title: [Multi-center analysis of calcinosis in children with juvenile dermatomyositis].
abstract: OBJECTIVE
  To reveal the frequency and the clinical characteristics of dystrophic calcification that occurs in children with juvenile dermatomyositis, multi-center analysis was constructed.
  
  
  METHODS
  Fifty children with JDM were enrolled, and 14 of them (28.0%) were complicated with calcinosis. Clinical symptoms and laboratory tests at onset, initial therapy and disease course were compared in children with and without calcinosis.
  
  
  RESULTS
  The mean age of the onset of calcinosis was 4.78 +/- 3.33 years, and it was younger than those of children without calcinosis (8.66 +/- 3.85 years) (P = 0.0017). No differences of clinical manifestation except Gower's sign were observed. The frequency of positive anti-nuclear antibody was 7.1% in children with calcinosis and 52.9% without calcinosis (P = 0.0112). The initial therapy of methylprednisolon pulses gave no effects on prognosis of calcium deposition. The calcinosis appeared in 1.56 +/- 1.91 year after the onset of the disease. The various types of calcium deposition including large tumorous clumps, subcutaneous plaques or nodules, sheet-type calcification were deserved. They appeared over knee joints (64.3%), elbow joint (64.3%), and hip processes (50.0%). Calcinosis affecting the subcutaneous tissues frequently resulted in painful superficial ulceration of the overlying skin (42.9%), local infection (50.0%), and limitation of joint movement (14.3%). Although aluminum phosphate was effective in 2 children among 7, no other effective treatment was recommended. In 5 cases, surgical removal of tumorous clumps was operated. Thus, juvenile dermatomyositis is frequently complicated with calcinosis. This type of calcinosis was found to be unlikely to resolve completely, and resulted in severe disability in children.
authors.affiliation: Department of Pediatrics, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama-city.
authors.forename: Takako
authors.initials: T
authors.lastname: Miyamae
authors.forename: Masaaki
authors.initials: M
authors.lastname: Mori
authors.forename: Yasuji
authors.initials: Y
authors.lastname: Inamo
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kohno
authors.forename: Shuji
authors.initials: S
authors.lastname: Takei
authors.forename: Motoharu
authors.initials: M
authors.lastname: Maeda
authors.forename: Takuji
authors.initials: T
authors.lastname: Murata
authors.forename: Shuji
authors.initials: S
authors.lastname: Nakata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawai
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Hirano
authors.forename: Yukiji
authors.initials: Y
authors.lastname: Date
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Kitamura
authors.forename: Shumpei
authors.initials: S
authors.lastname: Yokota
mesh_terms: D017668:Age of Onset; D000974:Antibodies, Antinuclear / Q000032:analysis; D002114:Calcinosis / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D003882:Dermatomyositis / Q000150:complications*; D004551:Elbow Joint; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000453:epidemiology / Q000209:etiology; D007719:Knee Joint; D008297:Male; D012871:Skin Diseases / Q000453:epidemiology / Q000209:etiology*
chemical_list: D000974:Antibodies, Antinuclear