nach oben

Current Rheumatology Reports

Erschienen in:

07.12.2023

Calcinosis in Juvenile Dermatomyositis—Epidemiology, Pathogenesis, Clinical Features, and Treatment: A Systematic Review

verfasst von: Jucier Gonçalves Júnior, Samuel Katsuyuki Shinjo

Erschienen in: Current Rheumatology Reports | Ausgabe 2/2024

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

We performed a systematic review of the literature on the epidemiology, pathogenesis, clinical and laboratory characterization, and treatment of calcinosis in patients with juvenile dermatomyositis (JDM). A qualitative systematic review was conducted from January 1975 to April 2023 according to the PRISMA protocol using three electronic databases: PubMed, Web of Science, and Scopus. Studies were analyzed based on the following eligibility criteria: at least one combination of the terms described in the search strategy appeared in the title, written in English, Portuguese, or Spanish, and addressed the epidemiology, pathogenesis, diagnosis, and treatment of calcinosis in juvenile dermatomyositis. Systematic or scoping reviews, letters, clinical images, book chapters, abstracts, inflammatory myopathy in other connective tissue diseases, idiopathic inflammatory myopathies in adults, and purely qualitative studies were excluded.

Recent Findings

Seventy-five studies were included. According to the literature, calcinosis is common in women, around five years old, with three years of disease in association with osteoarticular, cutaneous, pulmonary manifestations, and fever. The pathogenesis is still unknown, but the participation of interleukin 1 and 6, tumor necrosis factor alpha, and innate immunity dysregulation seem to be involved. Common autoantibodies are anti-NXP-2, anti-MDA-5, and anti-Mi-2, and their treatment remains controversial. Prospective, randomized, controlled studies are needed to evaluate treatment protocols and map the natural history of this serious complication.

Summary

Calcinosis seems to be more common in White female children with muscle weakness, fever, arthritis, severe pulmonary, and skin involvement with anti-NXP-2, anti-MDA-5, and anti-Mi-2 autoantibodies. The multitargets and aggressive treatment is recommended.

Davuluri S, Duvuri B, Lood C, Faghihi-Kashani S, Chung L. Calcinosis in dermatomyositis: Origins and possible therapeutic avenues. Best Pract Res Clin Rheumatol. 2022;36: 101768. https://doi.org/10.1016/j.berh.2022.101768.CrossRefPubMedPubMedCentral

Lundberg I, Fujimoto M, Vencovsky J, et al. Idiopathic inflammatory myopathies. Nat Rev Dis Primers. 2021;7:86. https://doi.org/10.1038/s41572-021-00321-x.CrossRefPubMed

• McCann LJ, Juggins AD, Maillard SM, et al. The Juvenile Dermatomyositis National Registry and 290 Repository (UK and Ireland) - clinical characteristics of children recruited within the first 5 yr. Rheumatology. 2006;45:1255–60. https://doi.org/10.1093/rheumatology/kel099. This study describes a cohort that helps understand the natural history of the disease.CrossRefPubMed

Clemente G, Piotto DGP, Barbosa C, et al. High frequency of calcinosis in juvenile 293 dermatomyositis: a risk factor study. Rev Bras Reumatol. 2012;52:549–53.CrossRefPubMed

Chander S, Gordon P. Soft tissue and subcutaneous calcification in connective tissue diseases. Curr Opin Rheumatol. 2012;24:158–64. https://doi.org/10.1097/BOR.0b013e32834ff5cd.CrossRefPubMed

Chung MP, Richardson C, Kirakossian D, et al. Calcinosis biomarkers in adult and juvenile dermatomyositis. Autoimmun Rev. 2020;19: 102533. https://doi.org/10.1016/j.autrev.2020.102533.CrossRefPubMedPubMedCentral

Elahmar H, Feldman BM, Johnson SR. Management of calcinosis cutis in rheumatic diseases. J Rheumatol. 2022;49:980–9. https://doi.org/10.3899/jrheum.211393.CrossRefPubMed

Shinjo SK, Souza FH. Update on the treatment of calcinosis in dermatomyositis. Rev Bras Reumatol. 2013;53:211–4.PubMed

Traineua H, Aggarwal R, Monfort J-B, et al. Treatment of calcinosis cutis in systemic sclerosis and dermatomyositis: A review of the literature. J Am Acad Dermatol. 2022;82:317–25. https://doi.org/10.1016/j.jaad.2019.07.006.CrossRef

10.

Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med. 1975;292:344–7. https://doi.org/10.1056/NEJM197502132920706.CrossRefPubMed

11.

•• Duvvuri B, Pachman LM, Hermanson P, et al. Role of mitochondria in the myopathy of juvenile dermatomyositis and implications for skeletal muscle calcinosis. J Autoimmun. 2023;138: 103061. https://doi.org/10.1016/j.jaut.2023.103061. This study highlights possible pathophysiological pathways of calcinosis in JDM.CrossRefPubMedPubMedCentral

12.

Mastrolia MV, Orsini SI, Marrani E, et al. Efficacy of Janus kinase inhibitor baricitinib in the treatment of refractory juvenile dermatomyositis complicated by calcinosis. Clin Exp Rheumatol. 2023;41:402–3. https://doi.org/10.55563/clinexprheumatol/7k9ajj.CrossRefPubMed

13.

• Sener S, Basaran O, Batu ED, et al. Early-onset juvenile dermatomyositis: A tertiary referral center experience and review of the literature. Semin Arthritis Rheum. 2023;58: 152133. https://doi.org/10.1016/j.semarthrit.2022.152133. This study describes a cohort that helps understand the natural history of the disease.CrossRefPubMed

14.

• Cancarini P, Nozawa T, Whitney K, et al. The clinical features of juvenile dermatomyositis: A single-centre inception cohort. Semin Arthritis Rheum. 2022;57: 152104. https://doi.org/10.1016/j.semarthrit.2022.152104. This study describes a cohort that helps understand the natural history of the disease.CrossRefPubMed

15.

• El-Garf K, El-Garf A, Salah S, Marzouk H, Farag Y, Mostafa N. A juvenile dermatomyositis: demographics, characteristics and disease outcome in an Egyptian cohort. Clin Exp Rheumatol. 2022;40:450–6. https://doi.org/10.55563/clinexprheumatol/h0s7tq. This study describes a cohort that helps understand the epidemiology of the disease.CrossRefPubMed

16.

Janarthanan M, Mohan M, Murali A. Bisphosphonate therapy for juvenile dermatomyositis-associated calcinosis and metaphyseal zebra lines. BMJ Case Rep. 2022;15: e252814. https://doi.org/10.1136/bcr-2022-252814.CrossRefPubMed

17.

Jin J, Yu H. Use of adalimumab in a child with juvenile dermatomyositis and calcinosis. Indian J Pediatr. 2022;89:1270. https://doi.org/10.1007/s12098-022-04332-8.CrossRefPubMed

18.

Linan-Barroso JM, Gonzalez-Estrada A, García-Morillo JS. Therapy-resistant dermatomyositis with extensive ‘lumbar belt’ calcinosis. BMJ Case Rep. 2022;15: e249110. https://doi.org/10.1136/bcr-2022-249110.CrossRefPubMed

19.

Neely J, Long CS, Sturrock H, Kim S. Association of short-term ultraviolet radiation exposure and disease severity in juvenile dermatomyositis: results from the Childhood Arthritis and Rheumatology Research Alliance Legacy Registry. Arthritis Care Res (Hoboken). 2019;71:1600–5. https://doi.org/10.1002/acr.23840.CrossRefPubMed

20.

