat Prof Dr JP Garrahan, Serv Immunol & Rheumatol, Buenos Aires, DF, Argentina..
    Cimaz, Rolando
    Osped Pediat Anna Meyer, Pediat, Florence, Italy..
    Janarthanan, Mahesh
    Pediat Rheumatol, Chennai, Tamil Nadu, India..
    Anton, Jordi
    Univ Childrenxs Hosp, Pediat Rheumatol, Barcelona, Spain..
    Kostik, Mikhail
    State Pediat Med Univ, Hosp Pediat, St Petersburg, Russia..
    Nemkova, Dana
    Gen Univ Hosp Prague, Dept Pediat & Adolescent Med, Pediat Rheumatol Unit, Prague, Czech Republic..
    Sifuentes-Giraldo, Walter A.
    Hosp Univ Ramon y Cajal, Rheumatol, Madrid, Spain..
    Stanevicha, Valda
    Riga Stradins Univ, Pediat Cathedra, Riga, Latvia..
    Torok, Kathryn S.
    Univ Pittsburgh, Med Ctr, Pediat Rheumatol, Pittsburgh, PA USA..
    Appenzeller, Simone
    Univ Estadual Campinas, Pediat Rheumatol Unit, Campinas, SP, Brazil..
    Avcin, Tadey
    Univ Childrens Hosp, Ljubljana, Slovenia..
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Harel, Liora
    Tel Aviv Univ, Sackler Sch Med, Schneider Childrens Med Ctr Israel, Tel Aviv, Israel..
    Kallinich, Tilmann
    Humbolt Univ Med Berlin, Charite, Berlin, Germany..
    Santos, Maria Jose
    Reuma Pt, Almada, Portugal..
    Terreri, Maria Teresa
    Univ Fed Sao Paulo, UNIFESP, Pediat Rheumatol Unit, Sao Paulo, Brazil..
    Uziel, Yosef
    Meir Med Ctr, Kefar Sava, Israel..
    Helmus, Nicola
    Hamburg Ctr Pediat & Adolescent Rheumatol, Hamburg, Germany..
    Performance of Juvenile Scleroderma Classification Criteria for Juvenile Systemic Sclerosis: Results from the Jssc Inception Cohort2017In: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 69, no S10, article id 1286Article in journal (Other academic)
  • 24. Nordal, E. B.
    et al.
    Zak, M.
    Aalto, K.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Fasth, A.
    Herlin, T.
    Lahdenne, P.
    Nielsen, S.
    Peltoniemi, S.
    Straume, B.
    Rygg, M.
    Validity and predictive ability of the juvenile arthritis disease activity score based on CRP versus ESR in a Nordic population-based setting2012In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 71, no 7, p. 1122-1127Article in journal (Refereed)
    Abstract [en]

    Objective To compare the juvenile arthritis disease activity score (JADAS) based on C reactive protein (CRP) (JADAS-CRP) with JADAS based on erythrocyte sedimentation rate (ESR) (JADAS-ESR) and to validate JADAS in a population-based setting.

    Methods The CRP and ESR values and the corresponding JADAS scores (JADAS10/27/71) were compared in a longitudinal cohort study of 389 children newly diagnosed with juvenile idiopathic arthritis (JIA) in the Nordic JIA study. The construct validity and the discriminative and predictive ability of JADAS were assessed during a median disease course of 8 years by comparing JADAS with other measures of disease activity and outcome.

    Results At the first study visit the correlation between JADAS27-CRP and JADAS27-ESR was r = 0.99 whereas the correlation between CRP and ESR was r = 0.57. Children with higher JADAS scores had an increased risk of concomitant pain, physical disability and use of disease-modifying antirheumatic drugs (DMARDs). A higher JADAS score at the first study visit also significantly predicted physical disability, damage and no remission off medication at the final study visit, and also use of DMARDs during the disease course. Sensitivity to change, demonstrated as change in JADAS score compared with the American College of Rheumatology paediatric measures of improvement criteria, mostly showed excellent classification ability.

