@article {10778, title = {Fecal Calprotectin to Detect Inflammatory Bowel Disease in Juvenile Idiopathic Arthritis.}, journal = {J Rheumatol}, volume = {45}, year = {2018}, month = {2018 Oct}, pages = {1418-1421}, abstract = {

OBJECTIVE: This study aimed to test fecal calprotectin (FC) as a screening tool to identify inflammatory bowel disease (IBD) among patients with juvenile idiopathic arthritis (JIA).

METHODS: FC level < 100 g/kg was considered normal. Patients with 2 consecutive FC dosage >= 100 g/kg underwent endoscopic evaluation.

RESULTS: There were 113 patients with JIA enrolled. FC was raised in 7 patients out of 113. All patients had IBD. In 3/7 patients, high FC levels were the only sign consistent with IBD.

CONCLUSION: FC is a useful, economical, and noninvasive diagnostic tool to identify JIA patients with underlying IBD.

}, issn = {0315-162X}, doi = {10.3899/jrheum.171200}, author = {Ferrara, Giovanna and Pastore, Serena and Sancin, Lara and Torelli, Lucio and Radillo, Oriano and Bramuzzo, Matteo and Bibalo, Chiara and Tommasini, Alberto and Ventura, Alessandro and Taddio, Andrea} } @article {10533, title = {ANCA-associated vasculitis in childhood: recent advances.}, journal = {Ital J Pediatr}, volume = {43}, year = {2017}, month = {2017 May 05}, pages = {46}, abstract = {

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides are rare systemic diseases that usually occur in adulthood. They comprise granulomatosis with polyangiitis (GPA, Wegener{\textquoteright}s), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss syndrome). Their clinical presentation is often heterogeneous, with frequent involvement of the respiratory tract, the kidney, the skin and the joints. ANCA-associated vasculitis is rare in childhood but North-American and European cohort studies performed during the last decade have clarified their phenotype, patterns of renal involvement and their prognostic implications, and outcome. Herein, we review the main clinical and therapeutic aspects of childhood-onset ANCA-associated vasculitis, and provide preliminary data on demographic characteristics and organ manifestations of an Italian multicentre cohort.

}, keywords = {Age Distribution, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, Antibodies, Antineutrophil Cytoplasmic, Child, Child, Preschool, Churg-Strauss Syndrome, Female, Granulomatosis with Polyangiitis, Humans, Incidence, Male, Microscopic Polyangiitis, Rare Diseases, Risk Assessment, Severity of Illness Index, Sex Distribution, Survival Rate}, issn = {1824-7288}, doi = {10.1186/s13052-017-0364-x}, author = {Calatroni, Marta and Oliva, Elena and Gianfreda, Davide and Gregorini, Gina and Allinovi, Marco and Ramirez, Giuseppe A and Bozzolo, Enrica P and Monti, Sara and Bracaglia, Claudia and Marucci, Giulia and Bodria, Monica and Sinico, Renato A and Pieruzzi, Federico and Moroni, Gabriella and Pastore, Serena and Emmi, Giacomo and Esposito, Pasquale and Catanoso, Mariagrazia and Barbano, Giancarlo and Bonanni, Alice and Vaglio, Augusto} } @article {10501, title = {A boy with fever and arthralgia.}, journal = {BMJ}, volume = {356}, year = {2017}, month = {2017 03 29}, pages = {j1347}, keywords = {Anti-Bacterial Agents, Anti-Inflammatory Agents, Non-Steroidal, Antibodies, Bacterial, Aortic Valve Insufficiency, Arthralgia, Child, Echocardiography, Echocardiography, Doppler, Color, Fever, Humans, Male, Mitral Valve Insufficiency, Rheumatic Fever, Rheumatic Heart Disease, Streptolysins}, issn = {1756-1833}, doi = {10.1136/bmj.j1347}, author = {Poropat, Federico and Pastore, Serena and Gesuete, Valentina and Barbi, Egidio} } @article {8483, title = {Describing Kawasaki shock syndrome: results from a retrospective study and literature review.}, journal = {Clin Rheumatol}, volume = {36}, year = {2017}, month = {2017 Jan}, pages = {223-228}, abstract = {

