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A clinical analysis of juvenile dermatomyositis; focus on clinical manifestations at diagnosis (소아기 피부근염의 임상적 고찰; 진단시 임상증상을 중심으로 한 고찰)

  • Lee, So Young;Bang, Ji Seok;Kim, Hee Seok;Kim, Joong Gon
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1116-1124
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    • 2007
  • Purpose : Juvenile dermatomyositis (JDM) is the most common of the idiopathic inflammatory myopathies in children. The purpose of this study is to observe demographic, initial presentations, duration of time between disease onset and diagnosis, clinical manifestations and laboratory findings at diagnosis of patients with JDM. Methods : Forty seven patients identified at Seoul National University Children's Hospital from January 1986 to May 2007. Medical records were reviewed retrospectively focusing on initial presentations, clinical manifestations and laboratory findings at the time of diagnosis of patients with JDM. Results : Male and female patients were 25 and 22, respectively and sex ratio was 1.14:1. The average age at the time of diagnosis was 6.51 years. Skin rash (94%) was the most common symptom, followed by the proximal muscle weakness (89%). The disease activity score was 10.8. The duration between the onset of the skin rash and the muscle weakness and diagnosis was 7.18 and 4.70 months, respectively. The serum muscle enzymes, LDH, AST, CK and aldolase, were elevated in the patient with JDM. Autoimmune antibodies, antinuclear antibody, anti SSA antibody and anti SSB antibody, were negative findings. Electromyography findings were consistent with JDM in 88% of the patients, the muscle biopsy was in 91% and all MRI findings were compatible with those of patients with JDM. The most common symptom besides musculocutaneous lesions was the calcinosis (62.5%). The most common site of calcinosis was the pelvic area and buttocks. Conclusion : This study shows that the major symptoms are proximal muscle weakness and cutaneous lesion, and they are important to diagnose JDM.

Outcome of pregnant mothers with systemic lupus erythematosus (focusing on congenital heart block) (전신성 홍반성 루푸스 산모의 출산아의 임상적 고찰 (완전 방실 블록을 중심으로))

  • Baek, Hey Sung;Choi, Jae Hyung;Kim, Nam Su;Kim, Chang Ryul;Moon, Su Ji
    • Clinical and Experimental Pediatrics
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    • v.49 no.4
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    • pp.381-387
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    • 2006
  • Purpose : Neonatal lupus is characterized by congenital complete heart block(CCHB), cutaneous rash, and laboratory abnormalities in infants born to mothers with systemic lupus erythematosus(SLE). This study aims to examine the incidence of CCHB and clinical outcome in neonates born to mothers with SLE. Methods : The study group consisted of 49 neonates, born from 57 pregnancies of 55 women with SLE, diagnosed at Hanyang University Hospital for the period between January 1997 and January 2005. Clinical and laboratory data were retrospectively identified from medical record. Results : There were 5(8.8 percent) spontaneous abortions and one(1.8 percent) still births among 57 pregnancies of 55 mothers. Of 49 live births, 15(26.3 percent) were premature and eight(12.3 percent) were small for their gestational age. There was one(1.8 percent) CCHB suspected during pregnancy on fetal echocardiograpy in a fetus of mother with systemic lupus erythematosus and the fetus was not born by artificial abortion because of mother. There was no CCHB among EKG findings of 49 newborns. Laboratory testing showed hematologic abnormalities among 25.6 percent(10/39) of the babies. 5.1 percent(2/39) and 7.7 percent(3/39) of them were diagnosed as neutropenia, and thrombocytopenia was seen respectively. Anti-SSA(Ro) and antiphospholipid antibodies were predictive factors for prematurity(P=0.003, P=0.049). Anticardiolipin antibodies were predictive factors for ventilatory care(P=0.018). Conclusion : The incidence of CCHB among neonates born to mothers with SLE, which was measured in this study, was lower than that in earlier studies. A high incidence of hematologic abnormalities was found in our study. It is suggested that careful examination should be made of skin for the diagnosis of neonatal lupus.