    Conclusion The JADAS-CRP and JADAS-ESR correlate closely, show similar test characteristics and are feasible and valid tools for assessing disease activity in JIA.

  • 25.
    Nordal, Ellen B.
    et al.
    Department of Pediatrics, University Hospital of North Norway, Institute of Community Medicine.
    Songstad, T
    Department of Pediatrics, University Hospital of North Norway, Institute of Clinical Medicine, University of Tromsø.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Moen, Torolf
    Department of Immunology, St. Olavs Hospital.
    Straume, Bjorn
    Institute of Community Medicine, University of Tromsø.
    Rygg, Marite
    Department of Laboratory Medicine, Children’s and Women’s Health, Faculty of Medicine, Norwegian University of Science and Technology and Department of Pediatrics, St. Olavs Hospital.
    Biomarkers of Chronic Uveitis in Juvenile Idiopathic Arthritis: Predictive Value of Antihistone Antibodies and Antinuclear Antibodies2009In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 36, no 8, p. 1737-1743Article in journal (Refereed)
    Abstract [en]

    Objective. To study the predictive value of antinuclear autoantibody (ANA) tests and antihistone antibodies (AHA) as risk factors for development of chronic asymptomatic uveitis of insidious onset in juvenile idiopathic arthritis (RA). Methods. ANA by indirect immunofluorescence using HEp-2 cells (IF-ANA), ELISA for ANA (E-ANA), and AHA were analyzed in sera of 100 children with recent-onset JIA and in 58 control sera. Clinical features, including age at onset, JIA subgroup, and presence Of Uveitis, were recorded in this prospective population-based cohort study. Results. E-ANA was positive in 4 of the 100 sera, and was not associated with uveitis. Chronic uveitis developed in 16 children with JIA: in 14 of 68 positive for IF-ANA : 80, and in 13 of 44 positive for AkA >= 8 U/ml. IgM/IgG AHA were found in higher proportions in children with uveitis (mean 12.4 U/ml) than in those with JIA and no uveitis (mean 6.9 U/ml) or in healthy controls (mean 4.3 U/ml). Conclusion. No association was found between E-ANA and uveitis, and most IF-ANA-positive sera were E-ANA-negative. E-ANA is not clinically relevant in this setting and should never be used to determine frequencies of eye examinations to detect new uveitis in JIA. AHA >= 8 U/ml, IF-ANA titer 320, and young age at onset of arthritis were significant predictors for development of chronic uveitis. The diagnostic value of AHA 8 U/ml as a biomarker of chronic uveitis in JIA is very similar to IF-ANA >= 80. (First Release July 1 2009; J Rheumatol 2009:36:1737-43; doi: 10.3899/jrheum.081318)