Kawasaki shock syndrome (KSS) is a rare manifestation of Kawasaki disease (KD) characterized by systolic hypotension or clinical signs of poor perfusion. The objectives of the study are to describe the main clinical presentation, echocardiographic, and laboratory findings, as well as the treatment options and clinical outcomes of KSS patients when compared with KD patients. This is a retrospective study. All children referred to two pediatric rheumatology units from January 1, 2012, to December 31, 2014, were enrolled. Patients were divided into patients with or without KSS. We compared the two groups according to the following variables: sex, age, type of KD (classic, with less frequent manifestations, or incomplete), clinical manifestations, cardiac involvement, laboratory findings, therapy administered, response to treatment, and outcome. Eighty-four patients with KD were enrolled. Of these, five (6~\%) met the criteria for KSS. Patients with KSS had higher values of C-reactive protein (p = 0.005), lower hemoglobin levels (p = 0.003); more frequent hyponatremia (p = 0.004), hypoalbuminemia (p = 0.004), and coagulopathy (p = 0.003); and increase in cardiac troponins (p = 0.000). Among the KSS patients, three had a coronary artery involvement, but none developed a permanent aneurysm. Intravenous immunoglobulin resistance was more frequent in the KSS group, although not significantly so (3/5, 60~\% vs. 23/79, 30~\%, P = NS). None of the five cases was fatal, and all recovered without sequelae. KSS patients are more likely to have higher rates of cardiac involvement. However, most cardiovascular abnormalities resolved promptly with therapy.

}, keywords = {C-Reactive Protein, Child, Child, Preschool, Echocardiography, Female, Heart Failure, Hemoglobins, Humans, Immunoglobulins, Intravenous, Male, Mucocutaneous Lymph Node Syndrome, Retrospective Studies, Shock, Syndrome}, issn = {1434-9949}, doi = {10.1007/s10067-016-3316-8}, author = {Taddio, Andrea and Rossi, Eleonora Dei and Monasta, Lorenzo and Pastore, Serena and Tommasini, Alberto and Lepore, Loredana and Bronzetti, Gabriele and Marrani, Edoardo and Mottolese, Biancamaria D{\textquoteright}Agata and Simonini, Gabriele and Cimaz, Rolando and Ventura, Alessandro} } @article {10555, title = {Intra-articular corticosteroids versus intra-articular corticosteroids plus methotrexate in oligoarticular juvenile idiopathic arthritis: a multicentre, prospective, randomised, open-label trial.}, journal = {Lancet}, volume = {389}, year = {2017}, month = {2017 03 04}, pages = {909-916}, abstract = {

BACKGROUND: Little evidence-based information is available to guide the treatment of oligoarticular juvenile idiopathic arthritis. We aimed to investigate whether oral methotrexate increases the efficacy of intra-articular corticosteroid therapy.

METHODS: We did this prospective, open-label, randomised trial at ten hospitals in Italy. Using a concealed computer-generated list, children younger than 18 years with oligoarticular-onset disease were randomly assigned (1:1) to intra-articular corticosteroids alone or in combination with oral methotrexate (15 mg/m; maximum 20 mg). Corticosteroids used were triamcinolone hexacetonide (shoulder, elbow, wrist, knee, and tibiotalar joints) or methylprednisolone acetate (ie, subtalar and tarsal joints). We did not mask patients or investigators to treatment assignments. Our primary outcome was the proportion of patients in the intention-to-treat population who had remission of arthritis in all injected joints at 12 months. This trial is registered with European Union Clinical Trials Register, EudraCT number 2008-006741-70.

FINDINGS: Between July 7, 2009, and March 31, 2013, we screened 226 participants and randomly assigned 102 to intra-articular corticosteroids alone and 105 to intra-articular corticosteroids plus methotrexate. 33 (32\%) patients assigned to intra-articular corticosteroids alone and 39 (37\%) assigned to intra-articular corticosteroids and methotrexate therapy had remission of arthritis in all injected joints (p=0{\textperiodcentered}48). Adverse events were recorded for 20 (17\%) patients who received methotrexate, which led to permanent treatment discontinuation in two patients (one due to increased liver transaminases and one due to gastrointestinal discomfort). No patient had a serious adverse event.

INTERPRETATION: Concomitant administration of methotrexate did not augment the effectiveness of intra-articular corticosteroid therapy. Future studies are needed to define the optimal therapeutic strategies for oligoarticular juvenile idiopathic arthritis.

FUNDING: Italian Agency of Drug Evaluation.

}, keywords = {Adrenal Cortex Hormones, Arthritis, Juvenile, Humans, Injections, Intra-Articular, Italy, Methotrexate, Prospective Studies, Treatment Outcome}, issn = {1474-547X}, doi = {10.1016/S0140-6736(17)30065-X}, author = {Ravelli, Angelo and Dav{\`\i}, Sergio and Bracciolini, Giulia and Pistorio, Angela and Consolaro, Alessandro and van Dijkhuizen, Evert Hendrik Pieter and Lattanzi, Bianca and Filocamo, Giovanni and Verazza, Sara and Gerloni, Valeria and Gattinara, Maurizio and Pontikaki, Irene and Insalaco, Antonella and De Benedetti, Fabrizio and Civino, Adele and Presta, Giuseppe and Breda, Luciana and Marzetti, Valentina and Pastore, Serena and Magni-Manzoni, Silvia and Maggio, Maria Cristina and Garofalo, Franco and Rigante, Donato and Gattorno, Marco and Malattia, Clara and Picco, Paolo and Viola, Stefania and Lanni, Stefano and Ruperto, Nicolino and Martini, Alberto} } @article {10547, title = {An Update on the Pathogenesis and Treatment of Chronic Recurrent Multifocal Osteomyelitis in Children.}, journal = {Paediatr Drugs}, volume = {19}, year = {2017}, month = {2017 Jun}, pages = {165-172}, abstract = {

Chronic recurrent multifocal osteomyelitis (CRMO), also known as chronic non-bacterial osteomyelitis (CNO), is a rare inflammatory disorder that primarily affects children. It is characterized by pain, local bone expansion, and radiological findings suggestive of osteomyelitis, usually at multiple sites. CRMO predominantly affects the metaphyses of long bones, but involvement of the clavicle or mandible are suggestive of the diagnosis. CRMO is a diagnosis of exclusion, and its pathogenesis remains unknown. Differential diagnosis includes infection, malignancies, benign bone tumors, metabolic disorders, and other autoinflammatory disorders. Biopsy of the bone lesion is not often required but could be necessary in unclear cases, especially for differentiation from bone neoplasia. Non-steroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment. Alternative therapies have been used, including corticosteroids, methotrexate, bisphosphonates, and tumor necrosis factor (TNF)-α inhibitors. No guidelines have been established regarding diagnosis and treatment options. This manuscript gives an overview of the most recent findings on the pathogenesis of CRMO and clinical approaches for patients with the condition.

}, keywords = {Adrenal Cortex Hormones, Anti-Inflammatory Agents, Non-Steroidal, Child, Chronic Disease, Diagnosis, Differential, Humans, Osteomyelitis, Recurrence, Tumor Necrosis Factor-alpha}, issn = {1179-2019}, doi = {10.1007/s40272-017-0226-4}, author = {Taddio, Andrea and Zennaro, Floriana and Pastore, Serena and Cimaz, Rolando} } @article {10516, title = {A young goalkeeper with buttock pain and fever.}, journal = {BMJ}, volume = {357}, year = {2017}, month = {2017 06 08}, pages = {j2400}, keywords = {Adolescent, Buttocks, Fever, Humans, Male, Musculoskeletal Pain, Pyomyositis}, issn = {1756-1833}, doi = {10.1136/bmj.j2400}, author = {Moressa, Valentina and Pastore, Serena and Naviglio, Samuele and Ventura, Alessandro} } @article {8332, title = {Chronic nonbacterial osteomyelitis may be associated with renal disease and bisphosphonates are a good option for the majority of patients.}, journal = {Acta Paediatr}, volume = {105}, year = {2016}, month = {2016 Jul}, pages = {e328-33}, abstract = {

AIM: The aim of this Italian study was to describe the clinical features, treatment options and outcomes of a cohort of patients with chronic nonbacterial osteomyelitis (CNO).

METHODS: This was a retrospective cohort study. Laboratory data, diagnostic imaging, histological features and clinical course are reported.

RESULTS: We enrolled 47 patients diagnosed with CNO. Bone pain was the leading symptom, and multifocal disease was present in 87\% of the patients. The majority of the bone lesions were located in the appendicular skeleton (58\%). Extraosseous manifestations were present in 34\% of the patients, and renal involvement was detected in four patients. Inflammatory indices were increased in 80\%, and bone x-rays were negative in 15\% of the patients. Nonsteroidal anti-inflammatory drugs (NSAIDs) were the first therapy for all patients, achieving clinical remission in 27\%. A good response to NSAIDs was significantly associated with a better prognosis. Bisphosphonates were used in 26 patients, with remission in 73\%. Only six patients (13\%), all with spine involvement, developed sequelae.

