title: Comparative Long-Term Evaluation of Patients With Juvenile Inflammatory Myopathies.
abstract: OBJECTIVE
  We conducted a retrospective study analyzing the clinical features, laboratory findings, demographics, and long-term prognoses of patients with juvenile inflammatory myopathies to determine possible predictors indicating the use of aggressive immunotherapy and the response to and complications of treatment.
  
  
  METHODS
  The medical records of 41 patients with juvenile inflammatory myopathies seen at University of Tennessee-affiliated hospitals in Memphis from 1969 to 2008 were evaluated. Patients' clinical characteristics, laboratory studies, muscle biopsies, and electromyography were reviewed. All patients were treated with prednisone initially; additionally, 14 patients received varying combinations of other immunosuppressant therapies.
  
  
  RESULTS
  Seventy-three percent of the patients experienced remission. Patients in the group that did not go into remission had specific characteristics at onset: they were comparatively older and had more severe rashes, contractures, arthritis, and systemic involvement. Also, patients with positive autoantibodies (antinuclear antibody, rheumatoid arthritis factor) had better outcomes.
  
  
  CONCLUSIONS
  Juvenile inflammatory myopathies have relatively good prognoses. Initial presentation at advanced age or with severe rash, systemic vasculopathies, anemia, or arthritis portends refractory disease; in these patients, second- and third-line therapies improve outcome.
authors.affiliation: *UTHSC, Memphis, TN; ‡Le Bonheur Medical Center, Memphis, TN; and §UAB, Birmingham, AL.
authors.forename: Hafiz A
authors.initials: HA
authors.lastname: Elahi
authors.forename: Tulio E
authors.initials: TE
authors.lastname: Bertorini
authors.forename: Masanori
authors.initials: M
authors.lastname: Igarashi
authors.forename: William H
authors.initials: WH
authors.lastname: Mays
authors.forename: John N
authors.initials: JN
authors.lastname: Whitaker
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D009220:Myositis / Q000175:diagnosis* / Q000188:drug therapy*; D011241:Prednisone / Q000627:therapeutic use*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D063189:Symptom Assessment
chemical_list: D007166:Immunosuppressive Agents; D011241:Prednisone