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Rheumatology (Oxford). 2010 Dec;49(12):2381-90. doi: 10.1093/rheumatology/keq277. Epub 2010 Aug 27.

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

Author information

  • 1Environmental Autoimmunity Group, National Institute of Environmental Sciences, National Institutes of Health, DHHS, Clinical Research Center Room 4-2352, 10 Center Drive, MSC 1301, Bethesda, MD 20892-1301, USA. riderl@mail.nih.gov

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.

PMID:
20802007
[PubMed - indexed for MEDLINE]
PMCID:
PMC2981509
Free PMC Article
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