Nitiyarom R, Charuvanji S, Likasitwattanakul S, et al. Juvenile dermatomyositis in Thai children: Retrospective review of 30 cases from a tertiary care center. Indian J Dermatol Venereol Leprol. 2023;88:162–70. https://doi.org/10.25259/IJDVL_297_20.CrossRef

21.

Toplak N, Pimpale Chavan P, et al. Is Anti-NXP2 autoantibody a risk factor for calcinosis and poor outcome in juvenile dermatomyositis patients? Case Series Front Pediatr. 2022;9: 810785. https://doi.org/10.3389/fped.2021.810785.CrossRefPubMed

22.

Concannon A, Han DY. Incidence, severity and clinical manifestations of juvenile dermatomyositis among Maori and Pacific Island compared to European children. J Paediatr Child Health. 2021;57:1881–5. https://doi.org/10.1111/jpc.15595.CrossRefPubMed

23.

Chung CH. Calcinosis universalis in juvenile dermatomyositis. Chonnam Med J. 2020;56: 212213. https://doi.org/10.4068/cmj.2020.56.3.212.CrossRef

24.

• Campanilho-Marques R, Deakin CT, Simou S, et al. Retrospective analysis of infliximab and adalimumab treatment in a large cohort of juvenile dermatomyositis patients. Arthritis Res Ther. 2020;22:79. https://doi.org/10.1186/s13075-020-02164-5. This study describes a cohort that helps understand the disease's response to immunobiologicals.CrossRefPubMedPubMedCentral

25.

Giri S, Parida JR, Dash M, Panda M. pamidronate in treatment of calcinosis in juvenile dermatomyositis. Indian Pediatr. 2020;57:75–6.CrossRefPubMed

26.

Lebrón CV, Montesino MDR, Navarrete VM, Miera FJTS. Treatment with rituximab in juvenile dermatomyositis: effect on calcinosis. Reumatol Clin. 2020;16:368–70. https://doi.org/10.1016/j.reuma.2018.06.010.CrossRef

27.

Moegle C, Lipsker D. Juvenile dermatomyositis: A series of 22 cases. Ann Dermatol Venereol. 2020;147:494–503. https://doi.org/10.1016/j.annder.2020.04.016.CrossRefPubMed

28.

Tsaltskan V, Aldous A, Serafi S, et al. Long-term outcomes in juvenile myositis patients. Semin Arthritis Rheum. 2020;50:149–55. https://doi.org/10.1016/j.semarthrit.2019.06.014.CrossRefPubMed

29.

Rathore U, Gupta L. Scalp calcinosis in juvenile dermatomyositis. Rheumatology. 2020;60:1569. https://doi.org/10.1093/rheumatology/keaa566.CrossRef

30.

Sukumaran S, Vijayan V. Abatacept in the treatment of juvenile dermatomyositis-associated calcifications in a 16-year-old girl. Case Rep Rheumatol. 2020;28:4073879. https://doi.org/10.1155/2020/4073879.CrossRef

31.

Li J, Zhou Z. Calcinosis in juvenile dermatomyositis. N Engl J Med. 2019;381: e31. https://doi.org/10.1056/nejmicm1809669.CrossRefPubMed

32.

Gupta P, Shruti S, Chaudhary V, Khullar G, Siraj F. Juvenile dermatomyositis: A case report and review of literature. Cureus. 2019;11: e3935. https://doi.org/10.7759/cureus.3935.CrossRefPubMedPubMedCentral

33.

Çakan M, Karadağ ŞG, Ayaz NA. Complete and sustained resolution of calcinosis universalis in a juvenile dermatomyositis case with mycophenolate mofetil. Turk J Pediatr. 2019;61:771–5. https://doi.org/10.24953/turkjped.2019.05.018.CrossRefPubMed

34.

• Orandi AB, Dharnidharka VR, Al-Hammadi N, et al. Clinical phenotypes and biologic treatment use in juvenile dermatomyositis-associated calcinosis. Pediatr Rheumatol Online J. 2018;16:84. https://doi.org/10.1186/s12969-018-0299-9. This study helps understand the disease's response to immunobiologicals.