CONCLUSION: We found a possible association between CNO and renal disease. Bisphosphonates were more likely to lead to clinical remission when NSAIDs and corticosteroids had failed. Vertebral localisation was the only risk factor for potential sequelae.

}, issn = {1651-2227}, doi = {10.1111/apa.13420}, author = {Pastore, Serena and Ferrara, Giovanna and Monasta, Lorenzo and Meini, Antonella and Cattalini, Marco and Martino, Silvana and Alessio, Maria and La Torre, Francesco and Teruzzi, Barbara and Gerloni, Valeria and Breda, Luciana and Taddio, Andrea and Lepore, Loredana} } @article {8356, title = {A minor trauma revealing linear morphoea in a 4-year-old female.}, journal = {Arch Dis Child}, year = {2016}, month = {2016 May 12}, issn = {1468-2044}, doi = {10.1136/archdischild-2016-310670}, author = {Pastore, Serena and Contorno, Sarah and Caddeo, Giulia and Calligaris, Lorenzo and Taddio, Andrea} } @article {3592, title = {5-Aminoimidazole-4-carboxamide ribonucleotide-transformylase and inosine-triphosphate-pyrophosphatase genes variants predict remission rate during methotrexate therapy in patients with juvenile idiopathic arthritis.}, journal = {Rheumatol Int}, volume = {35}, year = {2015}, month = {2015 Apr}, pages = {619-27}, abstract = {

For children with juvenile idiopathic arthritis (JIA) who fail to respond to methotrexate, the delay in identifying the optimal treatment at an early stage of disease can lead to long-term joint damage. Recent studies indicate that relevant variants to predict methotrexate response in JIA are those in 5-aminoimidazole-4-carboxamide ribonucleotide-transformylase (ATIC), inosine-triphosphate-pyrophosphatase (ITPA) and solute-liquid-carrier-19A1 genes. The purpose of the study was, therefore, to explore the role of these candidate genetic factors on methotrexate response in an Italian cohort of children with JIA. Clinical response to methotrexate was evaluated as clinical remission stable for a 6-month period, as ACRPed score and as change in Juvenile Arthritis Disease score. The most relevant SNPs for each gene considered were assayed on patients{\textquoteright} DNA. ITPA activity was measured in patients{\textquoteright} erythrocytes. Sixty-nine patients with JIA were analyzed: 52.2 \% responded to therapy (ACRPed70 score), while 37.7 \% reached clinical remission stable for 6 months. ATIC rs2372536 GG genotype was associated with improved clinical remission (adjusted p value = 0.0090). For ITPA, rs1127354 A variant was associated with reduced clinical remission: (adjusted p value = 0.028); this association was present even for patients with wild-type ITPA and low ITPA activity. These preliminary results indicate that genotyping of ATIC rs2372536 and ITPA rs1127354 variants or measuring ITPA activity could be useful to predict methotrexate response in children with JIA after validation by further prospective studies on a larger patient cohort.

}, issn = {1437-160X}, doi = {10.1007/s00296-014-3131-y}, author = {Pastore, Serena and Stocco, Gabriele and Moressa, Valentina and Zandon{\`a}, Luigi and Favretto, Diego and Malus{\`a}, Noelia and Decorti, Giuliana and Lepore, Loredana and Ventura, Alessandro} } @article {8030, title = {Delayed reactivation of chronic infantile neurologic, cutaneous, articular syndrome (CINCA) in a patient with somatic mosaicism of CIAS1/NLRP3 gene after withdrawal of anti-IL-1 beta therapy.}, journal = {Clin Exp Rheumatol}, volume = {33}, year = {2015}, month = {2015 Sep-Oct}, pages = {766}, keywords = {Antibodies, Monoclonal, Carrier Proteins, Cryopyrin-Associated Periodic Syndromes, Drug Administration Schedule, Female, Genetic Predisposition to Disease, Humans, Immunosuppressive Agents, Interleukin 1 Receptor Antagonist Protein, Interleukin-1beta, Mosaicism, Phenotype, Recurrence, Remission Induction, Time Factors, Treatment Outcome, Young Adult}, issn = {0392-856X}, author = {Paloni, Giulia and Pastore, Serena and Tommasini, Alberto and Lepore, Loredana and Taddio, Andrea} } @article {8074, title = {Fever tree revisited: From malaria to autoinflammatory diseases.}, journal = {World J Clin Pediatr}, volume = {4}, year = {2015}, month = {2015 Nov 8}, pages = {106-12}, abstract = {

Over the centuries the idea of recurrent fevers has mainly been associated with malaria, but many other fevers, such as typhoid and diphtheria were cause for concern. It is only in recent times, with the more severe forms of fever from infectious origin becoming less frequent or a cause for worry that we started noticing recurrent fevers without any clear infectious cause, being described as having a pathogenesis of autoinflammatory nature. The use of molecular examinations in many cases can allow a diagnosis where the cause is monogenic. In other cases, however the pathogenesis is likely to be multifactorial and the diagnostic-therapeutic approach is strictly clinical. The old fever tree paradigm developed to describe fevers caused by malaria has been revisited here to describe today{\textquoteright}s periodic fevers from the periodic fever adenitis pharyngitis aphthae syndrome to the more rare autoinflammatory diseases. This model may allow us to place cases that are yet to be identified which are likely to be of multifactorial origin.

}, issn = {2219-2808}, doi = {10.5409/wjcp.v4.i4.106}, author = {Pastore, Serena and Vuch, Josef and Bianco, Anna Monica and Taddio, Andrea and Tommasini, Alberto} } @article {7762, title = {Genetic determinants for methotrexate response in juvenile idiopathic arthritis.}, journal = {Front Pharmacol}, volume = {6}, year = {2015}, month = {2015}, pages = {52}, abstract = {

Juvenile idiopathic arthritis (JIAs) is the most common chronic rheumatic disease of childhood and is an important cause of disability. The folic acid analog methotrexate is the first choice disease-modifying anti-rheumatic drug in this disease, however, 35-45\% of patients fail to respond. Molecular elements, such as variants in genes of pharmacological relevance, influencing response to methotrexate in JIA, would be important to individualize treatment strategies. Several studies have evaluated the effects of candidate genetic variants in the complex pathway of genes involved in methotrexate pharmacodynamics and pharmacokinetics, however, results are still contrasting and no definitive genetic marker of methotrexate response useful for the clinician to tailor therapy of children with JIA has been identified. Recently, genome-wide approaches have been applied, identifying new potential biological processes involved in methotrexate response in JIA such as TGF-beta signaling and calcium channels. If these genomic results are properly validated and integrated with innovative analyses comprising deep sequencing, epigenetics, and pharmacokinetics, they will greatly contribute to personalize therapy with methotrexate in children with JIA.

}, issn = {1663-9812}, doi = {10.3389/fphar.2015.00052}, author = {Pastore, Serena and Stocco, Gabriele and Favretto, Diego and De Iudicibus, Sara and Taddio, Andrea and d{\textquoteright}Adamo, Pio and Malus{\`a}, Noelia and Addobbati, Riccardo and Decorti, Giuliana and Lepore, Loredana and Ventura, Alessandro} } @article {3571, title = {Clinical significance of hyper-IgA in a paediatric laboratory series.}, journal = {Arch Dis Child}, volume = {99}, year = {2014}, month = {2014 Dec}, pages = {1114-6}, abstract = {

The causes of extremely elevated IgA, whether isolated or associated with an increase in other classes of immunoglobulin, are poorly defined in paediatrics. We reviewed the diagnostic significance of very high IgA levels (greater than 3 SD above the mean for age) in a cohort of patients referred to a tertiary care children{\textquoteright}s hospital. Hyper-IgA was found in 91 of 6364 subjects (1.4\%) and in 68 cases was not associated with an increased IgG and/or IgM level. Most subjects with hyper-IgA (73.5\%) had a severe immune defect, a chronic rheumatic disease or inflammatory bowel disease, while these conditions were very rare in a control group with normal IgA values (8\%). Although our results may in part reflect the experience of a tertiary care centre, we suggest that hyper-IgA in children should always arouse suspicion of a serious disease.

}, keywords = {Adolescent, Child, Child, Preschool, Female, Hospitals, Pediatric, Humans, Hypergammaglobulinemia, Immunoglobulin A, Infant, Italy, Male, Tertiary Care Centers}, issn = {1468-2044}, doi = {10.1136/archdischild-2014-306607}, author = {Copetti, Valentina and Pastore, Serena and De Pieri, Carlo and Radillo, Oriano and Taddio, Andrea and Ventura, Alessandro and Tommasini, Alberto} } @article {3517, title = {A girl with photosensitivity and hepatic steatosis.}, journal = {J Pediatr}, volume = {165}, year = {2014}, month = {2014 Jul}, pages = {201-201.e1}, keywords = {Child, Diagnosis, Differential, Fatty Liver, Female, Humans, Photosensitivity Disorders, Protoporphyria, Erythropoietic}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2014.02.056}, author = {Pavan, Matteo and Gortani, Giulia and Rubinato, Elisa and Faletra, Flavio and Pastore, Serena and Ventura, Alessandro} } @article {3475, title = {Hemophagocytic lymphohistiocytosis in total parenteral nutrition dependent children: description of 5 cases and practical tips for management.}, journal = {J Pediatr Hematol Oncol}, volume = {36}, year = {2014}, month = {2014 Oct}, pages = {e440-2}, abstract = {

Although total parenteral nutrition (TPN) is mandatory in children with intestinal failure, this treatment is not risk free. The main complications of TPN include catheter-related sepsis, thrombosis, hepatic cholestasis and cirrhosis, metabolic bone disease, and, rarely, reactive hemophagocytic lymphohistiocytosis (HLH). The pathogenesis of HLH in patients with TPN is not known, although some authors hypothesized that it can result from the activation of macrophages because of "fat overload." We reported 5 cases of HLH that occurred in patients with 4 different underlying disorders, all requiring TPN for a long term. In our series, an underlying immunological defect or a serious infection (sepsis) can have triggered HLH. Therefore, it could be reasonable to hypothesize that besides TPN in itself, minor immune defects and infections may act together by overcoming a threshold of immune stimulation, which ultimately leads to HLH.

}, keywords = {Child, Preschool, Fatty Acids, Female, Humans, Infant, Intestinal Diseases, Lymphohistiocytosis, Hemophagocytic, Male, Parenteral Nutrition, Total, Steroids, Treatment Outcome}, issn = {1536-3678}, doi = {10.1097/MPH.0b013e31829f381b}, author = {Pastore, Serena and Barbieri, Francesca and Di Leo, Grazia and Valencic, Erica and Tommasini, Alberto and Ventura, Alessandro} } @article {3482, title = {Procedural sedation for intra-articular corticosteroid injections in juvenile idiopathic arthritis (JIA) should be a standard of care.}, journal = {Eur J Pediatr}, volume = {173}, year = {2014}, month = {2014 Jun}, pages = {831}, keywords = {Arthritis, Juvenile, Conscious Sedation, Female, Glucocorticoids, Humans, Male, Pain, Patient Preference}, issn = {1432-1076}, doi = {10.1007/s00431-013-2246-6}, author = {Pastore, Serena and Gortani, Giulia and Taddio, Andrea and Barbi, Egidio} } @article {3577, title = {Serum amyloid protein A concentration in cryopyrin-associated periodic syndromes patients treated with interleukin-1 beta antagonist.}, journal = {Clin Exp Rheumatol}, volume = {32}, year = {2014}, month = {2014 Jul-Aug}, pages = {S63-6}, abstract = {

OBJECTIVES: Cryopyrin-associated periodic syndromes (CAPS) are a group of chronic, relapsing autoinflammatory disorders which may be complicated by systemic AA amyloidosis. The aim of our study was to evaluate serum amyloid protein A (SAA) level in CAPS patients treated with Interleukin-1beta (IL-1β) antagonist and to correlate its level with treatment response.

METHODS: All patients of CAPS Italian Register treated with IL-1β inhibitor were enrolled. SAA levels before starting therapy, and at last visit were evaluated. Patients were then divided in complete responders and partial responders.

RESULTS: Twenty-five patients were enrolled. SAA level before starting therapy was increased (median 118.5 mg/L, IQR 96.4-252.8; normal value <6.4 mg/L), while at last visit SAA was significantly reduced (median 4.3 mg/L, IQR 2.3-12.7) (p<0.001). However 12 patients still presented SAA levels beyond normal range, 10/25 patients (40\%) showed a complete response to treatment. Conversely, 15 patients presented only a partial response, of which 12 for increased SAA value and 3 for increased CRP value. Patients with partial response had SAA values significantly higher than patients with complete response (median 12.6 mg/L; IQR 8.3-20.0 vs. 2.7 mg/L; IQR 1.6-4.1, p<0.001).