  • 26. Nordal, Ellen
    et al.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Aalto, Kristiina
    Peltoniemi, Suvi
    Nielsen, Susan
    Herlin, Troels
    Fasth, Anders
    Rygg, Marite
    Uveitis In The Nordic Juvenile Idiopathic Arthritis Cohort; High Incidence, Frequent Complications, and Gender Associated Risk Factors2013In: Arthritis and Rheumatism, ISSN 0004-3591, E-ISSN 1529-0131, Vol. 65, no Suppl. 10, p. S124-S124Article in journal (Other academic)
  • 27.
    Nordal, Ellen
    et al.
    Univ Hosp North Norway, Dept Pediat, N-9038 Tromso, Norway;UIT Arctic Univ Norway, Dept Clin Med, Tromso, Norway.
    Rypdal, Veronika
    Univ Hosp North Norway, Dept Pediat, N-9038 Tromso, Norway;UIT Arctic Univ Norway, Dept Clin Med, Tromso, Norway.
    Arnstad, Ellen Dalen
    NTNU Norwegian Univ Sci & Technol, Dept Clin & Mol Med, Trondheim, Norway;Nord Trondelag Hosp Trust, Levanger Hosp, Dept Pediat, Levanger, Norway.
    Aalto, Kristiina
    Univ Helsinki, Childrens Hosp, Helsinki, Finland.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Ekelund, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research. Ryhov Cty Hosp, Dept Pediat, Jonkoping, Sweden.
    Fasth, Anders
    Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden.
    Glerup, Mia
    Aarhus Univ Hosp, Dept Pediat, Aarhus, Denmark.
    Herlin, Troels
    Aarhus Univ Hosp, Dept Pediat, Aarhus, Denmark.
    Nielsen, Susan
    Copenhagen Univ Hosp, Rigshosp, Dept Pediat, Copenhagen, Denmark.
    Peltoniemi, Suvi
    Univ Helsinki, Childrens Hosp, Helsinki, Finland.
    Zak, Marek
    Copenhagen Univ Hosp, Rigshosp, Dept Pediat, Copenhagen, Denmark.
    Songstad, Nils Thomas
    Univ Hosp North Norway, Dept Pediat, N-9038 Tromso, Norway;UIT Arctic Univ Norway, Dept Clin Med, Tromso, Norway.
    Rygg, Marite
    NTNU Norwegian Univ Sci & Technol, Dept Clin & Mol Med, Trondheim, Norway;St Olavs Hosp, Dept Pediat, Trondheim, Norway.
    Participation in school and physical education in juvenile idiopathic arthritis in a Nordic long-term cohort study2019In: Pediatric Rheumatology, ISSN 1546-0096, E-ISSN 1546-0096, Vol. 17, article id 44Article in journal (Refereed)
    Abstract [en]

    Background: The aim of the study was to describe school attendance and participation in physical education in school among children with juvenile idiopathic arthritis (JIA).

    Methods: Consecutive cases of JIA from defined geographical areas of Finland, Sweden and Norway with disease onset in 1997 to 2000 were followed for 8 years in a multi-center cohort study, aimed to be as close to population-based as possible. Clinical characteristics and information on school attendance and participation in physical education (PE) were registered.

    Results: Participation in school and in PE was lowest initially and increased during the disease course. Eight years after disease onset 228/274 (83.2%) of the children reported no school absence due to JIA, while 16.8% reported absence during the last 2 months due to JIA. Full participation in PE was reported by 194/242 (80.2%), partly by 16.9%, and none by 2.9%. Lowest participation in PE was found among children with ERA and the undifferentiated categories. Absence in school and PE was associated with higher disease activity measures at the 8-year visit. School absence >1day at baseline predicted use of disease-modifying anti-rheumatic drugs, including biologics (DMARDs) (OR 1.2 (1.1-1.5)), and non-remission off medication (OR 1.4 (1.1-1.7) 8 years after disease onset.

    Conclusion: School absence at baseline predicted adverse long-term outcome. In children and adolescents with JIA participation in school activities is mostly high after 8years of disease. For the minority with low participation, special attention is warranted to promote their full potential of social interaction and improve long-term outcome.

  • 28.
    Nordal, Ellen
    et al.
    Univ Hosp North Norway, Dept Pediat, Tromso, Norway.;UiT Arctic Univ Norway, Dept Clin Med, Tromso, Norway..
    Rypdal, Veronika
    Univ Hosp North Norway, Dept Pediat, Tromso, Norway.;UiT Arctic Univ Norway, Dept Clin Med, Tromso, Norway..
    Christoffersen, Terje
    UiT Arctic Univ Norway, Dept Clin Med, Tromso, Norway.;Univ Hosp North Norway, Dept Ophtalmol, Tromso, Norway..
    Aalto, Kristiina
    Univ Helsinki, Hosp Children & Adolescents, Pediat Rheumatol Clin, Helsinki, Finland..
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Fasth, Anders
    Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden..
    Herlin, Troels
    Aarhus Univ Hosp, Dept Pediat, Aarhus, Denmark..
    Nielsen, Susan
    Copenhagen Univ Hosp, Rigshosp, Pediat Rheumatol Clin, Copenhagen, Denmark..
    Peltoniemi, Suvi
    Univ Helsinki, Hosp Children & Adolescents, Pediat Rheumatol Clin, Helsinki, Finland..
    Straume, Bjorn
    UiT Arctic Univ Norway, Dept Community Med, Tromso, Norway..
    Zak, Marek
    Copenhagen Univ Hosp, Rigshosp, Pediat Rheumatol Clin, Copenhagen, Denmark..
    Rygg, Marite
    NTNU Norwegian Univ Sci & Technol, Dept Clin & Mol Med, Trondheim, Norway.;St Olavs Hosp, Dept Pediat, Trondheim, Norway..
    Incidence and predictors of Uveitis in juvenile idiopathic arthritis in a Nordic long-term cohort study2017In: Pediatric Rheumatology, ISSN 1546-0096, E-ISSN 1546-0096, Vol. 15, article id 66Article in journal (Refereed)
    Abstract [en]