35.

Al-Mayouf SM, Al Mutiari N, Muzaffer M, et al. Phenotypic characteristics and outcome of juvenile dermatomyositis in Arab children. Rheumatol Int. 2017;37:1513–7. https://doi.org/10.1007/s00296-017-3770-x.CrossRefPubMed

36.

Barut K, Ydin POA, Adrovic A, Sahin S, Kasapcopur O. Juvenile dermatomyositis: a tertiary center experience. Clin Rheumatol. 2017;36:361–6. https://doi.org/10.1007/s10067-016-3530-4.CrossRefPubMed

37.

Grijsen ML, Mchaile D, Geult I, et al. Juvenile dermatomyositis in a 4-year-old Kenyan girl. Clin Case Rep. 2017;5:134–8. https://doi.org/10.1002/ccr3.816.CrossRefPubMedPubMedCentral

38.

Phillippi K, Hoeltzel M, Byun Robinson A, et al. Race, income, and disease outcomes in juvenile dermatomyositis. J Pediatr. 2017;184(38–44): e1. https://doi.org/10.1016/j.jpeds.2017.01.046.CrossRef

39.

Ibarra M, Rigsby C, Morgan GA, Sammet CL, et al. Monitoring change in volume of calcifications in juvenile idiopathic inflammatory myopathy: a pilot study using low dose computed tomography. Pediatr Rheumatol Online J. 2016;14:64. https://doi.org/10.1186/s12969-016-0123-3.CrossRefPubMedPubMedCentral

40.

Okong’o LO, Esser M, Wilmshurst J, Scott C. Characteristics and outcome of children with juvenile dermatomyositis in Cape Town: a cross-sectional study. Pediatr Rheumatol Online J. 2016;14:60. https://doi.org/10.1186/s12969-016-0118-0.CrossRefPubMedPubMedCentral

41.

Saini I, Kalaivani M, Kabra SK. Calcinosis in juvenile dermatomyositis: frequency, risk factors and outcome. Rheumatol Int. 2016;36:961–5. https://doi.org/10.1007/s00296-016-3467-6.CrossRefPubMed

42.

Nagar RP, Bharati J, Sheriff A, Priyadarshini P, Chumber S, Kabra SK. Calcinosis in juvenile dermatomyositis mimicking cold abscess. Natl Med J India. 2016;29:87–8.PubMed

43.

Tayfur AC, Topaloglu R, Gulhan B, Bilginer Y. Bisphosphonates in juvenile dermatomyositis with dystrophic calcinosis. Mod Rheumatol. 2015;25:615–20. https://doi.org/10.3109/14397595.2014.988197.CrossRefPubMed

44.

Turan E, Yesilova Y, Surucu HA, et al. Juvenile dermatomyositis with joint contractures and calcinosis cutis. Dermatol Online J. 2015;21:13030/qt1cg4c5pn.CrossRefPubMed

45.

Faller G, Mistry BJ, Tikly M. Juvenile dermatomyositis in South African children is characterised by frequent dystrophic calcification: a cross sectional study. Pediatr Rheumatol Online J. 2014;12:2. https://doi.org/10.1186/1546-0096-12-2.CrossRefPubMedPubMedCentral

46.

Martillotti J, Moote D, Zemel L. Improvement of calcinosis using pamidronate in a patient with juvenile dermatomyositis. Pediatr Radiol. 2014;44:115–8. https://doi.org/10.1007/s00247-013-2738-6.CrossRefPubMed

47.

Meher BK, Mishra P, Sivaraj P, Padhan P. Severe calcinosis cutis with cutaneous ulceration in juvenile dermatomyositis. Indian Pediatr. 2014;251:925–7. https://doi.org/10.1007/s13312-014-0531-8.CrossRef

48.

