J Rheumatol
-
Kawasaki disease (KD) is an acute febrile disease in infants and young children. Five percent to 8% of cases will be complicated with coronary dilatation or aneurysm, although introduction of high-dose intravenous immunoglobulin (IVIG) therapy has provided remarkable results for reducing the frequency of cardiac involvement. We describe the results of an open-label trial of infliximab, an anti-tumor necrosis factor-α monoclonal antibody, for suppressing the progression of coronary artery lesions in cases of KD refractory to extensive IVIG therapy. Plasma exchange (PE) was available as a rescue therapy for patients refractory to infliximab. ⋯ Eighteen of 20 patients were effectively treated with infliximab, and 2 cases were effectively treated with PE to prevent progression to coronary artery lesions. No adverse event such as anaphylactoid reaction, heart failure, severe infectious diseases, or tuberculosis was observed in this trial.
-
Comparative Study
Preliminary validation of a self-reported screening questionnaire for inflammatory back pain.
Inflammatory back pain (IBP) is an important feature of axial spondyloarthritis (SpA) that is poorly recognized in primary care, perhaps delaying diagnosis of SpA. We aimed to develop and validate a self-report questionnaire using important domains reported by patients with IBP. ⋯ Assessment of a single self-reported item, "diurnal variation," had substantial classification utility for IBP. This domain is not addressed in existing criteria for IBP, indicating a potentially important omission.
-
To determine the timeliness of consultation and initiation of disease-modifying antirheumatic drugs (DMARD) in patients with rheumatoid arthritis (RA) referred to rheumatologists. ⋯ In Northern Alberta, patients with RA are seen and started on DMARD therapy in a timely fashion. Most of the delay is at the primary care level, suggesting a need for improved education of patients and primary care physicians rather than a formal triage system.