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Published in: Pediatric Rheumatology 1/2017

Open Access 01-12-2017 | Research article

Cardiac findings in children with juvenile Dermatomyositis at disease presentation

Authors: Serdar Cantez, Gil J. Gross, Ian MacLusky, Brian M. Feldman

Published in: Pediatric Rheumatology | Issue 1/2017

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Abstract

Background

Juvenile Dermatomyositis (JDM) is a pediatric vasculopathy characterized primarily by skin and muscle involvement. Cardiac findings have been reported in children with JDM but have rarely been investigated in detail.

Methods

We aimed to describe the relevant clinical and laboratory cardiac findings of a cohort of patients with JDM, followed at one centre, at disease diagnosis.

Results

We performed a retrospective review of 105 patients with JDM, followed from 1991 to 2007. Six of 70 patients (9%, 6% of the entire cohort) had abnormal electrocardiographic (ECG) findings, while 26 of 54 patients (48%, 25% of the entire cohort) had abnormal echocardiographic (echo) findings. Many of these findings were either mild or unlikely to be a result of JDM.

Conclusions

Our findings suggest that cardiac abnormalities at JDM disease onset are frequently seen, but are rarely significant findings due to disease; however, JDM patients should be considered for screening for cardiac disease as late cardiac complications are well recognized.
Literature
1.
go back to reference Feldman BM, Rider LG, Reed AM, Pachman LM. Juvenile dermatomyositis and other idiopathic inflammatory myopathies of childhood. Lancet. 2008 Jun 28;371(9631):2201–12.CrossRefPubMed Feldman BM, Rider LG, Reed AM, Pachman LM. Juvenile dermatomyositis and other idiopathic inflammatory myopathies of childhood. Lancet. 2008 Jun 28;371(9631):2201–12.CrossRefPubMed
2.
go back to reference Ramanan AV, Feldman BM. Clinical features and outcomes of juvenile dermatomyositis and other childhood onset myositis syndromes. Rheum Dis Clin N Am. [Review]. 2002 Nov;28(4):833-857. Ramanan AV, Feldman BM. Clinical features and outcomes of juvenile dermatomyositis and other childhood onset myositis syndromes. Rheum Dis Clin N Am. [Review]. 2002 Nov;28(4):833-857.
3.
go back to reference Ravelli A, Trail L, Ferrari C, Ruperto N, Pistorio A, Pilkington C, et al. Long-term outcome and prognostic factors of juvenile dermatomyositis: a multinational, multicenter study of 490 patients. Arthritis Care Res (Hoboken). [Comparative Study Multicenter Study Research Support, Non-U.S. Gov't]. 2010 Jan 15;62(1):63-72. Ravelli A, Trail L, Ferrari C, Ruperto N, Pistorio A, Pilkington C, et al. Long-term outcome and prognostic factors of juvenile dermatomyositis: a multinational, multicenter study of 490 patients. Arthritis Care Res (Hoboken). [Comparative Study Multicenter Study Research Support, Non-U.S. Gov't]. 2010 Jan 15;62(1):63-72.
4.
go back to reference Pachman LM, Cooke N. Juvenile dermatomyositis: a clinical and immunologic study. J Pediatr. [Research Support, U.S. Gov't, P.H.S.]. 1980 Feb;96(2):226-234. Pachman LM, Cooke N. Juvenile dermatomyositis: a clinical and immunologic study. J Pediatr. [Research Support, U.S. Gov't, P.H.S.]. 1980 Feb;96(2):226-234.
5.
go back to reference Na SJ, Kim SM, Sunwoo IN, Choi YC. Clinical characteristics and outcomes of juvenile and adult dermatomyositis. J Korean Med Sci. [Case Reports]. 2009 Aug;24(4):715-721. Na SJ, Kim SM, Sunwoo IN, Choi YC. Clinical characteristics and outcomes of juvenile and adult dermatomyositis. J Korean Med Sci. [Case Reports]. 2009 Aug;24(4):715-721.
6.
go back to reference Rider LG, Lachenbruch PA, Monroe JB, Ravelli A, Cabalar I, Feldman BM, et al. Damage extent and predictors in adult and juvenile dermatomyositis and polymyositis as determined with the myositis damage index. Arthritis Rheum. [Comparative Study Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't]. 2009 Nov;60(11):3425-3435. Rider LG, Lachenbruch PA, Monroe JB, Ravelli A, Cabalar I, Feldman BM, et al. Damage extent and predictors in adult and juvenile dermatomyositis and polymyositis as determined with the myositis damage index. Arthritis Rheum. [Comparative Study Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't]. 2009 Nov;60(11):3425-3435.
7.