Pagnini I, Simonini G, Giani T, et al. Sodium thiosulfate for the treatment of calcinosis secondary to juvenile dermatomyositis. Clin Exp Rheumatol. 2014;32:408–9.PubMed

49.

Palaniappan P, Lionel A, Kumar S. Successful treatment of calcinosis cutis in juvenile dermatomyositis with pamidronate. J Clin Rheumatol. 2014;20:454–5. https://doi.org/10.1097/rhu.0000000000000199.CrossRefPubMed

50.

Sanyal S, Atwal SS, Mondal D, Garga UC. Radiographic patterns of soft tissue calcinosis in juvenile dermatomyositis and its clinical implications. J Clin Diagn Res. 2014;8:RD08-11. https://doi.org/10.7860/JCDR/2014/10787.5321.CrossRefPubMedPubMedCentral

51.

Tansley SL, Betteridge ZE, Shaddick G, et al. Calcinosis in juvenile dermatomyositis is influenced by both anti-NXP2 autoantibody status and age at disease onset. Rheumatology (Oxford). 2014;53:2204–8. https://doi.org/10.1093/rheumatology/keu259.CrossRefPubMed

52.

Gowdie PJ, Allen RC, Kornberg AJ, Akikusa JD. Clinical features and disease course of patients with juvenile dermatomyositis. Int J Rheum Dis. 2013;16:561–7. https://doi.org/10.1111/1756-185X.12107.CrossRefPubMed

53.

Prasad S, Misra R, Agarwal V, Lawrece A, Aggarwal A. Juvenile dermatomyositis at a tertiary care hospital: is there any change in the last decade? Int J Rheum Dis. 2013;16:556–60. https://doi.org/10.1111/1756-185X.12053.CrossRefPubMed

54.

Toumiy M, Janani S, Rachidi W, Etaouil N, Mkinsi O. Calcinosis universalis complicating juvenile dermatomyositis: improvement after intravenous immunoglobulin therapy. Joint Bone Spine. 2013;80:108–9. https://doi.org/10.1016/j.jbspin.2012.07.001.CrossRef

55.

Ya-ling L, Jing H, Qian L. A severe case of universal calcinosis with juvenile dermatomyositis. Indian J Dermatol Venereol Leprol. 2021;78:774. https://doi.org/10.4103/0378-6323.102395.CrossRef

56.

Arabshahi B, Silverman RA, Jones OY, Rider LG. Abatacept and sodium thiosulfate for treatment of recalcitrant juvenile dermatomyositis complicated by ulceration and calcinosis. J Pediatr. 2012;160:520–2. https://doi.org/10.1016/j.jpeds.2011.11.057.CrossRefPubMedPubMedCentral

57.

Cairoli E, Garra V, Bruzzone MJ, Gambini JP. Extensive calcinosis in juvenile dermatomyositis. Acta Reumatol Port. 2011;36:180–1.PubMed

58.

Lorenzoni PJ, Scola RH, Kay CSK, et al. Idiopathic inflammatory myopathies in childhood: a brief review of 27 cases. Pediatr Neurol. 2011;45:17–22. https://doi.org/10.1016/j.pediatrneurol.2011.01.018.CrossRefPubMed

59.

Al-Mayouf SM, Alsonbul A, Alismail K. Localized calcinosis in juvenile dermatomyositis: successful treatment with intralesional corticosteroids injection. Int J Rheum Dis. 2010;13:e26–8. https://doi.org/10.1111/j.1756-185X.2010.01483.x.CrossRefPubMed

60.

Miyamae T, Sano F, Ozawa R, et al. Efficacy of thalidomide in a girl with inflammatory calcinosis, a severe complication of juvenile dermatomyositis. Pediatr Rheumatol Online J. 2010;8:6. https://doi.org/10.1186/1546-0096-8-6.CrossRefPubMedPubMedCentral

61.

Puche AM, Penades IC, Montesinos BL. Effectiveness of the treatment with intravenous pamidronate in calcinosis in juvenile dermatomyositis. Clin Exp Rheumatol. 2010;28:135–40.

62.

Ravelli A, Trail L, Ferrari C, et al. Long-term outcome and prognostic factors of juvenile dermatomyositis: a multinational, multicenter study of 490 patients. Arthritis Care Res (Hoboken). 2010;62:63–72. https://doi.org/10.1002/acr.20015.CrossRefPubMed

63.

Rider LG, Lachenbruch PA, Monroe JB, et al. Damage extent and predictors in adult and juvenile dermatomyositis and polymyositis as determined with the myositis damage index. Arthritis Rheum. 2009;60:3425–35. https://doi.org/10.1002/art.24904.CrossRefPubMedPubMedCentral

64.

Slimani S, Abdessemed A, Haddouche A, Ladjouze-Rezig A. Complete resolution of universal calcinosis in a patient with juvenile dermatomyositis using pamidronate. Joint Bone Spine. 2010;77:70–2. https://doi.org/10.1016/j.jbspin.2009.04.011.CrossRefPubMed

65.

Sato JO, Sallum AME, Ferriani VPL, et al. A Brazilian registry of juvenile dermatomyositis: onset features and classification of 189 cases. Clin Exp Rheumatol. 2009;27:1031–8.PubMed

66.

Ayala ZM, Ramírez RM, Zerón SM, Fuentes EF, Velázquez RM. Dermatomiositis juvenil y calcinosis extensa. Tratamiento con metilprednisolona y metotrexato. Reumatol Clin. 2008;4:248–50. https://doi.org/10.1016/S1699-258X(08)75546-3.CrossRef

67.

Riley P, McCann LJ, Maillard SM, et al. Effectiveness of infliximab in the treatment of refractory juvenile dermatomyositis with calcinosis. Rheumatology (Oxford). 2008;47:877–80. https://doi.org/10.1093/rheumatology/ken074.CrossRefPubMed

68.

Jat KR, Singh S. Calcinosis in juvenile dermatomyositis. Indian Pediatr. 2008;45:784.PubMed

69.

Salum AME, Pivato FCMM, Doria-Filho U, et al. Risk factors associated with calcinosis of juvenile dermatomyositis. J Pediatr. 2008;84:68–74. https://doi.org/10.2223/JPED.1746.CrossRef

70.

Wu JJ, Metz BJ. Calcinosis cutis of juvenile dermatomyositis treated with incision and drainage. Dermatol Surg. 2008;34:575–7. https://doi.org/10.1111/j.1524-4725.2007.34106.x.CrossRefPubMed

71.

Constatin T, Ponyi A, Orbán I, et al. National registry of patients with juvenile idiopathic inflammatory myopathies in Hungary-clinical characteristics and disease course of 44 patients with juvenile dermatomyositis. Autoimmunity. 2006;39:223–32. https://doi.org/10.1080/08916930600622819.CrossRef

72.

Chiu SK, Yang YH, Wang LC, Chiang BL. Ten-year experience of juvenile dermatomyositis: a retrospective study. J Microbiol Immunol Infect. 2007;40:68–73.PubMed

73.

Pachman LM, Veis A, Stock S, et al. Composition of calcifications in children with juvenile dermatomyositis: association with chronic cutaneous inflammation. Arthritis Rheum. 2006;54:3345–50. https://doi.org/10.1002/art.22158.CrossRefPubMedPubMedCentral

74.

Singh S, Bansal A. Twelve years experience of juvenile dermatomyositis in North India. Rheumatol Int. 2006;26:510–5. https://doi.org/10.1007/s00296-005-0030-2.CrossRefPubMed

75.

Briso-Montiano ME, Sánchez PS, Velasco MB, et al. Juvenile amyopathic dermatomyositis and calcinosis. An Pediatr (Barc). 2005;62:286–8. https://doi.org/10.1157/13071846.CrossRef

76.

Sallum AM, Kiss MHB, Sachetti S, et al. Juvenile dermatomyositis: clinical, laboratorial, histological, therapeutical and evolutive parameters of 35 patients. Arq Neuropsiquiatr. 2022;60:889–99. https://doi.org/10.1590/S0004-282X2002000600001.CrossRef

77.

Harel L, Harel G, Korenreich L, Straussberg R, Amir J. Treatment of calcinosis in juvenile dermatomyositis with probenecid: the role of phosphorus metabolism in the development of calcifications. J Rheumatol. 2001;28:1129–32.PubMed

78.

Mukamel M, Horev G, Mimouni M. New insight into calcinosis of juvenile dermatomyositis: a study of composition and treatment. J Pediatr. 2001;138:763–6. https://doi.org/10.1067/mpd.2001.112473.CrossRefPubMed

79.

•• Huber AM, Lang B, LeBlanc CM, et al. Medium- and long-term functional outcomes in a multicenter cohort of children with juvenile dermatomyositis. Arthritis Rheum. 2000;43:541–9. https://doi.org/10.1002/1529-0131(200003)43:3%3c541::AID-ANR9%3e3.0.CO;2-T. This study describes a cohort that helps understand the natural history of the disease.CrossRefPubMed

80.

Pachman LM, Hayford JR, Chung A, et al. Juvenile dermatomyositis at diagnosis: clinical characteristics of 79 children. J Rheumatol. 1998;25:1198–204.PubMed

81.

Kobayashi S, Higuchi K, Tamaki H, et al. Characteristics of juvenile dermatomyositis in Japan. Pediatr Int. 1997;39:257–62. https://doi.org/10.1111/j.1442-200x.1997.tb03595.x.CrossRef

82.

Wanakul S, Pongprasit P, Wattakankrai P. Calcinosis cutis presenting years before other clinical manifestations of juvenile dermatomyositis: report of two cases. Australas J Dermatol. 1997;38:202–5. https://doi.org/10.1111/j.1440-0960.1997.tb01698.x.CrossRef

83.

Oliveri MB, Palermo R, Mautalen C, Hübscher O. Regression of calcinosis during diltiazem treatment in juvenile dermatomyositis. J Rheumatol. 1996;23:2152–5.PubMed

84.

Nakagawa T, Taikawa T. Calcinosis cutis in juvenile dermatomyositis responsive to aluminum hydroxide treatment. J Dermatol. 1993;20:558–90. https://doi.org/10.1111/j.1346-8138.1993.tb01338.x.CrossRefPubMed

85.

Agud-Dios M, Arroyo-Andres J, Rubio-Muñiz C, et al. Juvenile dermatomyositis-associated calcinosis successfully treated with combined immunosuppressive, bisphosphonate, oral baricitinib and physical therapy. Dermatol Ther. 2022;35: e15960. https://doi.org/10.1111/dth.15960.CrossRefPubMedPubMedCentral

Titel: Calcinosis in Juvenile Dermatomyositis—Epidemiology, Pathogenesis, Clinical Features, and Treatment: A Systematic Review
verfasst von: Jucier Gonçalves Júnior
Samuel Katsuyuki Shinjo
Publikationsdatum: 07.12.2023
Verlag: Springer US
Erschienen in: Current Rheumatology Reports / Ausgabe 2/2024
Print ISSN: 1523-3774
Elektronische ISSN: 1534-6307
DOI: https://doi.org/10.1007/s11926-023-01126-5

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Strenge Blutdruckeinstellung lohnt auch im Alter noch

30.04.2024 Arterielle Hypertonie Nachrichten

Ältere Frauen, die von chronischen Erkrankungen weitgehend verschont sind, haben offenbar die besten Chancen, ihren 90. Geburtstag zu erleben, wenn ihr systolischer Blutdruck < 130 mmHg liegt. Das scheint selbst für 80-Jährige noch zu gelten.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen