Publications by authors named "Mahesh Janarthanan"

Article Synopsis
  • The study aimed to evaluate the effectiveness of adalimumab in treating noninfectious uveitis in children by analyzing medical records and treatment outcomes.
  • It included 16 pediatric patients with demographic data and treatment history, revealing that adalimumab resulted in significant improvements in both ocular inflammation and visual acuity after 22 months of average follow-up.
  • The results indicated that adalimumab is a safe and effective option for managing pediatric noninfectious uveitis, achieving high rates of disease inactivity and remission.
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Sarcoidosis is a chronic multisystem granulomatous disease of unknown etiology. It is rare in young children. A 9-year-old boy presented with failure to thrive, skin rashes, persistent fever, and respiratory symptoms since 5 years of age.

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Article Synopsis
  • Mixed connective tissue disease (MCTD) is rare in children, and there's limited research on juvenile-onset MCTD (jMCTD), particularly in Southeast Asia.
  • A study involving eleven pediatric rheumatology centers in India analyzed clinical and laboratory data from 31 jMCTD patients, revealing common symptoms like arthritis, malar rash, and Raynaud's phenomenon.
  • The findings highlight the need for better understanding and management of jMCTD in children, with 45% of patients in remission after an average follow-up of 43 months.
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  • This study investigates the use of tofacitinib, an oral medication, in nine pediatric patients with treatment-resistant uveitis and one with scleritis, focusing on its effectiveness and safety.* -
  • The patients, primarily affected by juvenile idiopathic arthritis, showed significant improvement, with most achieving remission and no systemic side effects reported during the follow-up period of around 278 days.* -
  • The findings suggest that tofacitinib could serve as a beneficial second-line treatment for pediatric uveitis, particularly in low- and middle-income countries.*
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Objective: To compare organ involvement and disease severity between male and female patients with juvenile onset systemic sclerosis.

Methods: Demographics, organ involvement, laboratory evaluation, patient-reported outcomes and physician assessment variables were compared between male and female juvenile onset systemic sclerosis patients enrolled in the prospective international juvenile systemic sclerosis cohort at their baseline visit and after 12 months.

Results: One hundred and seventy-five juvenile onset systemic sclerosis patients were evaluated, 142 females and 33 males.

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Background And Aim: pGALS (pediatric Gait Arms Legs Spine) is a useful screening tool in identifying musculoskeletal problems in children. Although musculoskeletal problems are common in children, only a small fraction of them have an underlying serious pathology. There is limited data on this subject from north India but none from south India.

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Article Synopsis
  • - Children with malignancies may show symptoms like fever, muscle pain, and joint issues that can easily be mistaken for rheumatological or orthopedic problems.
  • - The study analyzed 53 cases from pediatric rheumatology clinics in South India, finding that common symptoms included bone pain, fever, and difficulty walking, with a median age of diagnosis at 6.1 years.
  • - A significant number of patients had blood abnormalities, and many were unnecessarily treated with steroids before being correctly diagnosed, which could delay proper treatment and worsen outcomes.
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Aim To study the various pathological patterns of pediatric lupus nephritis (LN) by renal biopsies and to correlate the histopathological data with the clinical and biochemical outcomes. Methods This is a retrospective study in children between 1 month and 18 years of age with renal biopsy-proven lupus nephritis, conducted between January 2015 and December 2019. Various pathological and clinical parameters were compared between the groups with lupus nephritis activity and those without activity.

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Juvenile dermatomyositis (JDM) is the most common inflammatory myopathy in children and is characterised by the presence of proximal muscle weakness, heliotrope dermatitis, Gottron's papules and occasionally auto antibodies. The disease primarily affects skin and muscles, but can also affect other organs. Renal manifestations though common in autoimmune conditions like lupus are rare in JDM.

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Objective: To evaluate the baseline clinical characteristics of juvenile systemic sclerosis (SSc) patients in the international juvenile SSc inception cohort, and to compare these characteristics between the classically defined juvenile diffuse cutaneous SSc (dcSSc) and limited cutaneous SSc (lcSSc) subtypes and among those with overlap features.

Methods: A cross-sectional study was performed using baseline visit data. Information on demographic characteristics, organ system evaluation, treatment, and patient- and physician-reported outcomes was extracted and summary statistics applied.

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In children with systemic lupus erythematosus on immunosuppressive therapy, infection is a known complication. We present a case of a 12-year-old girl who was previously diagnosed with lupus nephritis but had stopped taking allopathic medications and had been on herbal medicines for a year. She was referred to us with persistent fever and disease activity in spite of restarting immunosuppressive treatment.

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Objective: Utilizing data obtained from a prospective, international, juvenile systemic sclerosis (SSc) cohort, the present study was undertaken to determine if pulmonary screening with forced vital capacity (FVC) and diffusing capacity for carbon monoxide (DLco) is sufficient to assess the presence of interstitial lung disease (ILD) in comparison to high-resolution computed tomography (HRCT) in juvenile SSc.

Methods: The juvenile SSc cohort database was queried for patients enrolled from January 2008 to January 2020 with recorded pulmonary function tests (PFTs) parameters and HRCT to determine the discriminatory properties of PFT parameters, FVC, and DLco in detecting ILD.

Results: Eighty-six juvenile SSc patients had both computed tomography imaging and FVC values for direct comparison.

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Background: X-linked agammaglobulinemia, a primary immunodeficiency, can present with musculoskeletal manifestations.

Case Characteristics: A 4-year-old boy, diagnosed as systemic juvenile idiopathic arthritis at the age of 3 years and treated with biological agents, presented with fever, dyspnea and chest pain. Blood culture and pericardial fluid culture revealed Achromobacter xylosoxidans.

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Introduction: Juvenile systemic sclerosis is an orphan disease. Currently, the majority of juvenile systemic sclerosis cohort studies are retrospective in design without standardized assessment. This study was conducted prospectively to investigate the difference in manifestations of limited cutaneous juvenile systemic sclerosis and diffuse cutaneous juvenile systemic sclerosis subtypes.

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Introduction: Outcome data in pediatric plasma exchange, especially in nonrenal indications are scarce. We aimed to evaluate its role and outcome in our patients.

Subjects And Methods: A retrospective study of children admitted in the year 2016 to the Pediatric Intensive Care Unit requiring plasma exchange for nonrenal indications was undertaken.

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Blau syndrome (BS) is a rare autoinflammatory disorder characterized by the clinical triad of arthritis, uveitis, and dermatitis due to heterozygous gain-of-function mutations in the NOD2 gene. BS can mimic juvenile idiopathic arthritis (JIA)-associated uveitis, rheumatoid arthritis, and ocular tuberculosis. We report a family comprising a mother and her two children, all presenting with uveitis and arthritis.

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