    Background:

    The incidence of uveitis associated with juvenile idiopathic arthritis (JIA) varies around the world. Our aim was to investigate the incidence and predictors of uveitis in a Nordic population-based cohort.

    Methods:

    Consecutive JIA cases from defined geographical areas in Denmark, Finland, Sweden and Norway with disease onset between January 1997 to June 2000 were followed for median 98 months in this prospective longitudinal cohort study. Potential clinical and immunological predictors of uveitis were identified with logistic regression analysis.

    Results:

    Uveitis occurred in 89 (20.5%) of the 435 children with regular ophtalmologic follow-up among the 500 included. Chronic asymptomatic uveitis developed in 80 and acute symptomatic uveitis in 9 children. Uveitis developed at a median interval of 0.8 (range - 4.7 to 9.4) years after onset of arthritis. Predictors of uveitis were age < 7 years at JIA onset (Odds ratio (OR) 2.1, 95% confidence interval (CI) 1.3 to 3.5), presence of antihistone antibodies (AHA) > 15 U/ml (OR 4.8 (1.8 to 13.4)) and antinuclear antibodies (ANA) (OR 2.4 (1.5 to 4.0)). Mean combined IgM/IgG AHA was significantly higher in the uveitis group (19.2 U/ml) than in the non-uveitis group (10.2 U/ml) (p = 0.002). Young age at JIA onset predicted uveitis in girls (p < 0.001), but not in boys (p = 0.390).

    Conclusion:

    Early-onset arthritis and presence of AHA in girls, as well as presence of ANA in both genders, were significant predictors of chronic uveitis. The high incidence of uveitis in this long-term Nordic JIA cohort may have severe implications in a lifelong perspective.

  • 29.
    Nordal, Ellen
    et al.
    Dept of Pediatrics, Univ Hospital of North Norway, Institute of Community Medicine and Institute of Clinical Medicine University of Tromsø.
    Zak, Marek
    University Clinic of Pediatrics II, Rigshospitalet, Copenhagen, Denmark.
    Aalto, Kristiina
    Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Fasth, Anders
    Herlin, Troels
    Lahdenne, Pekka
    Nielsen, Susan
    Straume, Bjørn
    Rygg, Marite
    Department of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology and Department of Pediatrics, St. Olavs Hospital, Trondheim, Norway.
    Ongoing disease activity and changing categories in a long-term nordic cohort study of juvenile idiopathic arthritis2011In: Arthritis and Rheumatism, ISSN 0004-3591, E-ISSN 1529-0131, Vol. 63, no 9, p. 2809-2818Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    To describe the disease characteristics, long-term course, and outcome of patients with juvenile idiopathic arthritis (JIA) in a population-based setting.

    METHODS:

    Consecutive cases of JIA from defined geographic areas of Denmark, Finland, Sweden, and Norway in whom disease onset occurred in 1997-2000 were included in a prospective, multicenter cohort study. The study was designed to be as close to a population-based study as possible, with centers participating only if they were able to include in their catchment area all children in whom JIA was diagnosed.

