Abstract:
BACKGROUND:Juvenile dermatomyositis (JDM) is the most common inflammatory myopathy in childhood and a major cause of morbidity among children with pediatric rheumatic diseases. The management of JDM is very heterogeneous. The JDM working group of the Society for Pediatric Rheumatology (GKJR) aims to define consensus- and practice-based strategies in order to harmonize diagnosis, treatment and monitoring of JDM. METHODS:The JDM working group was established in 2015 consisting of 23 pediatric rheumatologists, pediatric neurologists and dermatologists with expertise in the management of JDM. Current practice patterns of management in JDM had previously been identified via an online survey among pediatric rheumatologists and neurologists. Using a consensus process consisting of online surveys and a face-to-face consensus conference statements were defined regarding the diagnosis, treatment and monitoring of JDM. During the conference consensus was achieved via nominal group technique. Voting took place using an electronic audience response system, and at least 80% consensus was required for individual statements. RESULTS:Overall 10 individual statements were developed, finally reaching a consensus of 92 to 100% regarding (1) establishing a diagnosis, (2) case definitions for the application of the strategies (moderate and severe JDM), (3) initial diagnostic testing, (4) monitoring and documentation, (5) treatment targets within the context of a treat-to-target strategy, (6) supportive therapies, (7) explicit definition of a treat-to-target strategy, (8) various glucocorticoid regimens, including intermittent intravenous methylprednisolone pulse and high-dose oral glucocorticoid therapies with tapering, (9) initial glucocorticoid-sparing therapy and (10) management of refractory disease. CONCLUSION:Using a consensus process among JDM experts, statements regarding the management of JDM were defined. These statements and the strategies aid in the management of patients with moderate and severe JDM.
journal_name
Pediatr Rheumatol Online Jjournal_title
Pediatric rheumatology online journalauthors
Hinze CH,Oommen PT,Dressler F,Urban A,Weller-Heinemann F,Speth F,Lainka E,Brunner J,Fesq H,Foell D,Müller-Felber W,Neudorf U,Rietschel C,Schwarz T,Schara U,Haas JPdoi
10.1186/s12969-018-0257-6subject
Has Abstractpub_date
2018-06-25 00:00:00pages
40issue
1issn
1546-0096pii
10.1186/s12969-018-0257-6journal_volume
16pub_type
杂志文章abstract:BACKGROUND:Recently preliminary ultrasonography (US) definitions, in B mode, for normal components of pediatric joints have been developed by the OMERACT US group. The aim of the current study was to include Doppler findings in the evaluation and definition of normal joint features that can be visualized in healthy chi...
journal_title:Pediatric rheumatology online journal
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doi:10.1186/s12969-020-00487-w
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journal_title:Pediatric rheumatology online journal
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doi:10.1186/s12969-018-0277-2
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journal_title:Pediatric rheumatology online journal
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journal_title:Pediatric rheumatology online journal
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journal_title:Pediatric rheumatology online journal
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journal_title:Pediatric rheumatology online journal
pub_type: 杂志文章
doi:10.1186/1546-0096-8-15
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journal_title:Pediatric rheumatology online journal
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journal_title:Pediatric rheumatology online journal
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pub_type: 杂志文章,多中心研究
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pub_type: 已发布勘误
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journal_title:Pediatric rheumatology online journal
pub_type: 杂志文章
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journal_title:Pediatric rheumatology online journal
pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
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journal_title:Pediatric rheumatology online journal
pub_type: 杂志文章
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journal_title:Pediatric rheumatology online journal
pub_type: 社论
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