Environmental factors preceding illness onset differ in phenotypes of the juvenile idiopathic inflammatory myopathies.

Publication/Presentation Date

12-1-2010

Abstract

OBJECTIVE: To assess whether certain environmental factors temporally associated with the onset of juvenile idiopathic inflammatory myopathies (JIIMs) differ between phenotypes.

METHODS: Physicians completed questionnaires regarding documented infections, medications, immunizations and an open-ended question about other noted exposures within 6 months before illness onset for 285 patients with probable or definite JIIM. Medical records were reviewed for 81% of the patients. Phenotypes were defined by standard clinical and laboratory measures.

RESULTS: Sixty per cent of JIIM patients had a reported exposure within 6 months before illness onset. Most patients (62%) had one recorded exposure, 26% had two and 12% had three to five exposures. Patients older than the median age at diagnosis, those with a longer delay to diagnosis and those with anti-signal recognition particle autoantibodies had a higher frequency of documented exposures [odds ratios (ORs) 95% CI 3.4, 31]. Infections were the most common exposure and represented 44% of the total number of reported exposures. Non-infectious exposures included medications (18%), immunizations (11%), stressful life events (11%) and unusual sun exposure (7%). Exposures varied by age at diagnosis, race, disease course and the presence of certain myositis autoantibodies.

CONCLUSION: The JIIMs may be related to multiple exposures and these appear to vary among phenotypes.

Volume

49

Issue

12

First Page

2381

Last Page

2390

ISSN

1462-0332

Disciplines

Medicine and Health Sciences | Pediatrics

PubMedID

20802007

Department(s)

Department of Pediatrics

Document Type

Article

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