    RESULTS:

    Of 500 children included, 440 (88.0%) had repeated visits, with the last visit occurring at least 7 years after disease onset (median 98 months, range 84-147 months). Changes in the International League of Associations for Rheumatology category were observed in 10.8% of the children, and, in addition, extended oligoarthritis developed in 34.7% of the group with oligoarticular JIA. During the observation period, 58.0% of the children were treated with disease-modifying antirheumatic drugs, including biologic medications. Ongoing disease activity was mostly mild, but some JIA-related damage developed in 22.9% of the children. At the last followup visit, remission off medication was observed in 42.4% of the children, 8.9% were in remission on medication, and 48.7% were not in remission. The highest rates of remission were observed in patients with persistent oligoarticular JIA and in those with systemic JIA.

    CONCLUSION:

    In this long-term prospective study of JIA in a population-based Nordic setting, ongoing disease was evident in a majority of the children. The present results underline the need to identify early predictors of outcome, to further improve therapy, and to continue long-term followup of patients with JIA.

  • 30.
    Prokopec, Kajsa E.
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Biology, Department of Cell and Molecular Biology.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Öman, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Kleinau, Sandra
    Uppsala University, Disciplinary Domain of Science and Technology, Biology, Department of Cell and Molecular Biology, Chemical Biology.
    Up Regulated Complement and Fc Receptors in Juvenile Idiopathic Arthritis and Correlation with Disease Phenotype2012In: Journal of Clinical Immunology, ISSN 0271-9142, E-ISSN 1573-2592, Vol. 32, no 3, p. 540-550Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The progress in identifying immunological mechanisms in juvenile idiopathic arthritis (JIA) has partly been hampered by the fact that the disease is heterogeneous. Here we have investigated complement and Fc receptors, as part of the inflammatory process, in two subgroups of JIA.

    METHODS: Blood from 26 patients with oligoarticular or polyarticular course type JIA and 21 healthy age and sex-matched controls were investigated by FACS and immunoassays.

    RESULTS: Increased numbers of monocytes and augmented plasma levels of C-reactive protein, C3a and IgG were found in both JIA subgroups. However, only polyarticular patients exhibited increased expression of Fc gamma receptor (FcγR) II and III and complement receptor (CR) 1 on monocytes along with enhanced CR1 expression on B cells. A correlation was observed between degree of receptor expression and C3a levels in the patients.

    CONCLUSIONS: Complement and Fc receptors are up regulated in children with multiple joint involvements, thus highlighting these pathways in the pathogenesis of polyarticular JIA.

  • 31.
    Rypdal, Veronika
    et al.
    Univ Hosp North Norway, Dept Pediat, Tromso, Norway;UIT Arctic Univ Norway, Dept Clin Med, Tromso, Norway.
    Arnstad, Ellen Dalen
    NTNU Norwegian Univ Sci & Technol, Dept Clin & Mol Med, Trondheim, Norway;Nord Trondelag Hosp Trust, Levanger Hosp, Dept Pediat, Levanger, Norway.
    Aalto, Kristiina
    Univ Helsinki, Hosp Children & Adolescents, Helsinki, Finland.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Ekelund, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Fasth, Anders
    Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden.
    Glerup, Mia
    Aarhus Univ Hosp, Dept Pediat, Aarhus, Denmark.
    Herlin, Troels
    Aarhus Univ Hosp, Dept Pediat, Aarhus, Denmark.
    Nielsen, Susan
    Copenhagen Univ Hosp, Dept Pediat, Rigshosp, Copenhagen, Denmark.
    Peltoniemi, Suvi
    Univ Helsinki, Hosp Children & Adolescents, Helsinki, Finland.
    Zak, Marek
    Copenhagen Univ Hosp, Dept Pediat, Rigshosp, Copenhagen, Denmark.
    Rygg, Marite
    NTNU Norwegian Univ Sci & Technol, Dept Clin & Mol Med, Trondheim, Norway;St Olays Hosp, Dept Pediat, Trondheim, Norway.
    Rypdal, Martin
    UIT Arctic Univ Norway, Dept Math & Stat, Tromso, Norway.
    Nordal, Ellen
    Univ Hosp North Norway, Dept Pediat, Tromso, Norway;UIT Arctic Univ Norway, Dept Clin Med, Tromso, Norway.
    Predicting unfavorable long-term outcome in juvenile idiopathic arthritis: results from the Nordic cohort study2018In: Arthritis Research & Therapy, ISSN 1478-6354, E-ISSN 1478-6362, Vol. 20, article id 91Article in journal (Refereed)
    Abstract [en]