go back to reference Schwartz T, Sanner H, Husebye T, Flato B, Sjaastad I. Cardiac dysfunction in juvenile dermatomyositis: a case-control study. Ann Rheum Dis. [Research Support, Non-U.S. Gov't]. 2011 May;70(5):766-771. Schwartz T, Sanner H, Husebye T, Flato B, Sjaastad I. Cardiac dysfunction in juvenile dermatomyositis: a case-control study. Ann Rheum Dis. [Research Support, Non-U.S. Gov't]. 2011 May;70(5):766-771.
8.
go back to reference Barth Z, Nomeland Witczak B, Schwartz T, Gjesdal K, Flato B, Koller A, et al. In juvenile dermatomyositis, heart rate variability is reduced, and associated with both cardiac dysfunction and markers of inflammation: a cross-sectional study median 13.5 years after symptom onset. Rheumatology (Oxford). 2016;55(3):535-43. doi:10.1093/rheumatology/kev376. Epub 2015 Oct 24. Barth Z, Nomeland Witczak B, Schwartz T, Gjesdal K, Flato B, Koller A, et al. In juvenile dermatomyositis, heart rate variability is reduced, and associated with both cardiac dysfunction and markers of inflammation: a cross-sectional study median 13.5 years after symptom onset. Rheumatology (Oxford). 2016;55(3):535-43. doi:10.​1093/​rheumatology/​kev376. Epub 2015 Oct 24.
9.
go back to reference Schwartz T, Sanner H, Gjesdal O, Flato B, Sjaastad I. In juvenile dermatomyositis, cardiac systolic dysfunction is present after long-term follow-up and is predicted by sustained early skin activity. Ann Rheum Dis. 2014;73(10):1805–10.CrossRefPubMed Schwartz T, Sanner H, Gjesdal O, Flato B, Sjaastad I. In juvenile dermatomyositis, cardiac systolic dysfunction is present after long-term follow-up and is predicted by sustained early skin activity. Ann Rheum Dis. 2014;73(10):1805–10.CrossRefPubMed
10.
go back to reference Huber AM, Mamyrova G, Lachenbruch PA, Lee JA, Katz JD, Targoff IN, et al. Early illness features associated with mortality in the juvenile idiopathic inflammatory myopathies. Arthritis Care Res (Hoboken). 2014;66(5):732–40.CrossRef Huber AM, Mamyrova G, Lachenbruch PA, Lee JA, Katz JD, Targoff IN, et al. Early illness features associated with mortality in the juvenile idiopathic inflammatory myopathies. Arthritis Care Res (Hoboken). 2014;66(5):732–40.CrossRef
11.
go back to reference Ramanan AV, Campbell-Webster N, Ota S, Parker S, Tran D, Tyrrell PN, et al. The effectiveness of treating juvenile dermatomyositis with methotrexate and aggressively tapered corticosteroids. Arthritis Rheum. 2005;52(11):3570–8.CrossRefPubMed Ramanan AV, Campbell-Webster N, Ota S, Parker S, Tran D, Tyrrell PN, et al. The effectiveness of treating juvenile dermatomyositis with methotrexate and aggressively tapered corticosteroids. Arthritis Rheum. 2005;52(11):3570–8.CrossRefPubMed
12.
go back to reference Lai WW, Geva T, Shirali GS, Frommelt PC, Humes RA, Brook MM, et al. Guidelines and standards for performance of a pediatric echocardiogram: a report from the task force of the pediatric Council of the American Society of echocardiography. J Am Soc Echocardiogr. 2006;19(12):1413–30.CrossRefPubMed Lai WW, Geva T, Shirali GS, Frommelt PC, Humes RA, Brook MM, et al. Guidelines and standards for performance of a pediatric echocardiogram: a report from the task force of the pediatric Council of the American Society of echocardiography. J Am Soc Echocardiogr. 2006;19(12):1413–30.CrossRefPubMed
13.
go back to reference Daubeney PE, Blackstone EH, Weintraub RG, Slavik Z, Scanlon J, Webber SA. Relationship of the dimension of cardiac structures to body size: an echocardiographic study in normal infants and children. Cardiol Young. 1999;9(4):402–10.CrossRefPubMed Daubeney PE, Blackstone EH, Weintraub RG, Slavik Z, Scanlon J, Webber SA. Relationship of the dimension of cardiac structures to body size: an echocardiographic study in normal infants and children. Cardiol Young. 1999;9(4):402–10.CrossRefPubMed
14.
go back to reference Davignon A, Rautaharju P, Boisselle E, Soumis F, Megelas M, Choquette A. Normal ECG standards for infants and children. Pediatr Cardiol. 1980;1(2):123–31.CrossRef Davignon A, Rautaharju P, Boisselle E, Soumis F, Megelas M, Choquette A. Normal ECG standards for infants and children. Pediatr Cardiol. 1980;1(2):123–31.CrossRef
Metadata
Title
Cardiac findings in children with juvenile Dermatomyositis at disease presentation
Authors
Serdar Cantez
Gil J. Gross
Ian MacLusky
Brian M. Feldman
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Pediatric Rheumatology / Issue 1/2017
Electronic ISSN: 1546-0096
DOI
https://doi.org/10.1186/s12969-017-0182-0

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