Association of Diagnostic Criteria and Autoantibodies with Juvenile Dermatomyositis in Newly Diagnosed Children (소아기 피부근염의 진단 기준과 자가항체의 진단적 의의)

  • Shin, Kyung Sue;Kim, Joong Gon
    • Clinical and Experimental Pediatrics
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    • v.46 no.9
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    • pp.898-902
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    • 2003
  • Purpose : To determine the clinical association of diagnostic criteria and the prevalence of autoantibodies in newly diagnosed children with juvenile dermatomyositis(JDM). Methods : Thirty-two children with JDM were identified at Seoul National University Children's Hospital from March 1985 to March 1999 by retrospective review. The diagnosis of JDM was based on the criteria proposed by Bohan and Peter. We investigated for the presence of several autoantibodies: antinuclear(ANA), double-stranded DNA, anti-Sm, anti-ribonucleoprotein(RNP), anti-SSA/ SSB, anti-Jo1, anti-Scl-70 antibodies and rheumatoid factor(RF). Results : Sex ratio and age at diagnosis were similar to data published in other studies. All the newly diagnosed children with JDM had a typical rash(100%) and proximal muscle weakness(100%); 17(53%) had muscle pain or tenderness; 10(31%) calcinosis; eight(25%) dysphagia; eight(25%) arthritis, and seven(22%) fever. Muscle enzymes were elevated in 90% of the patients. Of the 27 patients who had an electromyogram, 20(70%) had diagnostic results. Sixteen(70%) of biopsied patients had appropriated results for JDM. Patients were negative for all autoantibodies except ANA and RF. ANA and RF were detected in 47% and 7% of the patients respectively. Conclusion : Although the sensitivity of the criteria proposed by Bohan and Peter is superior, each of these criteria has possible confounding factors. Additional criteria may be needed for early diagnosis of JDM. Based on our findings of autoantibodies in JDM, we do not recommend routine testing for autoantibodies in children with typical JDM.

Relationship between Stratum Corneum Carbonylated Protein (SCCP) and Skin Biophysical Parameters (Stratum Corneum Carbonylated Protein (SCCP)의 피부 생물학적 파라미터와의 관계)

  • Lee, Yongjik;Nam, Gaewon
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.45 no.2
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    • pp.131-138
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    • 2019
  • Carbonylated proteins (CPs) are synthesized by the chemical reaction of basic amino acid residues in proteins with aldehyde compounds yielded by lipid peroxidation. CPs are excited by a range of light from UVA to blue light, and resulted in the generation of superoxide anion radicals ($^{\cdot}O_2{^-}$) by photosensitizing reaction. Then, they CPs induce new protein carbonylation in stratum corneum through ROS generation. Furthermore, the superoxide anion radicals produce CPs in the stratum corneum (SC) through lipid peroxidation and finally affects skin conditions including color and moisture functions. The purpose of this study was to investigate the relationship between the production of stratum corneum carbonylated protein (SCCP) and the skin elasticity. 46 healthy female Koream at the ages of 30 ~ 50 years old were participated in this study for 8 weeks. The skin test was experiment conducted into two groups; placebo group (N = 23) used cream that did not contain active ingredients, and the other group (N = 23) used cream containing the elasticity improving ingredients. Test areas were the crow 's feet and the cheek. Various non-invasive methods were carried out to measure biophysical parameters on human skin indicating that dermis density and skin wrinkle were measured by using DUB scanner and Primos premium, respectively. Skin elasticity were measured using dermal torque meter (DTM310) and balistometer (BLS780). SCCP was assessed in a simple and non-invasive method using skin surface biopsy on the cheek of the subject. The amount of SCCP was determined using image analysis. All measurements were taken at 0, 4 and 8 8week. Results revealed that the amount of CP in SC was reduced when the skin wrinkle and skin elasticity related parameters were improved. This indicates that the correlation between the elasticity improvement and the amount of CP can be used as a anti-aging indicator and applicable to the skin clinical test for the measurement of skin aging in the future.