    Background: The aim was to develop prediction rules that may guide early treatment decisions based on baseline clinical predictors of long-term unfavorable outcome in juvenile idiopathic arthritis (JIA).

    Methods: In the Nordic JIA cohort, we assessed baseline disease characteristics as predictors of the following outcomes 8 years after disease onset. Non-achievement of remission off medication according to the preliminary Wallace criteria, functional disability assessed by Childhood Health Assessment Questionnaire (CHAQ) and Physical Summary Score (PhS) of the Child Health Questionnaire, and articular damage assessed by the Juvenile Arthritis Damage Index-Articular (JADI-A). Multivariable models were constructed, and cross-validations were performed by repeated partitioning of the cohort into training sets for developing prediction models and validation sets to test predictive ability.

    Results: The total cohort constituted 423 children. Remission status was available in 410 children: 244 (59.5%) of these did not achieve remission off medication at the final study visit. Functional disability was present in 111/340 (32.7%) children assessed by CHAQ and 40/199 (20.1%) by PhS, and joint damage was found in 29/216 (13.4%). Model performance was acceptable for making predictions of long-term outcome. In validation sets, the area under the curves (AUCs) in the receiver operating characteristic (ROC) curves were 0.78 (IQR 0.72-0.82) for non-achievement of remission off medication, 0.73 (IQR 0.67-0.76) for functional disability assessed by CHAQ, 0.74 (IQR 0.65-0.80) for functional disability assessed by PhS, and 0.73 (IQR 0.63-0.76) for joint damage using JADI-A.

    Conclusion: The feasibility of making long-term predictions of JIA outcome based on early clinical assessment is demonstrated. The prediction models have acceptable precision and require only readily available baseline variables. Further testing in other cohorts is warranted.

  • 32.
    Öman, Anders
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Hansson, Tony
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Carlsson, Martin
    Hudiksvall Hosp, Dept Pediat, Hudiksvall, Sweden.
    Berntson, Lillemor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Evaluation of screening for coeliac disease in children with juvenile idiopathic arthritis2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 4, p. 688-693Article in journal (Refereed)
    Abstract [en]

    Aim: To study the prevalence of coeliac disease (CD) in children with Juvenile idiopathic arthritis (JIA), by screening a population-based cohort of children with JIA using autoantibodies against tissue transglutaminase (anti-TG2).

    Methods: All children diagnosed with JIA in three Swedish counties, with disease onset between 2007 and 2014, were included prospectively. Serum levels of IgA anti-TG2 antibodies, IgG anti-TG2 antibodies, and total IgA were analysed. Children with positive levels of IgA anti-TG2 antibodies and children with IgA deficiency in combination with positive levels of IgG anti-TG2 antibodies were referred to the paediatric gastroenterology unit for gastroscopy and small intestine biopsy.

    Results: A total of 216 children were included, and analysis of IgA and IgG anti-TG2 antibodies was performed in 213 children. Three children were diagnosed with CD prior to the diagnosis of JIA, and three additional children were found through screening, resulting in a CD point prevalence of 2.8% (95% CI 0.6-5.0%).

    Conclusion: We found a point prevalence of CD close to previous described prevalence in the general population of Swedish children. Therefore, general screening for CD in children with JIA is not supported by our data. However, this study shows that asymptomatic CD in children with JIA may be found by screening.

1 - 32 of 32
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf