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Miyamoto T, Izawa K, Masui S, Yamazaki A, Yamasaki Y, Matsubayashi T, Shiraki M, Ohnishi H, Yasumura J, Kawabe T, Miyamae T, Matsubara T, Arakawa N, Ishige T, Takizawa T, Shimbo A, Shimizu M, Kimura N, Maeda Y, Maruyama Y, Shigemura T, Furuta J, Sato S, Tanaka H, Izumikawa M, Yamamura M, Hasegawa T, Kaneko H, Nakagishi Y, Nakano N, Iida Y, Nakamura T, Wakiguchi H, Hoshina T, Kawai T, Murakami K, Akizuki S, Morinobu A, Ohmura K, Eguchi K, Sonoda M, Ishimura M, Furuno K, Kashiwado M, Mori M, Kawahata K, Hayama K, Shimoyama K, Sasaki N, Ito T, Umebayashi H, Omori T, Nakamichi S, Dohmoto T, Hasegawa Y, Kawashima H, Watanabe S, Taguchi Y, Nakaseko H, Iwata N, Kohno H, Ando T, Ito Y, Kataoka Y, Saeki T, Kaneko U, Murase A, Hattori S, Nozawa T, Nishimura K, Nakano R, Watanabe M, Yashiro M, Nakamura T, Komai T, Kato K, Honda Y, Hiejima E, Yonezawa A, Bessho K, Okada S, Ohara O, Takita J, Yasumi T, Nishikomori R. Clinical Characteristics of Cryopyrin-Associated Periodic Syndrome and Long-Term Real-World Efficacy and Tolerability of Canakinumab in Japan: Results of a Nationwide Survey. Arthritis Rheumatol 2024. [PMID: 38268504 DOI: 10.1002/art.42808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 01/09/2024] [Accepted: 01/22/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE We assess the clinical characteristics of patients with cryopyrin-associated periodic syndrome (CAPS) in Japan and evaluate the real-world efficacy and safety of interleukin-1 (IL-1) inhibitors, primarily canakinumab. METHODS Clinical information was collected retrospectively, and serum concentrations of canakinumab and cytokines were analyzed. RESULTS A total of 101 patients were included, with 86 and 15 carrying heterozygous germline and somatic mosaic mutations, respectively. We identified 39 mutation types, and the common CAPS-associated symptoms corresponded with those in previous reports. Six patients (5.9% of all patients) died, with four of the deaths caused by CAPS-associated symptoms. Notably, 73.7% of patients (100%, 79.6%, and 44.4% of familial cold autoinflammatory syndrome, Muckle-Wells syndrome, and chronic infantile neurological cutaneous articular syndrome/neonatal onset multisystem inflammatory disease, respectively) achieved complete remission with canakinumab, and early therapeutic intervention was associated with better auditory outcomes. In some patients, canakinumab treatment stabilized the progression of epiphysial overgrowth and improved height gain, visual acuity, and renal function. However, 23.7% of patients did not achieve inflammatory remission with crucial deterioration of organ damage, with two dying while receiving high-dose canakinumab treatment. Serological analysis of canakinumab and cytokine concentrations revealed that the poor response was not related to canakinumab shortage. Four inflammatory nonremitters developed inflammatory bowel disease (IBD)-unclassified during canakinumab treatment. Dual biologic therapy with canakinumab and anti-tumor necrosis factor-α agents was effective for IBD- and CAPS-associated symptoms not resolved by canakinumab monotherapy. CONCLUSION This study provides one of the largest epidemiologic data sets for CAPS. Although early initiation of anti-IL-1 treatment with canakinumab is beneficial for improving disease prognosis, some patients do not achieve remission despite a high serum concentration of canakinumab. Moreover, IBD may develop in CAPS after canakinumab treatment.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Tomoyo Matsubara
- Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | | | | | | | - Asami Shimbo
- Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Naoki Kimura
- Tokyo Medical and Dental University, Tokyo, Japan
| | | | | | | | | | - Satoshi Sato
- Saitama Children's Medical Center, Saitama, Japan
| | | | | | | | | | - Hiroshi Kaneko
- National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Naoko Nakano
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | | | | | | | - Takayuki Hoshina
- University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Toshinao Kawai
- National Center for Child Health and Development, Tokyo, Japan
| | | | | | | | | | | | | | | | | | | | - Masaaki Mori
- Tokyo Medical and Dental University, Tokyo, Japan, and St. Marianna University School of Medicine, Kawasaki, Japan
| | | | | | | | - Natsuko Sasaki
- University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Taisuke Ito
- Hamamatsu University School of Medicine, Hamamatsu, Japan
| | | | - Tae Omori
- Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | | | | | | | | | | | - Yuichiro Taguchi
- Department of Rheumatology, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | | | - Naomi Iwata
- Aichi Children's Health and Medical Center, Obu, Japan
| | - Hiroki Kohno
- Tokyo Women's Medical University Hospital, Tokyo, Japan
| | | | - Yasuhiko Ito
- Nagoya City University West Medical Center, Nagoya, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Osamu Ohara
- Kazusa DNA Research Institute, Kisarazu, Japan
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Nozawa T, Pullenayegum EM, Bell-Peter A, Marcuz JA, Whitney K, Vinik O, Shupak R, Dover S, Feldman BM. Disease activity trajectories in juvenile dermatomyositis from childhood to adulthood. Rheumatology (Oxford) 2024:keae027. [PMID: 38216715 DOI: 10.1093/rheumatology/keae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/17/2023] [Accepted: 12/25/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVES To assess whether there are identifiable subgroups of disease activity trajectory in a population of juvenile dermatomyositis (JDM) patients-followed throughout childhood and into adulthood-and determine factors that predict those trajectory groupings. METHODS This is a retrospective, longitudinal inception cohort of patients with idiopathic inflammatory myopathies, largely JDM. We sought to identify baseline factors that predict membership into different groups (latent classes) of disease activity trajectory. RESULTS A total of 172 patients (64% females), with median age at diagnosis of 7.7 years, were analyzed. We studied 4,725 visits (1,471 patient-years). We identified 3 latent classes of longitudinal disease activity, as measured by the modified disease activity score (DASm), with distinct class trajectories predicted by DASm at baseline, and by the changes of DASm from either baseline to 3 months or baseline to 6 months (early response to therapy). In the analysis in which DASm at baseline and the changes of DASm from baseline to 6 months are included as predictors, Class 1 (10%) has persistently high disease activity, Class 2 (34%) is characterized by moderate disease activity, and Class 3 (56%) is characterized by individuals with a high early disease activity but an apparently good response to treatment and long-term low disease activity. CONCLUSION High early disease activity, and treatment resistance in the first few months, predict a more chronic longitudinal course of JDM.
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Affiliation(s)
- Tomo Nozawa
- Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan
| | - Eleanor M Pullenayegum
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Audrey Bell-Peter
- Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jo-Anne Marcuz
- Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Rehabilitation, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kristi Whitney
- Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Rehabilitation, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ophir Vinik
- Division of Rheumatology, Saint Michael's Hospital, Toronto, Ontario, Canada
| | - Rachel Shupak
- Division of Rheumatology, Saint Michael's Hospital, Toronto, Ontario, Canada
| | - Saunya Dover
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Brian M Feldman
- Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Departments of Pediatrics and Institute of Health Policy Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
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Narazaki H, Akioka S, Akutsu Y, Araki M, Fujieda M, Fukuhara D, Hara R, Hashimoto K, Hattori S, Hayashibe R, Imagawa T, Inoue Y, Ishida H, Ito S, Itoh Y, Kawabe T, Kitoh T, Kobayashi I, Matsubayashi T, Miyamae T, Mizuta M, Mori M, Murase A, Nakagishi Y, Nagatani K, Nakano N, Nishimura T, Nozawa T, Okamoto N, Okura Y, Sawada H, Sawanobori E, Sugita Y, Tanabe Y, Tomiita M, Yamaguchi KI, Yasuoka R, Yokoyama K. Epidemiology conduction of paediatric rheumatic diseases based on the registry database of the Pediatric Rheumatology Association of Japan. Mod Rheumatol 2023; 33:1021-1029. [PMID: 36112493 DOI: 10.1093/mr/roac112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 08/27/2023]
Abstract
OBJECTIVES Although epidemiological surveys of paediatric rheumatic diseases in Japan have been conducted, they were single surveys with no continuity. This is the first report of the Pediatric Rheumatology Association of Japan registry database, which was established to continuously collect data for paediatric rheumatic diseases. METHODS Pediatric Rheumatology International Collaborate Unit Registry version 2 (PRICUREv2) is a registry database established by the Pediatric Rheumatology Association of Japan. The registry data were analysed for the age of onset, time to diagnosis, sex differences, seasonality, and other factors. RESULTS Our data showed the same trend regarding rates of paediatric rheumatic diseases reported in Japan and other countries. The age of onset was lower in juvenile idiopathic arthritis (JIA) and juvenile dermatomyositis and higher in systemic lupus erythematosus and Sjögren's syndrome. The time to diagnosis was relatively short in JIA and systemic lupus erythematosus but longer in juvenile dermatomyositis and Sjögren's syndrome. Rheumatoid factor-positive polyarticular JIA showed a seasonality cluster with regard to onset. CONCLUSION PRICUREv2 aided the retrieval and evaluation of current epidemiological information on patients with paediatric rheumatic diseases. It is expected that the data collection will be continued and will be useful for expanding research in Japan.
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Affiliation(s)
- Hidehiko Narazaki
- Committee on Patient Registries System, Pediatric Rheumatology Association of Japan, Kyoto, Japan
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Shinji Akioka
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuko Akutsu
- Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mariko Araki
- Department of Pediatrics, Kochi Medical School, Kochi University, Kochi, Japan
| | - Mikiya Fujieda
- Department of Pediatrics, Kochi Medical School, Kochi University, Kochi, Japan
| | - Daisuke Fukuhara
- Department of Pediatrics, Kyorin University School of Medicine, Tokyo, Japan
| | - Ryoki Hara
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kunio Hashimoto
- Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Seira Hattori
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ren Hayashibe
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Tomoyuki Imagawa
- Committee on Patient Registries System, Pediatric Rheumatology Association of Japan, Kyoto, Japan
- Department of Infection and Immunology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yuzaburo Inoue
- Committee on Patient Registries System, Pediatric Rheumatology Association of Japan, Kyoto, Japan
- Department of General Medical Science, Graduate School of Medicine, Chiba University, Chiba, Japan
- Department of Allergy and Rheumatology, Chiba Children's Hospital, Chiba, Japan
| | | | - Shuici Ito
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yasuhiko Itoh
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Tomohiro Kawabe
- Department of Pediatric Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Toshiyuki Kitoh
- Laboratory of Pediatrics, Aichi Gakuin University, School of Pharmacy, Nagoya, Japan
| | - Ichiro Kobayashi
- Center for Pediatric Allergy and Rheumatology, KKR Sapporo Medical Center, Sapporo, Japan
| | | | - Takako Miyamae
- Department of Pediatric Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Mao Mizuta
- Department of Pediatric Rheumatology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Masaaki Mori
- Department of Lifetime Clinical Immunology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Division of Rheumatology and Allergology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Ayako Murase
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yasuo Nakagishi
- Department of Pediatric Rheumatology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Koji Nagatani
- Department of Pediatrics, Uwajima City Hospital, Ehime, Japan
| | - Naoko Nakano
- Department of Pediatrics, Ehime Prefectural Central Hospital, Ehime, Japan
| | - Toyoki Nishimura
- Division of Pediatrics, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Tomo Nozawa
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Nami Okamoto
- Department of Pediatrics, Osaka Medical and Pharmaceutical University, Osaka, Japan
- Department of Pediatrics, Osaka Rosai Hospital, Osaka, Japan
| | - Yuka Okura
- Center for Pediatric Allergy and Rheumatology, KKR Sapporo Medical Center, Sapporo, Japan
| | | | - Emi Sawanobori
- Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Yuko Sugita
- Department of Pediatrics, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Yujiro Tanabe
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Minako Tomiita
- Department of Allergy and Rheumatology, Chiba Children's Hospital, Chiba, Japan
- Center of Pediatric Allergy and Rheumatology, National Hospital Organization Shimoshizu National Hospital, Chiba, Japan
| | - Ken-Ichi Yamaguchi
- Committee on Patient Registries System, Pediatric Rheumatology Association of Japan, Kyoto, Japan
- Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo, Japan
| | - Ryuhei Yasuoka
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Koji Yokoyama
- Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
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Hattori S, Nozawa T, Nishimura K, Hara R, Murase A, Ohara A, Ohnishi A, Ohya T, Ito S. Characteristics of persistent arthritis with refractory Kawasaki disease: a single-center retrospective study. Sci Rep 2023; 13:9890. [PMID: 37336934 DOI: 10.1038/s41598-023-36308-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 05/31/2023] [Indexed: 06/21/2023] Open
Abstract
Arthritis is one complication of Kawasaki disease (KD); however, the clinical features of arthritis in KD have not been well clarified. We retrospectively investigated the characteristics of persistent arthritis beyond the subacute phase of KD. In this cohort, 49 of 243 patients (20%) developed arthritis, with 33 patients (14%) experiencing persistent arthritis. Among these 33 patients, 31 (94%) had complete KD. Thirty (91%) were resistant to first intravenous immunoglobulin, and 15 (45%) required additional infliximab. Five patients (15%) developed coronary artery lesions, and 24 (73%) had oligoarthritis, mainly in large lower-extremity joints. Twenty-four patients (73%) complained of arthralgia. At arthritis onset, 16 patients (48%) presented with fever, including recurrent fever in 10 patients. Serum C-reactive protein concentration in patients with active arthritis significantly increased compared with after acute KD treatment (2.4 vs. 0.7 mg/dL, p < 0.001). Serum matrix metalloproteinase-3, a biomarker of arthritis, was significantly higher in patients with active arthritis than in remission (93.7 vs. 20.3 ng/mL, p < 0.001). Thirty (91%) and 14 (42%) patients, respectively, were treated with non-steroidal anti-inflammatory drugs and prednisolone, and they completely recovered. To summarize, persistent arthritis is a common complication in refractory KD, and adequate diagnosis and treatment are necessary.
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Affiliation(s)
- Seira Hattori
- Department of Paediatrics, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Tomo Nozawa
- Department of Paediatrics, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Kenichi Nishimura
- Department of Paediatrics, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Ryoki Hara
- Department of Paediatrics, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Ayako Murase
- Department of Paediatrics, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Asami Ohara
- Department of Paediatrics, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Ai Ohnishi
- Department of Paediatrics, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
- Department of Paediatrics, Nagasaki University Hospital, Nagasaki, Japan
| | - Takashi Ohya
- Department of Paediatrics, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Shuichi Ito
- Department of Paediatrics, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan.
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Nicho N, Nozawa T, Murase A, Hayashibe R, Tanoshima R, Okubo R, Hattori S, Nishimura K, Ohya T, Ito S. Difficulties of diagnosing idiopathic hypertrophic pachymeningitis in children: Case report and literature review. Mod Rheumatol Case Rep 2023; 7:233-236. [PMID: 35348716 DOI: 10.1093/mrcr/rxac026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/25/2022] [Accepted: 03/14/2022] [Indexed: 06/14/2023]
Abstract
Hypertrophic pachymeningitis (HP) is a rare inflammatory disorder characterised by local or diffuse thickening of the cranial and spinal dura mater. HP occurs owing to idiopathic or secondary causes, including autoimmune disease, infection, and trauma. HP has mainly been reported in adults, with few reported cases in children. We encountered an 11-year-old boy with idiopathic HP who presented with chronic inflammation and daily occipital headache. Gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) helped us to diagnose him with HP. He was successfully treated with corticosteroids and azathioprine with no recurrence. We also conducted a literature review of childhood-onset HP and found only 16 cases, including our patient. Seven patients had idiopathic HP, and the remaining nine had secondary HP, including two with rheumatic disease. The most common clinical symptoms were headache (68.8%) and cranial nerve-related symptoms (68.8%). Inflammatory laboratory markers were elevated in 60% of patients with available data. Fifteen cases were diagnosed using Gd-enhanced MRI. The main initial treatment was steroids and/or immunosuppressants, to which 87.5% of patients responded. However, two patients with HP associated with trauma and neuroblastoma (12.5%) died, and seven patients (43.8%) had left cranial nerve-related sequelae. As the prognosis for childhood HP is poor, early diagnosis and treatment are essential. Children with headache, cranial nerve symptoms, and elevated inflammatory marker levels should be suspected of having HP and Gd-enhanced MRI should be considered.
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Affiliation(s)
- Naoki Nicho
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Tomo Nozawa
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Ayako Murase
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Ren Hayashibe
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Reo Tanoshima
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Risa Okubo
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Seira Hattori
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Kenichi Nishimura
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Takashi Ohya
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Shuichi Ito
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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Komatsu Y, Nozawa T, Kamiyama Y, Hattori S, Nishimura K, Ito S. Purple eyelid sign in multisystem inflammatory syndrome in children. Pediatr Int 2023; 65:e15510. [PMID: 36802119 DOI: 10.1111/ped.15510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/07/2023] [Accepted: 02/16/2023] [Indexed: 02/20/2023]
Affiliation(s)
- Yosuke Komatsu
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Tomo Nozawa
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Yuji Kamiyama
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Seira Hattori
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Kenichi Nishimura
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Shuichi Ito
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
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Cancarini P, Nozawa T, Whitney K, Bell-Peter A, Marcuz JA, Taddio A, Guo J, Dover S, Feldman BM. The clinical features of juvenile dermatomyositis: A single-centre inception cohort. Semin Arthritis Rheum 2022; 57:152104. [PMID: 36183479 DOI: 10.1016/j.semarthrit.2022.152104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 08/30/2022] [Accepted: 09/21/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Juvenile Dermatomyositis (JDM), a severe and rare autoimmune disease, is the most common idiopathic inflammatory myopathy in children. We describe the clinical features of a large single-centre cohort. METHODS We studied an inception cohort (0-18 years old) referred for diagnosis to the JDM clinic at The Hospital for Sick Children (SickKids), between January 1989 and September 2017. Probable or definite diagnosis of JDM was done according to the 2017 ACR/EULAR Criteria. We excluded children who had treatment started at another hospital. The data were collected retrospectively from clinical charts and the SickKids JDM database. RESULTS 172/230 (74.8%) patients were included. They were most often female (female:male = 1.8:1); the age at diagnosis was 8.5±4.3 years. There was a positive family history for autoimmune disease in 52%, mainly rheumatoid arthritis. No patient died. The most common signs at inception were muscle weakness (85.5%), nailfold capillary abnormalities (83.4%), Gottron papules (78.5%), heliotrope rash (66.3%), abnormal gait (55.8%), and malar/facial rash (54.7%). The prevalence of Gottron papules, heliotrope rash, facial/malar rash, nailfold capillary abnormalities, Raynaud phenomenon, dysphonia/dysphagia (a frequent cause of hospitalization), mouth ulcers, calcinosis, eye problems, joint involvement, acanthosis nigricans and lipodystrophy increased during follow-up. Muscle enzymes, namely CK, ALT, AST, were often normal or only slightly raised despite active muscle disease; conversely LD was often high. Anti-Nuclear Autoantibodies were positive in 49.7% of patients at diagnosis. The course of the disease was: 29.1% monocyclic, 5.3% polycyclic, 33.1% chronic. The course of 56 patients (32.5%) was not classifiable due to length of follow-up. Corticosteroids were used as treatment in almost all our patients and 30% required intravenous therapy due to the severity of the presentation; methotrexate was added in 64%, more often in recent years. Unresponsive patients were treated mostly with intravenous immunoglobulins (IVIG). CONCLUSIONS The information obtained from this relatively large number of patients adds to the growing knowledge base of this rare disease. TRIAL REGISTRATION SickKids Research Ethics Board approved the study.
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Affiliation(s)
- Paola Cancarini
- Operative Unit of Pediatrics, ASST del Garda, Desenzano del Garda (BS), Italy
| | - Tomo Nozawa
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan; Division of Rheumatology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada
| | - Kristi Whitney
- Division of Rheumatology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada; Department of Rehabilitation, The Hospital for Sick Children, Toronto, Canada
| | - Audrey Bell-Peter
- Division of Rheumatology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada
| | - Jo-Anne Marcuz
- Division of Rheumatology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada; Department of Rehabilitation, The Hospital for Sick Children, Toronto, Canada
| | - Andrea Taddio
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo" and University of Trieste, Trieste, Italy
| | - Jessica Guo
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Canada
| | - Saunya Dover
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Canada
| | - Brian M Feldman
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Canada; Division of Rheumatology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada; Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management & Evaluation, The Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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Nozawa T, Bell-Peter A, Marcuz JA, Whitney K, Vinik O, Shupak R, Dover S, Feldman BM. Early abnormal nailfold capillary changes are predictive of calcinosis development in juvenile dermatomyositis. J Rheumatol 2022; 49:1250-1255. [PMID: 35914785 DOI: 10.3899/jrheum.220249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The long-term outcomes of juvenile dermatomyositis (JDM) are more favorable in recent years. However, calcinosis is still among the complications that can cause serious functional impairment. Little is known about the pathogenesis and risk factors of calcinosis. The aim of this study is to determine risk factors for the development of calcinosis in JDM. METHODS This was a single-center, retrospective cohort study. All patients were diagnosed and followed at The Hospital for Sick Children's multidisciplinary JDM clinic, from January 1, 1989 until May 31, 2018. To investigate predictors of incident calcinosis, Cox regression analysis was performed. RESULTS A total of 172 patients met inclusion criteria, median age at diagnosis of 7.7 years (interquartile range [IQR] 4.9-12.1), median follow-up of 8.5 years (IQR 8.5-12.6, range 0.13-28.3). The only risk factor significantly associated with the development of calcinosis in the univariate analysis was nailfold abnormality at baseline (hazard ratio [HR] 4.857, p = 0.029), and the other variables had no significant relationship with calcinosis. In multivariable analysis, including nailfold abnormality, age of diagnosis, sex, and duration from onset to diagnosis, the only statistically significant risk factor for calcinosis was the presence of nailfold abnormalities (HR 4.975, p = 0.027). Furthermore, calcinosis was significantly increased in patients with a chronic course (chi-square 25.8, p = 0.00001). CONCLUSION The presence of abnormal nailfold capillary changes at baseline is predictive for the development of calcinosis in children with idiopathic inflammatory myopathies.
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Affiliation(s)
- Tomo Nozawa
- The source(s) of support in the form of grants or industrial support: Tomo Nozawa was supported by research fellowships of Japan Society of Allergology, Mochida Memorial Foundation, and Gushinkai. Brian Feldman is supported by the Ho Family Chair in Autoimmune Diseases. Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan; Department of Rehabilitation, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Rheumatology, Saint Michael's Hospital, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Departments of Pediatrics and Institute of Health Policy Management & Evaluation, University of Toronto, Toronto, Ontario, Canada. Conflict of Interests: The authors have no potential conflicts of interest relevant to this article to disclose. Corresponding author: Tomo Nozawa MD, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Address: 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan.
| | - Audrey Bell-Peter
- The source(s) of support in the form of grants or industrial support: Tomo Nozawa was supported by research fellowships of Japan Society of Allergology, Mochida Memorial Foundation, and Gushinkai. Brian Feldman is supported by the Ho Family Chair in Autoimmune Diseases. Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan; Department of Rehabilitation, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Rheumatology, Saint Michael's Hospital, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Departments of Pediatrics and Institute of Health Policy Management & Evaluation, University of Toronto, Toronto, Ontario, Canada. Conflict of Interests: The authors have no potential conflicts of interest relevant to this article to disclose. Corresponding author: Tomo Nozawa MD, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Address: 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan.
| | - Jo-Anne Marcuz
- The source(s) of support in the form of grants or industrial support: Tomo Nozawa was supported by research fellowships of Japan Society of Allergology, Mochida Memorial Foundation, and Gushinkai. Brian Feldman is supported by the Ho Family Chair in Autoimmune Diseases. Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan; Department of Rehabilitation, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Rheumatology, Saint Michael's Hospital, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Departments of Pediatrics and Institute of Health Policy Management & Evaluation, University of Toronto, Toronto, Ontario, Canada. Conflict of Interests: The authors have no potential conflicts of interest relevant to this article to disclose. Corresponding author: Tomo Nozawa MD, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Address: 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan.
| | - Kristi Whitney
- The source(s) of support in the form of grants or industrial support: Tomo Nozawa was supported by research fellowships of Japan Society of Allergology, Mochida Memorial Foundation, and Gushinkai. Brian Feldman is supported by the Ho Family Chair in Autoimmune Diseases. Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan; Department of Rehabilitation, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Rheumatology, Saint Michael's Hospital, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Departments of Pediatrics and Institute of Health Policy Management & Evaluation, University of Toronto, Toronto, Ontario, Canada. Conflict of Interests: The authors have no potential conflicts of interest relevant to this article to disclose. Corresponding author: Tomo Nozawa MD, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Address: 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan.
| | - Ophir Vinik
- The source(s) of support in the form of grants or industrial support: Tomo Nozawa was supported by research fellowships of Japan Society of Allergology, Mochida Memorial Foundation, and Gushinkai. Brian Feldman is supported by the Ho Family Chair in Autoimmune Diseases. Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan; Department of Rehabilitation, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Rheumatology, Saint Michael's Hospital, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Departments of Pediatrics and Institute of Health Policy Management & Evaluation, University of Toronto, Toronto, Ontario, Canada. Conflict of Interests: The authors have no potential conflicts of interest relevant to this article to disclose. Corresponding author: Tomo Nozawa MD, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Address: 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan.
| | - Rachel Shupak
- The source(s) of support in the form of grants or industrial support: Tomo Nozawa was supported by research fellowships of Japan Society of Allergology, Mochida Memorial Foundation, and Gushinkai. Brian Feldman is supported by the Ho Family Chair in Autoimmune Diseases. Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan; Department of Rehabilitation, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Rheumatology, Saint Michael's Hospital, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Departments of Pediatrics and Institute of Health Policy Management & Evaluation, University of Toronto, Toronto, Ontario, Canada. Conflict of Interests: The authors have no potential conflicts of interest relevant to this article to disclose. Corresponding author: Tomo Nozawa MD, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Address: 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan.
| | - Saunya Dover
- The source(s) of support in the form of grants or industrial support: Tomo Nozawa was supported by research fellowships of Japan Society of Allergology, Mochida Memorial Foundation, and Gushinkai. Brian Feldman is supported by the Ho Family Chair in Autoimmune Diseases. Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan; Department of Rehabilitation, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Rheumatology, Saint Michael's Hospital, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Departments of Pediatrics and Institute of Health Policy Management & Evaluation, University of Toronto, Toronto, Ontario, Canada. Conflict of Interests: The authors have no potential conflicts of interest relevant to this article to disclose. Corresponding author: Tomo Nozawa MD, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Address: 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan.
| | - Brian M Feldman
- The source(s) of support in the form of grants or industrial support: Tomo Nozawa was supported by research fellowships of Japan Society of Allergology, Mochida Memorial Foundation, and Gushinkai. Brian Feldman is supported by the Ho Family Chair in Autoimmune Diseases. Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama City, Kanagawa, Japan; Department of Rehabilitation, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Rheumatology, Saint Michael's Hospital, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Departments of Pediatrics and Institute of Health Policy Management & Evaluation, University of Toronto, Toronto, Ontario, Canada. Conflict of Interests: The authors have no potential conflicts of interest relevant to this article to disclose. Corresponding author: Tomo Nozawa MD, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Address: 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan.
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9
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Ohya T, Nishimura K, Murase A, Hattori S, Ohara A, Nozawa T, Hara R, Ito S. Impaired Interleukin-18 Signaling in Natural Killer Cells From Patients With Systemic Juvenile Idiopathic Arthritis. ACR Open Rheumatol 2022; 4:503-510. [PMID: 35275436 PMCID: PMC9190221 DOI: 10.1002/acr2.11426] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 01/07/2022] [Accepted: 02/01/2022] [Indexed: 12/03/2022] Open
Abstract
Objective Systemic juvenile idiopathic arthritis (sJIA) is characterized by fever, arthritis, rash, hepatosplenomegaly, and macrophage activation syndrome; however, its pathogenesis is still unclear. Elevated serum interleukin (IL)‐18 concentrations and decreased natural killer (NK) cell activity are characteristic of active disease; thus, we examined IL‐18 signaling in NK cells from sJIA. Methods We analyzed mitogen‐activated protein kinase (MAPK) p38 and nuclear factor κ light chain enhancer of activated B cells (NFκB) p65 phosphorylation in NK cells after in vitro recombinant IL‐18 (rIL‐18) stimulation in 31 patients with sJIA. Associations between clinical features, serum IL‐18, and phosphorylation intensity were analyzed. Furthermore, we investigated the effects of high IL‐18 concentrations on phosphorylation in NK cells. Results Patients were divided according to their disease activity: systemic features (n = 8), chronic arthritis (n = 7), remission on medication (n = 10), and remission off medication (n = 6). MAPK p38 and NFκB p65 phosphorylation intensity were the highest in healthy controls, followed by remission off medication, remission on medication (vs. control; MAPK p38, P < 0.01; NFκB p65, P < 0.05), chronic arthritis (P < 0.001, P < 0.001), and systemic features (P < 0.001, P < 0.001). The systemic features group showed a complete defect in phosphorylation. Serum IL‐18 was the highest in the systemic features group followed by chronic arthritis, remission on medication (P < 0.01), remission off medication (P < 0.01), and healthy controls (P < 0.01). Phosphorylation intensity was negatively correlated with serum IL‐18 (MAPK p38, r2 = 0.42; NFκB p65, r2 = 0.54). Furthermore, healthy control NK cells were cultured with rIL‐18; impaired phosphorylation was reproduced in vitro. Conclusion Impaired IL‐18 signaling in NK cells correlated with disease activity in sJIA. High serum IL‐18 exposure induces impaired MAPK and NFκB phosphorylation in NK cells.
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Affiliation(s)
- Takashi Ohya
- Yokohama City University, Yokohama, Kanagawa, Japan
| | | | - Ayako Murase
- Yokohama City University, Yokohama, Kanagawa, Japan
| | | | - Asami Ohara
- Yokohama City University, Yokohama, Kanagawa and Aichi Children's Health and Medical Center, Obu, Aichi, Japan
| | - Tomo Nozawa
- Yokohama City University, Yokohama, Kanagawa, Japan
| | - Ryoki Hara
- Yokohama City University and National Hospital Organization Yokohama Medical Center, Yokohama, Kanagawa, Japan
| | - Shuichi Ito
- Yokohama City University, Yokohama, Kanagawa, Japan
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10
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Yu J, Kurotaki H, Ando M, Nozawa T. Mechanical Properties of Self-Ion Irradiated Pure Tungsten using Nano-Indentation Test and Micro-Tensile Test. Nuclear Materials and Energy 2022. [DOI: 10.1016/j.nme.2022.101145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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11
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Miyazawa T, Hayashibe R, Nozawa T, Nishimura K, Ito S. Lipschütz ulcer induced by acute Epstein-Barr virus infection in a young girl. Pediatr Int 2022; 64:e15022. [PMID: 35484906 DOI: 10.1111/ped.15022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 09/13/2021] [Accepted: 10/08/2021] [Indexed: 01/05/2023]
Affiliation(s)
- Takuya Miyazawa
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Ren Hayashibe
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Tomo Nozawa
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Kenichi Nishimura
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Shuichi Ito
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
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12
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Ishii Y, Aiba N, Ando M, Asakura N, Bierwage A, Cara P, Dzitko H, Edao Y, Gex D, Hasegawa K, Hayashi T, Hiwatari R, Hoshino T, Ikeda Y, Ishida S, Isobe K, Iwai Y, Jokinen A, Kasugai A, Kawamura Y, Kim JH, Kondo K, Kwon S, Lorenzo SC, Masuda K, Matsuyama A, Miyato N, Morishita K, Nakajima M, Nakajima N, Nakamichi M, Nozawa T, Ochiai K, Ohta M, Oyaidzu M, Ozeki T, Sakamoto K, Sakamoto Y, Sato S, Seto H, Shiroto T, Someya Y, Sugimoto M, Tanigawa H, Tokunaga S, Utoh H, Wang W, Watanabe Y, Yagi M. R&D Activities for Fusion DEMO in the QST Rokkasho Fusion Institute. Fusion Science and Technology 2021. [DOI: 10.1080/15361055.2021.1925030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Y. Ishii
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - N. Aiba
- National Institutes for Quantum and Radiological Science and Technology, Naka Fusion Institute, Naka City, Japan
| | - M. Ando
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - N. Asakura
- National Institutes for Quantum and Radiological Science and Technology, Naka Fusion Institute, Naka City, Japan
| | - A. Bierwage
- National Institutes for Quantum and Radiological Science and Technology, Naka Fusion Institute, Naka City, Japan
| | - P. Cara
- IFMIF/EVEDA Project Team, Rokkasho-Vill., Japan
| | - H. Dzitko
- Fusion for Energy, Broader Approach, Garching, Germany
| | | | - D. Gex
- Fusion for Energy, Broader Approach, Garching, Germany
| | - K. Hasegawa
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Hayashi
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - R. Hiwatari
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Hoshino
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Ikeda
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. Ishida
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - K. Isobe
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Iwai
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - A. Jokinen
- IFMIF/EVEDA Project Team, Rokkasho-Vill., Japan
| | - A. Kasugai
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Kawamura
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - J. H. Kim
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - K. Kondo
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. Kwon
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. C. Lorenzo
- Fusion for Energy, Broader Approach, Barcelona, Spain
| | - K. Masuda
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - A. Matsuyama
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - N. Miyato
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - K. Morishita
- Kyoto University, Institute of Advanced Energy, Uji, Japan
| | - M. Nakajima
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - N. Nakajima
- National Institute for Fusion Science, Department of Helical Plasma Research Rokkasho Research Center, Rokkasho-Vill., Japan
| | - M. Nakamichi
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Nozawa
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - K. Ochiai
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - M. Ohta
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - M. Oyaidzu
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Ozeki
- NAT Corporation, Tohoku Branch Office, Rokkasho-Vill., Japan
| | - K. Sakamoto
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Sakamoto
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. Sato
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - H. Seto
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Shiroto
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Someya
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - M. Sugimoto
- NAT Corporation, Tohoku Branch Office, Rokkasho-Vill., Japan
| | - H. Tanigawa
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. Tokunaga
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - H. Utoh
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - W. Wang
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Watanabe
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - M. Yagi
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
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Nozawa T, Bell-Peter A, Doria AS, Marcuz JA, Stimec J, Whitney K, Feldman BM. Tibia stress injury and the imaging appearance of stress fracture in juvenile dermatomyositis: six patients' experiences. Pediatr Rheumatol Online J 2021; 19:17. [PMID: 33596941 PMCID: PMC7890837 DOI: 10.1186/s12969-021-00501-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 02/04/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Tibial stress injuries are frequent injuries of the lower extremity and the most common causes of exercise-induced leg pain among athletes and military recruits. They sometimes occur in patients with pathological conditions of bone metabolism such as osteoporosis or rheumatoid arthritis, but there are previously no cases reported in juvenile dermatomyositis (JDM). Here we report 6 JDM patients who presented with shin pain, and the imaging appearance of tibial stress fractures or stress reactions. CASE PRESENTATION All 6 patients with JDM presented with shin pain or tenderness in the anterior tibia without any evidence of excessive exercise or traumatic episode. They were diagnosed with tibial stress injuries based on a combination of radiographs, three-phase bone scans, and magnetic resonance imaging (MRI), and 5 out of 6 patients had been treated with prednisone and/or methotrexate at onset of tibial stress injuries. In one patient, we could not find any abnormalities in his radiograph, but the subsequent MRI showed tibial stress reaction. In all 6 patients, the tibial stress injuries improved with only rest and/or analgesics. CONCLUSION We experienced 6 children with JDM who presented with shin pain, and who were diagnosed with tibial stress fractures or stress reactions. Their underlying disease and weakness, treatment with glucocorticoid and methotrexate, or inactivity may have resulted in these tibial injuries, and made these patients more predisposed than other children. In addition to preventing JDM patients from getting osteoporosis, we need to consider stress reactions when children with JDM complain of sudden shin pain.
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Affiliation(s)
- Tomo Nozawa
- Division of Rheumatology, Department of Pediatrics, The Hospital for Sick Children, 555 University Ave, M5G 1X8, Toronto, ON, Canada. .,Department of Pediatrics, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan.
| | - Audrey Bell-Peter
- grid.42327.300000 0004 0473 9646Division of Rheumatology, Department of Pediatrics, The Hospital for Sick Children, 555 University Ave, M5G 1X8 Toronto, ON Canada
| | - Andrea S. Doria
- grid.17063.330000 0001 2157 2938Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave, M5G 1X8 Toronto, ON Canada
| | - Jo-Anne Marcuz
- grid.42327.300000 0004 0473 9646Division of Rheumatology, Department of Pediatrics, The Hospital for Sick Children, 555 University Ave, M5G 1X8 Toronto, ON Canada
| | - Jennifer Stimec
- grid.17063.330000 0001 2157 2938Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave, M5G 1X8 Toronto, ON Canada
| | - Kristi Whitney
- grid.42327.300000 0004 0473 9646Division of Rheumatology, Department of Pediatrics, The Hospital for Sick Children, 555 University Ave, M5G 1X8 Toronto, ON Canada
| | - Brian M. Feldman
- grid.42327.300000 0004 0473 9646Division of Rheumatology, Department of Pediatrics, The Hospital for Sick Children, 555 University Ave, M5G 1X8 Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, M5T 3M6 Toronto, Toronto, ON Canada
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14
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Kobayashi I, Akioka S, Kobayashi N, Iwata N, Takezaki S, Nakaseko H, Sato S, Nishida Y, Nozawa T, Yamasaki Y, Yamazaki K, Arai S, Nishino I, Mori M. Clinical practice guidance for juvenile dermatomyositis (JDM) 2018-Update. Mod Rheumatol 2020; 30:411-423. [PMID: 31955618 DOI: 10.1080/14397595.2020.1718866] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Juvenile dermatomyositis is the most common type of juvenile idiopathic inflammatory myopathy mainly affecting the skin and proximal muscles. We have published the Japanese version of 'Clinical practice guidance for juvenile dermatomyositis (JDM) 2018 'consisting of a review of articles in the field and evidence-informed consensus-based experts' opinion on the treatment strategy in collaboration with The Pediatric Rheumatology Association of Japan and The Japan College of Rheumatology under the financial support by 'Research on rare and intractable diseases, Health and Labor Sciences Research Grants'. This article is a digest version of the Japanese guidance.
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Affiliation(s)
- Ichiro Kobayashi
- Center for Pediatric Allergy and Rheumatology, KKR Sapporo Medical Center, Sapporo, Japan
| | - Shinji Akioka
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Norimoto Kobayashi
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Naomi Iwata
- Department of Infection and Immunology, Aichi Children's Health and Medical Center, Obu, Japan
| | | | - Haruna Nakaseko
- Department of Infection and Immunology, Aichi Children's Health and Medical Center, Obu, Japan
| | - Satoshi Sato
- Division of Infectious Disease and Immunology, Saitama Children's Medical Center, Omiya, Japan
| | - Yutaka Nishida
- Department of Pediatrics, School of Medicine, Gunma University, Maebashi, Japan
| | - Tomo Nozawa
- Department of Pediatrics, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Yuichi Yamasaki
- Department of Pediatrics, Kagoshima University Hospital, Kagoshima, Japan
| | - Kazuko Yamazaki
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Satoru Arai
- Department of Dermatology, St. Luke's International Hospital, Tokyo, Japan
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masaaki Mori
- Lifetime Clinical Immunology, Tokyo Medical and Dental University, Tokyo, Japan
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Isoda K, Nozawa T, Taira Y, Taira I, Shimizu Y, Ishida I. Effects of surface charge and palladium on hepatic and kidney injury induced by polystyrene nanoparticles co-administered to mice with paraquat and cisplatin. Pharmazie 2018; 73:165-168. [PMID: 29544565 DOI: 10.1691/ph.2018.7937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
Recently, with the advancement of nanotechnology, various nanoparticles have been developed and used in fields such as electronics, cosmetics, and foods. However, the toxicity of nanoparticles has yet to be fully investigated. In particular, the interactions between nanoparticles and therapeutic drugs require further study. We previously reported that unmodified polystyrene nanoparticles with a particle size of 50 nm (NPP50) co-administered with paraquat (PQ) or cisplatin (CDDP) induce hepatic and kidney injury. Here, we determined if NPP50 modified with the amino group (NPP50-NH2), carboxyl group (NPP50-COOH), or palladium (Pd-NPP50) caused liver or kidney injury when co-administered with PQ or CDDP. The results showed that when NPP50-NH2, NPP50-COOH, or Pd-NPP50 was administered alone via the mouse tail vein, serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and blood urea nitrogen (BUN) did not increase or cause injury. When NPP50, NPP50-NH2, NPP50-COOH, or Pd-NPP50 was co-administered with PQ, serum levels of ALT and AST increased in the NPP50 group but did not increase in the NPP50-NH2, NPP50-COOH, or Pd-NPP50 groups. When NPP50-NH2, NPP50-COOH, or Pd-NPP50 was co-administered with CDDP, ALT, AST, and BUN values did not increase. These data suggest that injury due to the interaction of polystyrene nanoparticles with CDDP or PQ can be suppressed by changes in the surface charge of nanoparticles or by Pd modification.
