Small fiber neuropathy in children, adolescents, and young adults with chronic orthostatic intolerance and postural orthostatic tachycardia syndrome: A retrospective study.

Purpose: To determine in children, adolescent and young adult (CAYA) patients presenting with Orthostatic Intolerance (OI) or Postural Orthostatic Tachycardia Syndrome (POTS) associated with the additional symptoms of neuropathic discomfort (pain, paresthesia and/or allodynia): 1) the incidence of small fiber neuropathy, and 2) assess if there was serologic evidence for an underlying inflammatory or autoimmune state.

Methods: A cohort of 109 CAYA patients with the above symptoms underwent epidermal skin biopsy for nerve fiber density. Blood biomarkers for inflammation were tested (CRP, ESR, ANA, complement (C3), thyroid function testing with antibodies (thyroid peroxidase antibody and thyroglobulin antibody), and cytokine panel 13).

The Challenges of Identifying Fibromyalgia in Adolescents.

Aim: Fibromyalgia (FM) is a noninflammatory disorder of the nervous system characterized by widespread musculoskeletal pain and somatic complaints of at least 3 months duration. There are no current diagnostic criteria for fibromyalgia in children to guide clinicians in recognition, thus leading to many subspecialty referrals and extensive imaging and tests. The purpose of this retrospective review is to compare two diagnostic criteria for juvenile fibromyalgia.

Slow speed resistance exercise training in children with polyarticular juvenile idiopathic arthritis.

Juvenile idiopathic arthritis (JIA) is an inflammatory autoimmune disease that can cause severe impairment and disability. Exercise is recommended to preserve joint mobility and function. Our objectives were to assess the safety, feasibility, and effects of slow speed resistance exercise in children with polyarticular JIA.

Approach to Membranous Lupus Nephritis: A Survey of Pediatric Nephrologists and Pediatric Rheumatologists.

Objective: To describe treatment practices for childhood pure membranous lupus nephritis (MLN).

Methods: Survey study of Childhood Arthritis and Rheumatology Research Alliance and American Society of Pediatric Nephrology members.

Results: There were 117 respondents who completed the survey (60 pediatric nephrologists, 57 pediatric rheumatologists).

Persistent low albumin and temporary vascular access in pediatric patients with SLE on hemodialysis.

Pediatric patients with systemic lupus erythematosus (SLE) often present with significant kidney disease. In a previous cross-sectional analysis, we showed that pediatric patients with ESRD secondary to SLE have lower serum albumin levels and less permanent vascular access for hemodialysis (HD) compared to pediatric patients on HD secondary to other causes. The goal of this longitudinal study was to determine if there was an improvement in these targets over time.

Reduced albumin levels and utilization of arteriovenous access in pediatric patients with systemic lupus erythematosus (SLE).

Systemic lupus erythematosus (SLE) is an autoimmune disease that affects between five and ten thousand children in the USA. Kidney disease may progress to end-stage renal disease (ESRD) and subsequent need for dialysis therapy in a significant number of children with SLE. We performed a cross-sectional analysis comparing achievement of National Kidney Foundation/Kidney Disease Outcomes Quality Initiative clinical targets in pediatric patients with SLE maintained on hemodialysis (HD) to pediatric patients with other causes of ESRD.

Preoperative autologous blood donation by arthritis patients is associated with preoperative anemia and perioperative transfusion.

Background: Preoperative autologous blood donation (PAD) became a common practice in the 1990s in an attempt to reduce the risk of transmission of infectious agents from allogeneic blood. However, a potential risk of PAD is the development of preoperative anemia that may lead, in turn, to an enhanced need for transfusion. Furthermore, the ready availability of autologous blood may predispose to more liberal transfusion peri-/postoperatively.

Treatment of scleroderma: an update.

The goal of this article is to update the reader and focus on novel therapies and clinical trials published since our last review [6]. Evidence suggests that drug intervention should target one or all of three biological processes: vascular disease, autoimmunity and tissue fibrosis. Efforts should be made to classify the subtype of scleroderma, to determine the activity of the disease process and the degree of specific organ involvement before specific treatment decisions are made.