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Okamoto N, Yokota S, Takei S, Okura Y, Kubota T, Shimizu M, Nozawa T, Iwata N, Umebayashi H, Kinjo N, Kunishima T, Yasumura J, Mori M. Clinical practice guidance for juvenile idiopathic arthritis (JIA) 2018. Mod Rheumatol 2018; 29:41-59. [PMID: 30126298 DOI: 10.1080/14397595.2018.1514724] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Juvenile idiopathic arthritis (JIA) is the most common disease in pediatric rheumatism. There is no specific symptom or examination finding for JIA, and the diagnosis is made by exclusion and differentiation. Because non-pediatric rheumatologists are sometimes involved in medical care, 'proposal for JIA guidance on diagnosis and treatment for primary care pediatricians and non-pediatric rheumatologists' was first published in 2007. In these 10 years, a number of new findings on pathophysiology and treatment of JIA have been published; therefore, we propose this guidance of 2018th edition aiming at updating and standardization of JIA medical care in Japan. This edition included the management of uveitis, macrophage activation syndrome, infectious diseases before and during treatment. Moreover, details of biologics are also described. Although this guidance is tailored to adaptation of examinations and drugs, we do not purpose to limit the physicians' discretion in clinical practice. This guidance should be viewed as recommendations and be individualized according to the condition of the patient. We hope that medical care for JIA will advance and more patients will get benefit based on this guidance. Then, further revisions are needed due to changes in future conditions.
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Affiliation(s)
- Nami Okamoto
- a Department of Pediatrics, Faculty of Medicine , Osaka Medical College , Takatsuki , Japan
| | - Shumpei Yokota
- b Laboratory of Pediatric Research , Institute of Tokyo Medical School , Tokyo , Japan
| | - Syuji Takei
- c Department of Pediatrics, Graduate School of Medical and Dental Sciences , Kagoshima University , Kagoshima , Japan
| | - Yuka Okura
- d Department of Pediatrics , KKR Sapporo Medical Center , Sapporo , Japan
| | - Tomohiro Kubota
- c Department of Pediatrics, Graduate School of Medical and Dental Sciences , Kagoshima University , Kagoshima , Japan
| | - Masaki Shimizu
- e Department of Pediatrics, Graduate School of Medical Sciences , Kanazawa University , Kanazawa , Japan
| | - Tomo Nozawa
- f Department of Pediatrics , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Naomi Iwata
- g Department of Infection and Immunology , Aichi Children's Health and Medical Center , Obu , Japan
| | - Hiroaki Umebayashi
- h Department of General Pediatrics , Miyagi Children's Hospital , Sendai , Japan
| | - Noriko Kinjo
- i Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan
| | - Tomoko Kunishima
- i Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan
| | - Junko Yasumura
- j Department of Pediatrics , Hiroshima University Graduate School of Biomedical & Health Sciences , Hiroshima , Japan
| | - Masaaki Mori
- k Department of Lifetime Clinical Immunology, Graduate School of Medical and Dental Sciences , Tokyo Medical and Dental University , Tokyo , Japan
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Sakurai N, Hino-Shishikura A, Nozawa T, Kamide H, Ohara A, Nishimura K, Kikuchi M, Hara R, Mori M, Ito S. Clinical significance of subcutaneous fat and fascial involvement in juvenile dermatomyositis. Mod Rheumatol 2018; 29:808-813. [DOI: 10.1080/14397595.2018.1511026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Nodoka Sakurai
- Department of Pediatrics, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Department of Pediatrics, Sapporo Medical University, Sapporo, Japan
| | - Ayako Hino-Shishikura
- Department of Radiology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Tomo Nozawa
- Department of Pediatrics, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Hiroyuki Kamide
- Department of Radiology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Asami Ohara
- Department of Pediatrics, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Kenichi Nishimura
- Department of Pediatrics, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Masako Kikuchi
- Department of Pediatrics, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Ryoki Hara
- Department of Pediatrics, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Masaaki Mori
- Department of Lifetime Clinical Immunology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shuichi Ito
- Department of Pediatrics, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
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18
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Masuda H, Kobayashi T, Hachiya A, Nakashima Y, Shimizu H, Nozawa T, Ogihara Y, Ito S, Takatsuki S, Katsumata N, Suzuki Y, Takenaka S, Hirono K, Kobayashi T, Suzuki H, Suganuma E, Takahashi K, Saji T. Infliximab for the Treatment of Refractory Kawasaki Disease: A Nationwide Survey in Japan. J Pediatr 2018; 195:115-120.e3. [PMID: 29224935 DOI: 10.1016/j.jpeds.2017.10.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/10/2017] [Accepted: 10/12/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess the safety and efficacy of infliximab (IFX) for the treatment of patients with Kawasaki disease (KD). STUDY DESIGN This was a nationwide survey of 274 Japanese institutions exploring how IFX was used to treat patients with KD. The patients' sex, age, treatment course, pre- and post-IFX therapy blood test results, coronary artery lesions (CALs), and adverse events (AEs) were evaluated. RESULTS We analyzed 434 patients with KD who received IFX between March 2005 and November 2014. The median age at onset was 33 months (range 1-138), and 66 patients (15.2%) were under 1 year old. In all cases, IFX was administered as additional treatment. The median days of illness at the initiation of IFX was 9 days. In 275 patients (63.4%), IFX was administered as third-line treatment, and in 106 patients (24.4%), IFX was administered as fourth-line treatment. Single dose IFX 5 mg/kg was administered to 412 patients (94.9%). After IFX, 363 patients (83.6%) became afebrile within 2 days, and the white blood cell count, percentage of neutrophils, and serum C-reactive protein levels significantly decreased (P < .001), although 119 patients (27.4%) received additional treatment. Before IFX, 132 patients (30.4%) had already developed CALs. In patients without CALs before IFX, 31 patients (10.3%) newly developed CAL after IFX, whereas 32 patients (24.2%) with CAL before IFX showed increased CAL severity. Eighty AEs were observed in 69 patients (15.9%); however, serious AEs were few and reversible. CONCLUSIONS IFX might be an effective and tolerable treatment for refractory KD.
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Affiliation(s)
- Hiroshi Masuda
- Department of General Pediatrics and Interdisciplinary Medicine, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan; Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Tohru Kobayashi
- Division of Clinical Research Planning, Department of Development Strategy, Center for Clinical Research and Development, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan.
| | - Akira Hachiya
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Yasutaka Nakashima
- Department of Pediatrics, Graduate School of Medical Sciences, Kyusyu University, Fukuoka, Fukuoka, Japan
| | - Hiroyuki Shimizu
- Children's Medical Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Tomo Nozawa
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Yoshihito Ogihara
- Department of Pediatrics, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Shuichi Ito
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan; Division of Pediatric Nephrology and Rheumatology, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
| | - Shinichi Takatsuki
- Department of Pediatrics, Toho University, Medical Center Omori Hospital, Ota-ku, Tokyo, Japan
| | - Nobuyuki Katsumata
- Department of Pediatrics, Faculty of Medicine University of Yamanashi, Chuo, Yamanashi, Japan
| | - Yasuo Suzuki
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Satoshi Takenaka
- Department of Pediatrics, Japan Community Healthcare Organization (JCHO), Kyusyu Hospital, Kitakyushu, Fukuoka, Japan
| | - Keiichi Hirono
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Toyama, Japan
| | - Tomio Kobayashi
- Division of Cardiology, Gunma Children's Medical Center, Shibukawa, Gunma, Japan
| | - Hiroshi Suzuki
- Department of Pediatrics, Yamagata University School of Medicine, Yamagata, Yamagata, Japan
| | - Eisuke Suganuma
- Division of Infectious Diseases and Immunology, Saitama Children's Medical Center, Saitama, Saitama, Japan
| | - Kei Takahashi
- Department of Pathology, Toho University Ohashi Medical Center, Shibuya-ku, Tokyo, Japan
| | - Tsutomu Saji
- Advanced and Integrated Cardiovascular Research Course in the Young and Adolescence, Ota-ku, Toho University, Tokyo, Japan
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- Japan Society of Kawasaki Disease, Tokyo, Japan
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19
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Affiliation(s)
- Tomo Nozawa
- Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | | | - Shuichi Ito
- Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Lomakina O, Alekseeva E, Valieva S, Bzarova T, Nikishina I, Zholobova E, Rodionovskaya S, Kaleda M, Nakagishi Y, Shimizu M, Mizuta M, Yachie A, Sugita Y, Okamoto N, Shabana K, Murata T, Tamai H, Smith EM, Yin P, Jorgensen AL, Beresford MW, Smith EM, Eleuteri A, Goilav B, Lewandowski L, Phuti A, Wahezi D, Rubinstein T, Jones C, Newland P, Marks S, Corkhill R, Ekdawy D, Pilkington C, Tullus K, Putterman C, Scott C, Fisher AC, Beresford MW, Smith EM, Lewandowski L, Phuti A, Jorgensen A, Scott C, Beresford MW, Batu ED, Kosukcu C, Taskiran E, Akman S, Ozturk K, Sozeri B, Unsal E, Ekinci Z, Bilginer Y, Alikasifoglu M, Ozen S, Lythgoe H, Beresford MW, Brunner HI, Gulati G, Jones JT, Altaye M, Eaton J, Difrancesco M, Yeo JG, Leong J, Bathi LDT, Arkachaisri T, Albani S, Abdelrahman N, Beresford MW, Leone V, Groot N, Shaikhani D, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Wright RD, Smith EM, Beresford MW, Abdawani R, Al Shaqshi L, Al Zakwani I, Gormezano NW, Kern D, Pereira OL, Esteves GCC, Sallum AM, Aikawa NE, Pereira RM, Silva CA, Bonfa E, Beckmann J, Bartholomä N, Foeldvari I, Bohnsack J, Milojevic D, Rabinovich C, Kingsbury D, Marzan K, Quartier P, Minden K, Chalom E, Horneff G, Venhoff N, Kuester RM, Dare J, Heinrich M, Kupper H, Kalabic J, Martini A, Brunner HI, Consolaro A, Horneff G, Burgos-Vargas R, Henneke P, Constantin T, Foeldvari I, Vojinovic J, Dehoorne J, Panaviene V, Susic G, Stanevica V, Kobusinska K, Zuber Z, Mouy R, Salzer U, Rumba-Rozenfelde I, Dolezalova P, Job-Deslandre C, Wulffraat N, Pederson R, Bukowski J, Hinnershitz T, Vlahos B, Martini A, Ruperto N, Janda A, Keskitalo P, Kangas S, Vähäsalo P, Valencia RAC, Martino D, Munro J, Ponsonby AL, Chiaroni-Clarke R, Meyer B, Allen RC, Boteanu AL, Akikusa JD, Craig JM, Saffrey R, Ellis JA, Davì S, Minoia F, Horne A, Wulffraat N, Wouters C, Wallace C, Corral SG, Uziel Y, Sterba G, Schneider R, Russo R, Ramanan AV, Schmid JP, Ozen S, Nichols KE, Miettunen P, Lovell DJ, Giraldo AS, Lehmberg K, Kitoh T, Khubchandani R, Ilowite NT, Henter JI, Grom AA, De Benedetti F, Behrens EM, Avcin T, Aricò M, Gámir MG, Martini A, Ruperto N, Cron RQ, Ravelli A, Grevich S, Lee P, Ringold S, Leroux B, Leahey H, Yuasa M, Mendoza AZ, Foster J, Sokolove J, Lahey L, Robinson W, Newson J, Stevens A, Shoop SJW, Hyrich KL, Verstappen SMM, Thomson W, Adrovic A, McDonagh JE, Beukelman T, Kimura Y, Natter M, Ilowite N, Mieszkalski K, Burrell G, Best B, Bristow H, Carr S, Dedeoglu R, Dennos A, Kaufmann R, Schanberg L, Parissenti I, Insalaco A, Taddio A, Mauro A, Pardeo M, Ricci F, Simonini G, Sahin S, Cattalini M, Montesano P, Parissenti I, Ricci F, Bonafini B, Medeghini V, Lancini F, Cattalini M, Gerbaux M, Lê PQ, Barut K, Goffin L, Badot V, La C, Caspers L, Willermain F, Ferster A, Ceci M, Licciardi F, Turco M, Santarelli F, Koka A, Montin D, Toppino C, Maggio MC, Alizzi C, Papia B, Vergara B, Corpora U, Messina L, Corsello G, Tsinti M, Oztunc F, Dermentzoglou V, Tziavas P, Tsitsami E, Perica M, Vidović M, Lamot L, Harjaček M, Bukovac LT, Çakan M, Ayaz NA, Kasapcopur O, Keskindemirci G, Miettunen P, Lang M, Laing C, Benseler S, Gerschman T, Luca N, Schmeling H, Dropol A, Taiani J, Rodriguez-Lozano AL, Johnson N, Rusted B, Nalbanti P, Trachana M, Pratsidou P, Pardalos G, Tzimouli V, Taparkou A, Stavrakidou M, Papachristou F, Rivas-Larrauri F, Kanakoudi-Tsakalidou F, Bale P, Robinson E, Palman J, Pilkington C, Ralph E, Gilmour K, Heard C, Wedderburn LR, Carlomagno R, de la Puente SG, Barrense-Dias Y, Gregory A, Amira D, Paolo S, Sylviane H, Michaël H, Panko N, Shokry S, Rakovska L, Pino S, Alves AGF, Diaz-Maldonado A, Guarnizo P, Torreggiani S, Cressoni P, Garagiola U, Di Landro G, Farronato G, Corona F, Filocamo G, Shenoi S, Giacomin MFDA, Bell S, Bhatti P, Nelson L, Mueller BA, Simon TA, Baheti A, Ray N, Guo Z, Ruperto N, Brunner HI, Farhat J, Hazra A, Stock T, Wang R, Mebus C, Alvey C, Lamba M, Krishnaswami S, Conte U, Wang M, Tzaribachev N, Braga ALF, Foeldvari I, Horneff G, Kingsbury D, Koskova E, Smolewska E, Vehe RK, Zuber Z, Martini A, Lovell D, Kubota T, Sallum AME, Shimizu M, Yasumura J, Nakagishi Y, Kizawa T, Yashiro M, Wakiguchi H, Yamatou T, Yamasaki Y, Takei S, Kawano Y, Campos LMDA, Nykvist UJ, Magnusson B, Wicksell R, Palmblad K, Olsson GL, Ziaee V, Modaressi M, Moradinejad MH, Seraya V, Zholobova E, Pereira LAA, Vitebskaya A, Moshe V, Amarilyo G, Harel L, Hashkes PJ, Mendelson A, Rabinowicz N, Reis Y, Uziel Y, Dāvidsone Z, Lichtenfels AJDFC, Lazareva A, Šantere R, Bērziņa D, Staņēviča V, Varnier GC, Consolaro A, Pilkington C, Maillard S, Ferrari C, Zaffarano S, Silva CA, Martini A, Ravelli A, Wienke J, Enders FB, van den Hoogen LL, Mertens JS, Radstake TR, Hotten HG, Fritsch R, de Jager W, Farhat SCL, Wedderburn L, Nistala K, Pilkington C, Prakken B, van Royen-Kerkhof A, van Wijk F, Alhemairi M, Muzaffer M, Van Dijkhuizen P, Deakin CT, Acar B, Simou S, Wedderburn LR, De Iorio M, Wu Q, Amin T, Simou S, Dossetter L, Wedderburn LR, Pilkington C, Campanilho-Marques R, Ozcakar ZB, Deakin C, Simou S, Wedderburn LR, Pilkington CA, Rosina S, Consolaro A, van Dijkhuizen P, Nistala K, Ruperto N, Pilkington C, Çakar N, Ravelli A, Soponkanaporn S, Simou S, Deakin CT, Wedderburn LR, Arıcı ZS, Tuğcu GD, Batu ED, Sönmez HE, Doğru-Ersöz D, Uncu N, Bilginer Y, Talim B, Kiper N, Özen S, Solyom A, Hügle B, Makay B, Magnusson B, Batu E, Mitchell J, Gür G, Kariminejad A, Hadipour F, Hadipour Z, Torcoletti M, Agostoni C, Di Rocco M, Tanpaiboon P, Superti-Furga A, Bonafé L, Arslan N, Özdel S, Guelbert N, Kostik M, Ehlert K, Grigelioniene G, Puri R, Ozen S, Schuchman E, Malagon C, Gomez P, Mosquera AC, Yalçınkaya F, Gonzalez T, Yepez R, Vargas C, Fernanda F, Lepri G, Ferrari A, Rigante D, Matucci-Cerinic M, Meini A, Moneta GM, Scott C, Caiello I, Marasco E, Nicolai R, Pardeo M, Bracaglia C, Insalaco A, Bracci-Laudiero L, De Benedetti F, Kopchak O, Kostik M, Brice N, Mushkin A, Maletin A, Makay B, Batu ED, Hügle B, Arslan N, Solyom A, Mitchell J, Schuchman E, Ozen S, Nourse P, Magnusson B, Malagon C, Gomez P, Mosquera C, Gonzalez T, Yepez R, Vargas C, Amorim RA, Len CA, Molina J, Lewandowski L, Moreira G, Santos FH, Fraga M, Keppeke L, Silva VM, Hirotsu C, Tufik S, Terreri MT, Braga VL, Fonseca MB, Arango C, Len CA, Fraga M, Schinzel V, Terreri MTR, Molina J, Len CA, Jorge L, Guerra L, Santos FH, Terreri MT, Mosquera AC, Junior EA, Fonseca MB, Braga VL, Len CA, Fraga M, Schinzel V, Terreri MTR, Alizzi C, Maggio MC, Castiglione MC, Malagon C, Tricarico A, Corsello G, Boulter E, Schultz A, Murray K, Falcini F, Lepri G, Stagi S, Bellucci E, Matucci-Cerinic M, Sakamoto AP, Grein IHR, Groot N, Pileggi G, Pinto NBF, de Oliveira AL, Wulffraat N, Chyzheuskaya I, Belyaeva L, Filonovich R, Khrustaleva H, Silva CA, Zajtseva L, Ilisson J, Pruunsild C, Kostik M, Kopchak O, Mushkin A, Maletin A, Gilliaux O, Corazza F, Lelubre C, Silva MFCD, Ferster A, Suárez RG, Morel Z, Espada G, Malagon C, C CSM, Lira L, Ladino M, Eraso R, Arroyo I, Lopes AS, Sztajnbok F, Silva C, Rose C, Russo GCS, Sallum AEM, Kozu K, Bonfá E, Saad-Magalhães C, Pereira RMR, Len CA, Terreri MT, Suri D, Didel S, Rawat A, Singh S, Maritsi D, Onoufriou MA, Vougiouka O, Tsolia M, Bosak EP, Vidović M, Lamot M, Lamot L, Harjaček M, Van Nieuwenhove E, Liston A, Wouters C, Tahghighi F, Ziaee V, Raeeskarami SR, Aguiar F, Pereira S, Rodrigues M, Moura C, Rocha G, Guimarães H, Brito I, Aguiar F, Fonseca R, Rodrigues M, Brito I, Horneff G, Klein A, Minden K, Huppertz HI, Weller-Heinemann F, Kuemmerle-Deschner J, Haas JP, Hospach A, Menendez-Castro R, Huegle B, Haas JP, Swart J, Giancane G, Bovis F, Castagnola E, Groll A, Horneff G, Huppertz HI, Lovell DJ, Wolfs T, Hofer M, Alekseeva E, Panaviene V, Nielsen S, Anton J, Uettwiller F, Stanevicha V, Trachana M, Marafon DP, Ailioaie C, Tsitsami E, Kamphuis S, Herlin T, Doležalová P, Susic G, Flatø B, Sztajnbok F, Pistorio A, Martini A, Wulffraat N, Ruperto N, Gattorno M, Brucato A, Finetti M, Lazaros G, Maestroni S, Carraro M, Cumetti D, Carobbio A, Lorini M, Rimini A, Marcolongo R, Valenti A, Erre GL, Belli R, Gaita F, Sormani MP, Ruperto N, Imazio M, Martini A, Abinun M, Smith N, Rapley T, McErlane F, Kearsley-Fleet L, Hyrich KL, Foster H, Ruperto N, Lovell DJ, Tzaribachev N, Zeft A, Cimaz R, Stanevicha V, Horneff G, Bohnsack J, Griffin T, Carrasco R, Trachana M, Dare J, Foeldvari I, Vehe R, Bovis F, Simon T, Martini A, Brunner H, Verazza S, Davì S, Consolaro A, Insalaco A, Gerloni V, Cimaz R, Zulian F, Pastore S, Corona F, Conti G, Barone P, Cattalini M, Cortis E, Breda L, Olivieri AN, Civino A, Podda R, Rigante D, La Torre F, D’Angelo G, Jorini M, Gallizzi R, Maggio MC, Consolini R, De Fanti A, Alpigiani MG, Martini A, Ravelli A, Sozeri B, Kısaarslan AP, Gunduz Z, Dusunsel R, Dursun I, Poyrazoglu H, Kuchinskaya E, Abduragimova F, Kostik M, Sundberg E, Omarsdottir S, Klevenvall L, Erlandsson-Harris H, Basbozkurt G, Erdemli O, Simsek D, Yazici F, Karsioglu Y, Tezcaner A, Keskin D, Ozkan H, Acikel C, Ozen S, Demirkaya E, Orbán I, Sevcic K, Brodszky V, Kiss E, Tekko IA, Rooney M, McElnay J, Taggart C, McCarthy H, Donnelly RF, Abinun M, Slatter M, Nademi Z, Friswell M, Foster H, Jandial S, McErlane F, Flood T, Hambleton S, Gennery A, Cant A, Finetti M, Bovis F, Swart J, Doležalová P, Tsitsami E, Trachana M, Demirkaya E, Duong PN, Koné-Paut I, Vougiouka O, Marafon DP, Cimaz R, Filocamo G, Gamir ML, Stanevicha V, Sanner H, Carenini L, Wulffraat N, Martini A, Ruperto N, Topdemir M, Basbozkurt G, Karslioglu Y, Ozkan H, Acikel C, Demirkaya E, Gok F, Zholobova E, Tsurikova N, Ligostaeva E, Ramchurn NR, Friswell M, Kostareva O, Nikishina I, Arsenyeva S, Rodionovskaya S, Kaleda M, Alexeev D, Dursun ID, Sozeri B, Kısaarslan AP, Dusunsel R, Poyrazoglu H, Poyrazoglu H, Murias S, Barral E, Alcobendas R, Enriquez E, Remesal A, de Inocencio J, Castro TM, Lotufo SA, Freye T, Carlomagno R, Zumbrunn T, Bonhoeffer J, Schneider EC, Kaiser D, Hofer M, Hentgen V, Woerner A, Schwarz T, Klotsche J, Niewerth M, Horneff G, Haas JP, Hospach A, Huppertz HI, Ganser G, Minden K, Jeyaratnam J, ter Haar N, Kasapcopur O, Rigante D, Dedeoglu F, Baris E, Vastert S, Wulffraat N, Frenkel J, Hausmann JS, Lomax KG, Shapiro A, Durrant KL, Brogan PA, Hofer M, Kuemmerle-Deschner JB, Lauwerys B, Speziale A, Leon K, Wei X, Laxer RM, Signa S, Rusmini M, Campione E, Chiesa S, Grossi A, Omenetti A, Caorsi R, Viglizzo G, Martini A, Ceccherini I, Gattorno M, Federici S, Frenkel J, Ozen S, Lachmann H, Finetti M, Martini A, Ruperto N, Gattorno M, Federici S, Vanoni F, Ozen S, Hofer M, Frenkel J, Lachmann H, Martini A, Ruperto N, Gattorno M, Gomes SM, Omoyinmi E, Arostegui JI, Gonzalez-Roca E, Eleftheriou D, Klein N, Brogan P, Volpi S, Santori E, Picco P, Pastorino C, Caorsi R, Rice G, Tesser A, Martini A, Crow Y, Candotti F, Gattorno M, Barut K, Sahin S, Adrovic A, Sinoplu AB, Yucel G, Pamuk G, Kasapcopur O, Damian LO, Lazea C, Sparchez M, Vele P, Muntean L, Albu A, Rednic S, Lazar C, Mendonça LO, Pontillo A, Kalil J, Castro FM, Barros MT, Pardeo M, Messia V, De Benedetti F, Insalaco A, Malighetti G, Gorio C, Ricci F, Parissenti I, Montesano P, Bonafini B, Medeghini V, Cattalini M, Giordano L, Zani G, Ferraro R, Vairo D, Giliani S, Cattalini M, Maggio MC, Luppino G, Corsello G, Fernandez MIG, Montesinos BL, Vidal AR, Gorospe JIA, Penades IC, Rafiq NK, Wynne K, Hussain K, Brogan PA, Ang E, Ng N, Kacar A, Gucenmez OA, Makay B, Unsal SE, Sahin Y, Barut K, Kutlu T, Cullu-Cokugras F, Sahin S, Adrovic A, Ayyildiz-Civan H, Kasapcopur O, Erkan T, Abdawani R, Al Zuhbi S, Abdalla E, Russo RA, Katsicas MM, Caorsi R, Minoia F, Viglizzo G, Grossi A, Chiesa S, Picco P, Ravelli A, Gattorno M, Bhattad S, Rawat A, Gupta A, Suri D, Pandiarajan V, Nada R, Tiewsoh K, Hawkins P, Rowczenio D, Singh S, Fingerhutova S, Franova J, Prochazkova L, Hlavackova E, Dolezalova P, Evrengül H, Yüksel S, Doğan M, Gürses D, Evrengül H, De Pauli S, Pastore S, Bianco AM, Severini GM, Taddio A, Tommasini A, Salugina SO, Fedorov E, Kamenets E, Zaharova E, Kaleda M, Salugina SO, Fedorov E, Kamenets E, Zaharova E, Kaleda M, Sleptsova T, Alexeeva E, Savostyanov K, Pushkov A, Bzarova T, Valieva S, Denisova R, Isayeva K, Chistyakova E, Lomakina O, Soloshenko M, Kaschenko E, Kaneko U, Imai C, Saitoh A, Teixeira VA, Ramos FO, Costa M, Aviel YB, Fahoum S, Brik R, Özçakar ZB, Çakar N, Uncu N, Celikel BA, Yalcinkaya F, Schiappapietra B, Davi’ S, Mongini F, Giannone L, Bava C, Alpigiani MG, Martini A, Ravelli A, Consolaro A, Lazarevic DS, Vojinovic J, Susic G, Basic J, Giancane G, Muratore V, Marzetti V, Quilis N, Benavente BS, Alongi A, Civino A, Quartulli L, Consolaro A, Martini A, Ravelli A, Januskeviciute G, van Dijkhuizen P, Muratore V, Giancane G, Schiappapietra B, Martini A, Ravelli A, Consolaro A, Groot N, van Dijk W, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Groot N, Kardolus A, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Suárez RG, Nordal EB, Rypdal VG, Berntson L, Ekelund M, Aalto K, Peltoniemi S, Zak M, Nielsen S, Glerup M, Herlin T, Arnstad ED, Fasth A, Rygg M, Duarte AC, Sousa S, Teixeira L, Cordeiro A, Santos MJ, Mourão AF, Santos MJ, Eusébio M, Lopes A, Oliveira-Ramos F, Salgado M, Estanqueiro P, Melo-Gomes J, Martins F, Costa J, Furtado C, Figueira R, Brito I, Branco JC, Fonseca JE, Canhão H, Mourão AF, Santos MJ, Eusébio M, Lopes A, Oliveira-Ramos F, Salgado M, Estanqueiro P, Melo-Gomes J, Martins F, Costa J, Furtado C, Figueira R, Brito I, Branco JC, Fonseca JE, Canhão H, Coda A, Cassidy S, West K, Hendry G, Grech D, Jones J, Hawke F, Grewal DS, Coda A, Jones J, Grech D, Grewal DS, Foley C, Killeen O, MacDermott E, Veale D, Fearon U, Konukbay D, Demirkaya E, Tarakci E, Arman N, Barut K, Şahin S, Adrovic A, Kasapcopur O, Munro J, Consolaro A, Morgan E, Riebschleger M, Horonjeff J, Strand V, Bingham C, Collante MTM, Ganeva M, Stefanov S, Telcharova A, Mihaylova D, Saraeva R, Tzveova R, Kaneva R, Tsakova A, Temelkova K, Picarelli MMC, Danzmann LC, Barbé-Tuana F, Grun LK, Jones MH, Frković M, Ištuk K, Birkić I, Sršen S, Jelušić M, Smith N, Jandial S, Easton A, Quarmby R, Khubchandani R, Chan M, Rapley T, Foster H, Srp R, Kobrova K, Franova J, Fingerhutova S, Nemcova D, Hoza J, Uher M, Saifridova M, Linkova L, Dolezalova P, Charuvanij S, Leelayuwattanakul I, Pacharapakornpong T, Vallipakorn SAO, Lerkvaleekul B, Vilaiyuk S, Muratore V, Giancane G, Lanni S, Alongi A, Alpigiani MG, Martini A, Ravelli A, Consolaro A, Alongi A, Bovis F, Minoia F, Davì S, Martini A, Ruperto N, Cron RQ, Ravelli A, Passarelli C, Pardeo M, Pisaneschi E, Novelli A, De Benedetti F, Bracaglia C, Bracaglia C, Marafon DP, Caiello I, de Graaf K, Guilhot F, Ferlin W, Davi’ S, Schulert G, Ravelli A, Grom AA, Nelson R, de Min C, De Benedetti F, Holzinger D, Kessel C, Fall N, Grom A, de Jager W, Vastert S, Strippoli R, Bracaglia C, Sundberg E, Horne A, Ehl S, Ammann S, Lehmberg K, De Benedetti F, Beutel K, Foell D, Minoia F, Horne A, Bovis F, Davì S, Pagani L, Espada G, Gao YJ, Insalaco A, Lehmberg K, Sanner H, Shenoi S, Weitzman S, Ruperto N, Martini A, Cron RQ, Ravelli A, Prencipe G, Caiello I, Pascarella A, Bracaglia C, Ferlin WG, Chatel L, Strippoli R, de Min C, De Benedetti F, Jacqmin P, De Graaf K, Ballabio M, Nelson R, Johnson Z, Ferlin W, Lapeyre G, de Benedetti F, Cristina DM, Wakiguchi H, Hasegawa S, Hirano R, Okazaki F, Nakamura T, Kaneyasu H, Ohga S, Yamazaki K, Nozawa T, Kanetaka T, Ito S, Yokota S, McLellan K, MacGregor I, Martin N, Davidson J, Kuemmerle-Deschner J, Hansmann S, Wulffraat N, Eikelberg A, Haug I, Schuller S, Benseler SM, Nazarova LS, Danilko KV, Malievsky VA, Viktorova TV, Mauro A, Omoyinmi E, Barnicoat A, Brogan P, Foley C, Killeen O, MacDermott E, Veale D, Foley C, Killeen O, MacDermott E, Veale D, Gomes SM, Omoyinmi E, Hurst J, Canham N, Eleftheriou D, Klein N, Lacassagne S, Brogan P, Wiener A, Hügle B, Denecke B, Costa-Filho I, Haas JP, Tenbrock K, Popp D, Boltjes A, Rühle F, Herresthal S, de Jager W, van Wijk F, Schultze J, Stoll M, Klotz L, Vogl T, Roth J, Quesada-Masachs E, de la Sierra DÁ, Prat MG, Sánchez AMM, Borrell RP, Barril SM, Gallo MM, Caballero CM, Chyzheuskaya I, Byelyaeva LM, Filonovich RM, Khrustaleva HK, Zajtseva LI, Yuraga TM, Chyzheuskaya I, Byelyaeva LM, Filonovich RM, Khrustaleva HK, Zajtseva LI, Yuraga TM, Giner T, Hackl L, Albrecht J, Würzner R, Brunner J, Pastore S, Minute M, Parentin F, Tesser A, Nocerino A, Taddio A, Tommasini A, Nørgaard M, Herlin T, Alberdi-Saugstrup M, Zak MS, Nielsen SM, Herlin T, Nordal E, Berntson L, Fasth A, Rygg M, Müller KG, Avramovič MZ, Dolžan V, Toplak N, Avčin T, Ruperto N, Lovell DJ, Wallace C, Toth M. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two. Pediatr Rheumatol Online J 2017. [PMCID: PMC5461533 DOI: 10.1186/s12969-017-0142-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Nozawa T, Nishimura K, Ohara A, Hara R, Ito S. Primary varicella infection in children with systemic juvenile idiopathic arthritis under tocilizumab therapy. Mod Rheumatol 2016; 29:558-562. [DOI: 10.1080/14397595.2016.1254314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Tomo Nozawa
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama City, Japan
| | - Kenichi Nishimura
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama City, Japan
| | - Asami Ohara
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama City, Japan
| | - Ryoki Hara
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama City, Japan
| | - Shuichi Ito
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama City, Japan
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Fujino H, Matsubara K, Tokoro N, Nozawa T. Improvement of Demold Time for Rigid Polyurethane Foam. J CELL PLAST 2016. [DOI: 10.1177/0021955x8902500607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- H. Fujino
- Polymer Research Laboratory Central Research Institute 2-5, Kasumigaseki 3-Chome Chiydaku, Tokyo Japan
| | - K. Matsubara
- Polymer Research Laboratory Central Research Institute 2-5, Kasumigaseki 3-Chome Chiydaku, Tokyo Japan
| | - N. Tokoro
- Polymer Research Laboratory Central Research Institute 2-5, Kasumigaseki 3-Chome Chiydaku, Tokyo Japan
| | - T. Nozawa
- Polymer Research Laboratory Central Research Institute 2-5, Kasumigaseki 3-Chome Chiydaku, Tokyo Japan
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Fujino H, Matsubara K, Tokoro N, Nozawa T. Improvement of Demold Time for Rigid Polyurethane Foam. J CELL PLAST 2016. [DOI: 10.1177/0021955x8902500601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Nozawa T, Mori M, Nishimura K, Sakurai N, Kikuchi M, Hara R, Yokota S. Usefulness of two interferon-γ release assays for rheumatic disease. Pediatr Int 2016; 58:347-52. [PMID: 26670306 DOI: 10.1111/ped.12885] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 10/08/2015] [Accepted: 10/22/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the performance of two interferon-γ release assays (IGRA), QuantiFERON-TB Gold In-Tube (QFT-GIT) and T-SPOT.TB, for pediatric patients with rheumatic disease in Japan and to analyze the frequencies of indeterminate test results with these kits. METHODS An IGRA was performed in 108 patients <20 years old in order to exclude tuberculosis infection at the time of first application of or change of biological agents and immunosuppressants in Yokohama City University Hospital. RESULTS None of the 108 patients tested had active tuberculosis during the 50 month observation period. Indeterminate results of QFT-GIT and T-SPOT.TB tests were obtained in 9.9% and in 0% of cases, respectively. Indeterminate results were obtained significantly more frequently in patients on prednisolone >0.5 mg/kg and in patients with active underlying disease. Use of biologicals and other immunosuppressants had no effect on these measurements. CONCLUSIONS IGRA are very useful for excluding tuberculosis infection in patients with rheumatic disease before starting new immunosuppressant therapy. Furthermore, the T-SPOT.TB test was suitable for evaluating latent tuberculosis infection even under immunosuppression, when TB tests are generally hard to perform.
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Affiliation(s)
- Tomo Nozawa
- Department of Pediatrics, Yokohama City University Hospital, Kanagawa, Japan
| | - Masaaki Mori
- Department of Pediatrics, Yokohama City University Medical Center, Kanagawa, Japan
| | - Kenichi Nishimura
- Department of Pediatrics, Yokohama City University Hospital, Kanagawa, Japan
| | - Nodoka Sakurai
- Department of Pediatrics, Yokohama City University Hospital, Kanagawa, Japan
| | - Masako Kikuchi
- Department of Pediatrics, Yokohama City University Hospital, Kanagawa, Japan
| | - Ryoki Hara
- Department of Pediatrics, Yokohama City University Hospital, Kanagawa, Japan
| | - Shumpei Yokota
- Department of Pediatrics, International University of Health and Welfare Atami Hospital, Shizuoka, Japan
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Ando M, Nozawa T, Hirose T, Tanigawa H, Wakai E, Stoller RE, Myers J. Effect of Helium on Irradiation Creep Behavior of B-Doped F82H Irradiated in HFIR. Fusion Science and Technology 2015. [DOI: 10.13182/fst14-963] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M. Ando
- Japan Atomic Energy Agency, Rokkasho-mura, Aomori-ken, Japan 039-3212
| | - T. Nozawa
- Japan Atomic Energy Agency, Rokkasho-mura, Aomori-ken, Japan 039-3212
| | - T. Hirose
- Japan Atomic Energy Agency, Rokkasho-mura, Aomori-ken, Japan 039-3212
| | - H. Tanigawa
- Japan Atomic Energy Agency, Rokkasho-mura, Aomori-ken, Japan 039-3212
| | - E. Wakai
- Japan Atomic Energy Agency, Rokkasho-mura, Aomori-ken, Japan 039-3212
| | - R. E. Stoller
- Oak Ridge National Laboratory, 1 Bethel Valley Rd, Oak Ridge, TN37831, USA
| | - J. Myers
- Oak Ridge National Laboratory, 1 Bethel Valley Rd, Oak Ridge, TN37831, USA
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Kanetaka T, Mori M, Nishimura KI, Nozawa T, Kikuchi M, Sakurai N, Hara R, Yamazaki K, Yokota S. Characteristics of FDG-PET findings in the diagnosis of systemic juvenile idiopathic arthritis. Mod Rheumatol 2015; 26:362-7. [DOI: 10.3109/14397595.2015.1082686] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Taichi Kanetaka
- Department of Pediatrics, Yokosuka Kyosai Hospital, Yokosuka, Japan,
- Department of Pediatrics, Yokohama City University School of Medicine, Yokosuka, Japan, and
| | - Masaaki Mori
- Department of Pediatrics, Yokohama City University Medical Center, Yokosuka, Japan
| | - Ken-ichi Nishimura
- Department of Pediatrics, Yokohama City University School of Medicine, Yokosuka, Japan, and
| | - Tomo Nozawa
- Department of Pediatrics, Yokohama City University School of Medicine, Yokosuka, Japan, and
| | - Masako Kikuchi
- Department of Pediatrics, Yokohama City University School of Medicine, Yokosuka, Japan, and
| | - Nodoka Sakurai
- Department of Pediatrics, Yokohama City University School of Medicine, Yokosuka, Japan, and
| | - Ryoki Hara
- Department of Pediatrics, Yokohama City University School of Medicine, Yokosuka, Japan, and
| | - Kazuko Yamazaki
- Department of Pediatrics, Yokohama City University School of Medicine, Yokosuka, Japan, and
| | - Shumpei Yokota
- Department of Pediatrics, Yokohama City University School of Medicine, Yokosuka, Japan, and
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Hara R, Miyazawa H, Nishimura K, Momoi T, Nozawa T, Kikuchi M, Sakurai N, Kizawa T, Shimamura S, Yasuda S, Hiromura K, Sada KE, Kawaguchi Y, Tamura N, Takei S, Takasaki Y, Atsumi T, Mori M. A national survey on current use of mycophenolate mofetil for childhood-onset systemic lupus erythematosus in Japan. Mod Rheumatol 2015. [PMID: 26215483 DOI: 10.3109/14397595.2015.1077555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To conduct a national survey of systemic lupus erythematosus (SLE) patients treated with mycophenolate mofetil (MMF). Based on current information on the use of MMF, we aimed to evaluate its efficacy and safety for childhood-onset (c-) SLE. TARGET We evaluated 115 patients by questionnaire on MMF use for c-SLE in medical facilities specializing in pediatric rheumatic and renal diseases. RESULTS Average age at SLE onset was 10.6 (range, 2-15) years; average age at the time of starting MMF was 12.3 (range, 2-15) years. Average dose per body surface area was 1,059.3 mg/m(2)/day. Corticosteroid dosing was 20.9 mg/day before treatment but 7.7 mg/day after treatment. Laboratory values before and after MMF treatment were as follows: C3 increased from 67.0 to 84.9 mg/dl (p < 0.001), C4 increased from 10.2 to 15.1 mg/dl (p < 0.001), and anti-DNA antibody decreased from 154.2 to 18.4 IU/ml (p < 0.001). 24 adverse events in 21 cases were reported, but MMF was not discontinued in any. CONCLUSIONS The amount of MMF for c-SLE in Japan is similar to the standard dose in other countries. Reduction of corticosteroid dose and improvement of laboratory values represent efficacy of MMF. The side effects recorded here indicated tolerability of the drug.
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Affiliation(s)
- Ryoki Hara
- a Department of Pediatrics , Yokohama City University School of Medicine
| | - Hirotaka Miyazawa
- a Department of Pediatrics , Yokohama City University School of Medicine
| | - Kenichi Nishimura
- a Department of Pediatrics , Yokohama City University School of Medicine
| | - Takahiro Momoi
- a Department of Pediatrics , Yokohama City University School of Medicine
| | - Tomo Nozawa
- a Department of Pediatrics , Yokohama City University School of Medicine
| | - Masako Kikuchi
- a Department of Pediatrics , Yokohama City University School of Medicine
| | - Nodoka Sakurai
- a Department of Pediatrics , Yokohama City University School of Medicine
| | - Toshitaka Kizawa
- a Department of Pediatrics , Yokohama City University School of Medicine
| | - Sanae Shimamura
- b Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine
| | - Shinsuke Yasuda
- b Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine
| | - Keiju Hiromura
- c Department of Medicine and Clinical Science , Gunma University Graduate School of Medicine
| | - Ken-ei Sada
- d Department of Medicine and Clinical Science , Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | | | - Naoto Tamura
- f Department of Internal Medicine and Rheumatology , Juntendo University Faculty of Medicine
| | - Syuji Takei
- g Department of Pediatrics , Kagoshima University Graduate School of Health Sciences
| | - Yoshinari Takasaki
- f Department of Internal Medicine and Rheumatology , Juntendo University Faculty of Medicine
| | - Tatsuya Atsumi
- b Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine
| | - Masaaki Mori
- a Department of Pediatrics , Yokohama City University School of Medicine
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Ikegawa T, Yamazaki K, Nishimura K, Kanetaka T, Kikuchi M, Nozawa T, Hara R, Sato T, Sakurai N, Yokota S. [A case of severe systemic juvenile idiopathic arthritis introduced tocilizumab in early phase of the disease]. ACTA ACUST UNITED AC 2015; 37:176-82. [PMID: 24974931 DOI: 10.2177/jsci.37.176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 14-year-old boy was admitted in the former hospital with remittent fever, erythematous rash, joint pain, and muscle pain. Antibiotics were ineffectively administered and then, methylprednisolone (mPSL) pulse therapy with methotrexate was introduced under the diagnosis of suspected systemic juvenile idiopathic arthritis (JIA). However, he still had clinical symptoms and signs, and was transferred to our hospital. Re-examination revealed no malignancies including acute leukemia by bone marrow aspiration, no infectious agents by septic work, and no significant increases of antibodies against several viruses including CMV, EBV, HSV, Parvovirus B19, adenovirus, and so forth. FDG-PET demonstrated the accumulation of (18)F-FDG in bone marrows suggesting systemic JIA. Laboratory findings were leukocytosis and granulocytosis, elevated levels of C-reactive protein, D-dimer, ferritin, and interleukin-6. He was finally diagnosed as having severe systemic JIA. Thus, soon after the additional mPSL pulse therapy, tocilizumab (TCZ) was successfully introduced. In conclusion, for systemic JIA patients with severe systemic inflammation, it will be reasonable to introduce tocilizumab earlier than the guideline suggested to reduce side effects of long-term and large amounts of steroids and to protect the transition to macrophage activation syndrome. Further studies will be needed to recommend appropriate timing of tocilizumab introduction.
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Kanai A, Park C, Noborio K, Kasada R, Konishi S, Hirose T, Nozawa T, Tanigawa H. Compatibility of Ni and F82H with liquid Pb–Li under rotating flow. Fusion Engineering and Design 2014. [DOI: 10.1016/j.fusengdes.2014.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Isoda K, Nozawa T, Tezuka M, Ishida I. Toxicity of 50-nm polystyrene particles co-administered to mice with acetaminophen, 5-aminosalicylic acid or tetracycline. Pharmazie 2014; 69:676-679. [PMID: 25272938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We investigated whether nano-sized polystyrene particles affect drug-induced toxicity. The particles, which are widely used industrially, had diameters of 50 (NPP50), 200 (NPP200) or 1000 (NPP1000) nm. The toxic chemicals tested were acetaminophen (APAP), 5-aminosalicylic acid (5-ASA), tetracycline (TC), and sodium valproate (VPA). All treatments in the absence of the nanoparticles were non-lethal and did not result in severe toxicity. However, when mice were injected with APAP, 5-ASA or TC together with polystyrene particles, synergistic, enhanced toxicity was observed in mice injected with NPP50. These synergic effects were not observed in mice co-injected with NPP200 or NPP1000. On the other hand, co-administration of VPA and NPP50, NPP200 or NPP1000 did not elevate toxicity. The results show that NPP50 differs in hepatotoxicity depending on the drug co-administered. These findings suggest that further evaluation of the interactions between polystyrene nanoparticles and drugs is a critical prerequisite to the pharmaceutical application of nanotechnology.
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Kizawa T, Nozawa T, Kikuchi M, Nagahama K, Okudela K, Miyamae T, Imagawa T, Nakamura T, Mori M, Yokota S, Tsutsumi H. Mycophenolate mofetil as maintenance therapy for childhood-onset systemic lupus erythematosus patients with severe lupus nephritis. Mod Rheumatol 2014; 25:210-4. [PMID: 25159157 DOI: 10.3109/14397595.2014.950810] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES We evaluated histological changes occurring in renal biopsy specimens, between the time before initial induction therapy and after 12 months' maintenance therapy, as well as changes in laboratory parameters, SLE disease activity (SLEDAI), and dosage of corticosteroid (CS) in childhood-onset systemic lupus erythematosus (SLE) patients treated with mycophenolate mofetil (MMF). METHODS A retrospective analysis was performed on nine patients diagnosed with childhood-onset SLE and lupus nephritis. They were treated with pulsed mPSL and intravenous cyclophosphamide as induction therapy and MMF (500-1500 mg/day) plus CS as maintenance therapy. Renal biopsy was performed before the initial induction therapy and after 12 months' maintenance therapy. RESULTS Pathological findings at second biopsy were improved in eight of nine patients (89%). The findings of SLEDAI, urinalysis, and blood tests also showed improvement. CS doses could be tapered satisfactorily. Adverse events were observed in two patients. No patients treated with MMF experienced any disease flares during maintenance therapy. CONCLUSIONS MMF as maintenance therapy might be useful in that not only the histological findings of lupus nephritis were improved, but also CS doses could be beneficially tapered. Nonetheless, this is a retrospective report of only nine cases and further prospective multicenter studies are necessary.
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Affiliation(s)
- Toshitaka Kizawa
- Department of Pediatrics, Yokohama City University School of Medicine , Yokohama , Japan
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Yokota S, Kikuchi M, Nozawa T, Kanetaka T, Sato T, Yamazaki K, Sakurai N, Hara R, Mori M. Pathogenesis of systemic inflammatory diseases in childhood: "Lessons from clinical trials of anti-cytokine monoclonal antibodies for Kawasaki disease, systemic onset juvenile idiopathic arthritis, and cryopyrin-associated periodic fever syndrome". Mod Rheumatol 2014; 25:1-10. [PMID: 24842480 DOI: 10.3109/14397595.2014.902747] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Inflammation has often been considered to be a nonspecific response and to play a bridging role in the activation of adaptive immunity. However, it is now accepted that inflammation is the product of an independent innate immune system closely linked to the adaptive immune system. The key mediators of inflammation are inflammatory cytokines, as determined by multiple lines of evidence both in vitro and in vivo. Due to the crucial role of inflammatory cytokines in the pathogenesis of autoimmune disorders, anti-cytokine treatment has been developed as a therapy for rheumatoid arthritis, juvenile idiopathic arthritis (JIA), and inflammatory bowel diseases. We recently completed several clinical trials of anti-cytokine treatment for children with systemic inflammatory diseases: anti-IL-6 receptor monoclonal antibody (tocilizumab) for children with two subtypes of JIA (poly-JIA and systemic JIA), anti-TNF-α monoclonal antibody (infliximab) for children with Kawasaki disease, and anti-IL-1-β monoclonal antibody (canakinumab) for children with cryopyrin-associated periodic syndrome. This review summarizes the basis of inflammation in terms of innate immunity and adaptive immunity in these systemic inflammatory diseases, clinical efficacy, and tolerability of these biologic agents, and attempts to determine the roles of individual inflammatory cytokines in disease pathogenesis.
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Affiliation(s)
- Shumpei Yokota
- Department of Pediatrics, Yokohama City University School of Medicine , Kanagawa , Japan
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Momomura M, Miyamae T, Nozawa T, Kikuchi M, Kizawa T, Imagawa T, Drouot L, Jouen F, Boyer O, Yokota S. Serum levels of anti-SRP54 antibodies reflect disease activity of necrotizing myopathy in a child treated effectively with combinatorial methylprednisolone pulses and plasma exchanges followed by intravenous cyclophosphamide. Mod Rheumatol 2014; 24:529-31. [DOI: 10.3109/14397595.2013.852852] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Nagashima S, Nozawa T, Kizawa T, Kikuchi M, Miyamae T, Imagawa T, Inaba H, Sato T, Hashimoto K, Aida N, Yokota S. [Chronic recurrent multifocal osteomyelitis with interstitial myositis]. ACTA ACUST UNITED AC 2013; 36:52-7. [PMID: 23445733 DOI: 10.2177/jsci.36.52] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory, non-infectious disorder of skeletal system mainly seen in children. We report a case of CRMO presenting with fever and leg pain. The patient was an 11-year-old boy complaining of a fever, swelling and pain on his right foot, and pain on both legs. Although serum levels of CK and aldolase were not increased, MRI imaging suggested polymyositis. Muscle biopsy showed interstitial infiltration of inflammatory cells without any evidences of dermatomyositis or polymyositis. One month later, he complained of a swelling, pain and redness of his left clavicle as recurrently experienced during the recent 6 months, and MRI investigation indicated the diagnosis of osteomyelitis. Bone biopsy was performed and showed chronic inflammatory changes with negative bacterial culture. Multiple bone lesions and muscle uptake of FDG in his legs were revealed by whole body FDG-PET/CT, and he was diagnosed as having CRMO with interstitial myositis. The combinatorial administration of non-steroidal anti-inflammatory drugs and bisphosphonate successfully improved his clinical symptoms and laboratory abnormalities. To our knowledge, there is no report of a patient of CRMO associated with interstitial myositis.
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Affiliation(s)
- Saori Nagashima
- Department of Pediatrics Yokohama City University School of Medicine
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Sato T, Nishimura K, Nozawa T, Kanetaka T, Kikuchi M, Hara R, Sakurai N, Yamazaki K, Takeuchi Y, Yokota S. PReS-FINAL-2110: Tocilizumab for patients with oligoarticular juvenile idiopathic arthritis refractory to conventional therapy. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044449 DOI: 10.1186/1546-0096-11-s2-p122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Kikuchi M, Nozawa T, Kanetaka T, Nishimura K, Hara R, Yamazaki K, Sato T, Sakurai N, Yokota S. PReS-FINAL-2172: Efficacy of corticosteroids and intravenous cyclophosphamide for patients with juvenile systemic sclerosis. Pediatr Rheumatol Online J 2013. [PMCID: PMC4043886 DOI: 10.1186/1546-0096-11-s2-p184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Kizawa T, Nozawa T, Kanetaka T, Hara T, Kikuchi M, Hara R, Miyamae T, Imagawa T, Mori M, Yokota S. FRI0239 Arthritis complicated with kawasaki disease is not TNF-alpha-dependent. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Nozawa T, Kanetaka T, Kikuchi M, Kizawa T, Miyamae T, Imagawa T, Takahashi K, Yokota S. AB1209 A clinical and cutaneous pathological study of 11 patients with juvenile dermatomyositis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Miyamae T, Nozawa T, Kikuchi M, Kizawa T, Imagawa T, Yokota S. OP0178 Tocilizumab-effects on growth impairment in systemic juvenile idiopathic arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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40
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Kikuchi M, Kanetaka T, Nozawa T, Kizawa T, Miyamae T, Imagawa T, Yokota S. SAT0407 Association between the rates of enlarged nailfold capillaries and serum FDP-E levels reflects microvascular injuries in juvenile dermatomyositis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Yokota S, Nishikomori R, Takada H, Kikuchi M, Nozawa T, Kanetaka T, Kizawa T, Miyamae T, Mori M, Heike T, Hara T, Imagawa T. Guidance on the use of canakinumab in patients with cryopyrin-associated periodic syndrome in Japan. Mod Rheumatol 2013. [DOI: 10.3109/s10165-012-0769-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Yokota S, Kikuchi M, Nozawa T, Kizawa T, Kanetaka T, Kadota K, Miyamae T, Mori M. [Febrile responses in patients with pediatric rheumatic diseases]. ACTA ACUST UNITED AC 2013; 35:511-9. [PMID: 23291486 DOI: 10.2177/jsci.35.511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Fever is one of the critical symptoms of patients in pediatrics field. It indicates inflammatory focus somewhere in the body, and the major causes of fever are infectious diseases. Recent progresses of our knowledge about autoinflammatory syndrome promoted the investigation of the mechanism of fever, and suggested that the pro-inflammatory cytokines are the direct causative agents of fever. The basic science revealed that cooperation of IL-6 and IL-1β induces febrile response. Fever of unknown origin (FUO) remains a challenging problem. Rheumatic diseases, rare infectious diseases, and benign tumors and malignancies are diagnoses to be differentiated. FDG-PET is recently proved a valuable tool for the identification of the etiology in patients with FUO. Since the introduction of biological response modifiers into the treatment of patients with pediatric rheumatic diseases has shifted the therapeutic paradigm, a new concept that the blockade of a unique pro-inflammatory cytokine brings cessation of whole inflammatory responses affected tremendously the clinical medicine. A more investigation of inflammation and its pathophisiology will be needed in pediatric rheumatology.
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Affiliation(s)
- Shumpei Yokota
- Department of Pediatrics, Yokohama City University Graduate School of Medicine
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Sato T, Nozawa T, Kanetaka T, Kikuchi M, Sakurai N, Yamazaki K, Momoi T, Namai Y, Yokota S. 2 cases of HLA-B27-positive seronegative spondylarthritides in pediatric age treated with adalimumab. Nihon Rinsho Meneki Gakkai Kaishi 2013; 36:473-477. [PMID: 24390108 DOI: 10.2177/jsci.36.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Seronegative spondyloarthritis is strongly correlated to HLA-B27, and in the long term, it causes limitations to the movements of vertebral joints. In recent years, the numbers of patients diagnosed with axial spondyloarthritis have increased due to the widespread use of magnetic resonance imaging (MRI) for diagnostic imaging. We report the cases of 2 pediatric patients diagnosed with axial spondyloarthritis, and whose disease activity was successfully controlled using adalimumab. In case 1, the patient was a 15-year-old boy. The onset of the disease was marked by neck pain ; HLA-B27 was positive, and the MRI revealed sacroiliac arthritis. After being diagnosed with axial spondyloarthritis, he began receiving oral steroid therapy. Gradual recurrence was observed, and adalimumab treatment was initiated. In case 2, the patient was a 9-year-old boy. Bilateral pain was present in the shoulder joints, ankles, and knee joints. The patient was diagnosed with polyarticular juvenile idiopathic arthritis, and treatment using oral steroids, immunosuppressants and tocilizumab. The arthralgia disappeared, but at the age of 12 years, pain recurred in the sacroiliac joint and the Achilles tendon, the HLA-B27 was positive, and the MRI revealed sacroiliac arthritis. The condition was diagnosed as axial spondyloarthritis; adalimumab treatment was initiated. Adalimumab was effective in the treatment of axial spondylitis occurring in childhood.
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Affiliation(s)
- Tomomi Sato
- Department of Pediatrics, Yokohama City University Hospital
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Momomura M, Miyamae T, Nozawa T, Kikuchi M, Kizawa T, Imagawa T, Drouot L, Jouen F, Boyer O, Yokota S. Serum levels of anti-SRP54 antibodies reflect disease activity of necrotizing myopathy in a child treated effectively with combinatorial methylprednisolone pulses and plasma exchanges followed by intravenous cyclophosphamide. Mod Rheumatol 2012. [DOI: 10.1007/s10165-012-0792-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Paveenkittiporn W, Nozawa T, Dejsirilert S, Baggett H, Hamada S. Unique distribution of emm types and superantigen gene profiles of group A streptococci isolated in Thailand. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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46
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Yokota S, Kikuchi M, Nozawa T, Kizawa T, Kanetaka T, Miyamae T, Mori MA, Nishikomori R, Takata H, Heike T, Hara T, Imagawa T. [An approach to the patients with cryopyrin-associated periodic syndrome (CAPS) : a new biologic response modifier, canakinumab]. ACTA ACUST UNITED AC 2012; 35:23-9. [PMID: 22374439 DOI: 10.2177/jsci.35.23] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cryopyrin-associated periodic syndrome (CAPS) comprises a group of rare, but severe, autoinflammatory syndrome, and includes 3 distinct conditions, familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disease (MONID). These syndromes are characterized by urticarial-like rash, periodic fever, central nervous system inflammation, an arthropathy, and the risk of amyloidosis. About 20% die by age 20 years in the most severe cases. The disease is associated with mutations in the NLRP3 gene that encodes for the protein cryopyrin, a component of the inflammasome complex that regulates the production and secretion of IL-1β. Canakinumab is a human IgG monoclonal antibody targeting IL-1β. The clinical trials of canakinumab for patients with CAPS in both western countries and Japan were well-tolerated in most patients, and provided significant advantages over existing competitive therapies. Although no serious adverse effects have been reported, the frequencies of common infectious diseases including nasopharyngitis, upper respiratory tract infections, and gastroenteritis were reported presumably due to the blockade of proinflammatory cytokine, IL-1β. For us pediatrician, it will be important to be more careful for infectious diseases to provide the maximum safety of canakinumab for these patients.
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Affiliation(s)
- Shumpei Yokota
- Department of Pediatrics, Yokohama City University School of Medicine
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Miyamae T, Nozawa T, Kikuchi M, Kizawa T, Imagawa T, Yokota S. Tocilizumab-effects on growth impairment in systemic juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194481 DOI: 10.1186/1546-0096-9-s1-p130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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48
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Matsuura M, Dwek E, Meixner M, Otsuka M, Babler B, Barlow MJ, Roman-Duval J, Engelbracht C, Sandstrom K, Lakićević M, van Loon JT, Sonneborn G, Clayton GC, Long KS, Lundqvist P, Nozawa T, Gordon KD, Hony S, Panuzzo P, Okumura K, Misselt KA, Montiel E, Sauvage M. Herschel Detects a Massive Dust Reservoir in Supernova 1987A. Science 2011; 333:1258-61. [PMID: 21737700 DOI: 10.1126/science.1205983] [Citation(s) in RCA: 252] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- M. Matsuura
- Astrophysics Group, Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, UK
- Mullard Space Science Laboratory, University College London, Holmbury St. Mary, Dorking, Surrey RH5 6NT, UK
| | - E. Dwek
- Observational Cosmology Laboratory, Code 665, NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - M. Meixner
- Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, MD 21218, USA
| | - M. Otsuka
- Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, MD 21218, USA
| | - B. Babler
- Department of Astronomy, 475 North Charter St., University of Wisconsin, Madison, WI 53706, USA
| | - M. J. Barlow
- Astrophysics Group, Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, UK
| | - J. Roman-Duval
- Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, MD 21218, USA
| | - C. Engelbracht
- Steward Observatory, University of Arizona, Tucson, AZ 85721, USA
| | - K. Sandstrom
- Max-Planck-Institut für Astronomie, Königstuhl 17, D-69117 Heidelberg, Germany
| | - M. Lakićević
- Astrophysics Group, Lennard-Jones Laboratories, Keele University, ST5 5BG, UK
- European Southern Observatory, Karl Schwarschild Straße 2, D-85748 Garching bei München, Germany
| | - J. Th. van Loon
- Astrophysics Group, Lennard-Jones Laboratories, Keele University, ST5 5BG, UK
| | - G. Sonneborn
- Observational Cosmology Laboratory, Code 665, NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - G. C. Clayton
- Louisiana State University, Department of Physics and Astronomy, 233-A Nicholson Hall, Tower Drive, Baton Rouge, LA 70803–4001, USA
| | - K. S. Long
- Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, MD 21218, USA
| | - P. Lundqvist
- Department of Astronomy, The Oskar Klein Centre, AlbaNova University Center, Stockholm University, SE-106 91 Stockholm, Sweden
| | - T. Nozawa
- Institute for the Physics and Mathematics of the Universe, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K. D. Gordon
- Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, MD 21218, USA
| | - S. Hony
- Commissariat à l’Energie Atomique et aux Energies Alternatives, Laboratoire Astrophysique, Instrumentation et Modélisation, Irfu/SAp, Orme des Merisiers, F-91191 Gif-sur-Yvette, France
| | - P. Panuzzo
- Commissariat à l’Energie Atomique et aux Energies Alternatives, Laboratoire Astrophysique, Instrumentation et Modélisation, Irfu/SAp, Orme des Merisiers, F-91191 Gif-sur-Yvette, France
| | - K. Okumura
- Commissariat à l’Energie Atomique et aux Energies Alternatives, Laboratoire Astrophysique, Instrumentation et Modélisation, Irfu/SAp, Orme des Merisiers, F-91191 Gif-sur-Yvette, France
| | - K. A. Misselt
- Steward Observatory, University of Arizona, Tucson, AZ 85721, USA
| | - E. Montiel
- Steward Observatory, University of Arizona, Tucson, AZ 85721, USA
| | - M. Sauvage
- Commissariat à l’Energie Atomique et aux Energies Alternatives, Laboratoire Astrophysique, Instrumentation et Modélisation, Irfu/SAp, Orme des Merisiers, F-91191 Gif-sur-Yvette, France
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Watanabe S, Sudo K, Nagashima T, Takemura T, Kawase H, Nozawa T. Future projections of surface UV-B in a changing climate. ACTA ACUST UNITED AC 2011. [DOI: 10.1029/2011jd015749] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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50
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Konda R, Osawa T, Nozawa T, Sugimura J, Fujioka T, Ishimoto Y, Ohki T, Uchida L, Kotera N, Tanaka M, Tanaka S, Sugimoto T, Mise N, Wu HY, Ko MJ, Yang JY, Hu FC, Chen SI, Jee SH, Chiu HC, Zumrutdal A, Hur E, Toz H, Ozkahya M, Usta M, Kayikcioglu LM, Sezis M, Asci G, Kahvecioglu S, Duman S, Ok E, Sakaguchi Y, Sonoda M, Kawabata H, Niihata K, Suzuki A, Shoji T, Tsubakihara Y, Emami Naini A, Moradi M, Mortazavi M, Shirani F, Gholamrezaei A, Demir S, San M, Koken T, Seok SJ, Gil HW, Yang JO, Lee EY, Hong SY, Stavroulopoulos A, Kossivakis A, Aresti V, Stamogiannos G, Kalliaropoulos A, Mentis A, Azak A, Huddam B, Kocak G, Altas AB, Sakaci M, Yalcin F, Ortabozkoyun L, Duranay M, Korukluoglu G, Eitner F, Scheithauer S, Mankartz J, Haefner H, Nowicki K, Floege J, Lemmen S, Hara S, Tanaka K, Suwabe T, Ubara Y, Takaichi K, Deleuze S, Bargnoux AS, Rivory JP, Rouanet C, Maurice F, Selcer I, Cristol JP, Dou Y, Thijssen S, Ouellet G, Kruse A, Rosales L, Kotanto P, Levin NW, Shahidi S, Sajjadieh S, Gholamrezaei A, Scholmann T, Straub M, Wagner D, Fliser D, Sester M, Sester U, Sikole A, Trajceska L, Selim G, Gelev S, Dzekova P, Amitov V, Arsov S, Strempska B, Bilinska M, Weyde W, Koszewicz M, Madziarska K, Golebiowski T, Klinger M, Ochi A, Ishimura E, Tsujimoto Y, Kakiya R, Tabata T, Mori K, Shoji T, Yasuda H, Nishizawa Y, Inaba M, Ezeonyeji A, Borg F, Harnett P, Dasgupta B, Raikou VD, Kyriaki D, Zeggos N, Skalioti C, Tzanatou H, Boletis JN, Viaene L, Meijers B, Bammens B, Vanrenterghem Y, Vanderschueren D, Evenepoel P, Ryu DR, An HR, Ryu JH, Yu M, Kim SJ, Kang DH, Choi KB, Miyamoto T, Rashid Qureshi A, Anderstam B, Yamamoto T, Alvestrand A, Stenvinkel P, Lindholm B, Axelsson J, Zitt E, Manamley N, Vervloet M, Georgianos P, Sarafidis P, Kanaki A, Divani M, Haidich AB, Sioulis A, Liakopoulos V, Papagianni A, Nikolaidis P, Lasaridis A, Morgado E, Pinho A, Guedes A, Guerreiro R, Mendes P, Bexiga I, Silva A, Marques J, Neves P. Pathophysiology and clinical studies in CKD 5D. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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