CONCLUSIONS: Our results confirm the long term efficacy of anti IL-1β treatment in CAPS and the decrease of SAA levels; however 48\% of patients still presented SAA elevation despite treatment. The real risk of these patients in developing amyloidosis is not clear but the persistent increase of SAA needs a close follow-up.

}, keywords = {Adolescent, Adult, Amyloidosis, Child, Child, Preschool, Cryopyrin-Associated Periodic Syndromes, Drug Monitoring, Female, Humans, Immunosuppressive Agents, Interleukin-1beta, Male, Middle Aged, Serum Amyloid A Protein, Treatment Outcome, Young Adult}, issn = {0392-856X}, author = {Pastore, Serena and Paloni, Giulia and Caorsi, Roberta and Ronfani, Luca and Taddio, Andrea and Lepore, Loredana} } @article {1848, title = {Pathergy as a cause of false-positive tuberculin skin test.}, journal = {Pediatr Infect Dis J}, volume = {31}, year = {2012}, month = {2012 Jan}, pages = {104}, keywords = {Adolescent, Behcet Syndrome, False Positive Reactions, Female, Humans, Hypersensitivity, Needles, Skin, Skin Tests, Tuberculin Test, Tuberculosis, Gastrointestinal}, issn = {1532-0987}, doi = {10.1097/INF.0b013e31823627ad}, author = {Pastore, Serena and Naviglio, Samuele and Ventura, Alessandro} } @article {1966, title = {A red baby should not be taken too lightly.}, journal = {Acta Paediatr}, volume = {101}, year = {2012}, month = {2012 Dec}, pages = {e573-7}, abstract = {

AIM: To identify clinical and laboratory features that can drive the differential diagnosis of a primary immunodeficiency diseases in patients with ectodermal defects.

METHODS: Analysis of selected teaching cases.

RESULTS: We identified four exemplary cases that allowed to point out specific clues.

CONCLUSIONS: A careful evaluation of immune and ectodermal signs is the key to the diagnosis. Therefore, a multidisciplinary approach can lead to diagnosis and to an appropriate treatment in most of the cases.

}, keywords = {Child, Preschool, Dermatitis, Ectodermal Dysplasia, Female, Humans, Immunologic Deficiency Syndromes, Infant, Male, Netherton Syndrome, Severe Combined Immunodeficiency, Skin}, issn = {1651-2227}, doi = {10.1111/apa.12018}, author = {Faletra, Flavio and Bruno, Irene and Berti, Irene and Pastore, Serena and Pirrone, Angela and Tommasini, Alberto} } @article {1827, title = {Successful induction of oral tolerance in Netherton syndrome.}, journal = {Allergol Immunopathol (Madr)}, volume = {40}, year = {2012}, month = {2012 Sep-Oct}, pages = {316-7}, keywords = {Allergens, Alopecia, Child, Preschool, Desensitization, Immunologic, Disease-Free Survival, Eczema, Female, Food Hypersensitivity, Hair Follicle, Humans, Immune Tolerance, Immunoglobulin E, Infant, Newborn, Mouth, Netherton Syndrome, Treatment Outcome}, issn = {1578-1267}, doi = {10.1016/j.aller.2011.07.005}, author = {Pastore, Serena and Gorlato, Gaia and Berti, Irene and Barbi, Egidio and Ventura, Alessandro} } @article {1685, title = {Refractory iron-deficiency anaemia in a child with portal cavernoma.}, journal = {Gut}, volume = {60}, year = {2011}, month = {2011 Mar}, pages = {317, 377}, keywords = {Anemia, Iron-Deficiency, Antihypertensive Agents, Child, Hemangioma, Cavernous, Humans, Hypertension, Portal, Ileal Diseases, Male, Propranolol, Vascular Neoplasms}, issn = {1468-3288}, doi = {10.1136/gut.2009.184697}, author = {Pastore, Serena and Londero, Margherita and Cont, Gabriele and Di Leo, Grazia and Ventura, Alessandro} } @article {1684, title = {The resurgence of rheumatic fever in a developed country area: the role of echocardiography.}, journal = {Rheumatology (Oxford)}, volume = {50}, year = {2011}, month = {2011 Feb}, pages = {396-400}, abstract = {

OBJECTIVES: The annual incidence of ARF ranges from 5 to 51/100, 000 population worldwide in the 5- to 15-year age group. In the past, there was a decline in the incidence of ARF; however, focal outbreaks have been reported. This study evaluated the incidence of ARF in 2007-08 in a region of a developed country compared with the previous decade.

METHODS: A retrospective review of all admission records for ARF in Trieste between January 2007 and December 2008 was undertaken. The diagnosis of ARF was established by the Jones criteria according to the 1992 revision.

RESULTS: Between January 2007 and December 2008: 13 cases of ARF were recorded, 11 females and 2 males. The estimated incidence was 23 and 27/100, 000 population new cases each year, respectively, in the 5- to 15-year age group. Migratory polyarthritis occurred in 6/13, chorea in 7/13 and clinical carditis in 5/13 cases. Five out of 13 patients had only echocardiographic abnormalities, with no clinical cardiac manifestations. Another two patients did not fulfil diagnostic criteria for ARF, presenting with only three minor criteria, but they revealed silent carditis at echocardiography evaluation. During the follow-up, in one case the carditis receded and in the other it significantly improved.

CONCLUSIONS: Our experience underlines that ARF has not yet disappeared in industrialized countries. We observed a high incidence of chorea, always associated with mild carditis. Echocardiographic assessment should be routinely performed in all patients with suspected ARF in order to identify those subclinical cases of valvulitis that would otherwise pass undiagnosed without receiving proper prophylaxis.

}, keywords = {Adolescent, Child, Child, Preschool, Chorea, Developed Countries, Diagnosis, Differential, Echocardiography, Female, Humans, Italy, Male, Myocarditis, Retrospective Studies, Rheumatic Fever}, issn = {1462-0332}, doi = {10.1093/rheumatology/keq290}, author = {Pastore, Serena and De Cunto, Angela and Benettoni, Alessandra and Berton, Emanuela and Taddio, Andrea and Lepore, Loredana} } @article {1792, title = {A singular case of congenital self-healing histiocytosis with skin, liver and atypical eye involvement.}, journal = {Ocul Immunol Inflamm}, volume = {19}, year = {2011}, month = {2011 Oct}, pages = {337-9}, abstract = {

PURPOSE: To describe a rare case of congenital self-healing Langerhans cell histiocytosis (CSHLCH) presenting with atypical eye involvement.

DESIGN: Case report.

METHODS: A female newborn presented with purpuric lesions over the trunk, limbs, and face. Liver ultrasonography revealed hypoechogenic lesions with blurred borders. Biomicroscopy showed right posterior synechiae with fibrinoid deposits on the lens. At 7 months she presented with right acute glaucoma.

RESULTS: Biomicroscopy showed the presence of inflammatory pseudo-membrane covering the anterior surface of the lens, iris, and iridocorneal angle. Ab externo trabeculotomy was performed; access to the anterior chamber with capsulorrhexis forceps permitted a peeling of the pseudo-membrane with normalization of the intraocular pressure. Histologic examination of the membrane revealed an inflammatory tissue with CD1a and S-100 positive histiocytic cells.

CONCLUSIONS: This is the first case of CSHLCH describing acute glaucoma secondary to a pseudo-inflammatory membrane with typical histiocytic cells, occluding the iridocorneal angle.

}, keywords = {Antigens, CD1, Convalescence, Female, Glaucoma, Histiocytosis, Langerhans-Cell, Humans, Infant, Intraocular Pressure, Iridocorneal Endothelial Syndrome, Liver Diseases, S100 Proteins, Skin Diseases, Trabeculectomy}, issn = {1744-5078}, doi = {10.3109/09273948.2010.605538}, author = {Parentin, Fulvio and Ventura, Giovanna and Pastore, Serena and Kiren, Valentina and Bibalo, Chiara and Pensiero, Stefano and Lepore, Loredana} } @article {1763, title = {Two lumens, one diagnosis.}, journal = {J Pediatr}, volume = {159}, year = {2011}, month = {2011 Sep}, pages = {511}, keywords = {Capsule Endoscopy, Child, Preschool, Gastrointestinal Hemorrhage, Humans, Male, Meckel Diverticulum, Recurrence}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2011.04.041}, author = {Pastore, Serena and Gortani, Giulia and Maschio, Massimo and Di Leo, Grazia and Ventura, Alessandro} } @article {1671, title = {A child with pain after mild trauma.}, journal = {J Pediatr}, volume = {157}, year = {2010}, month = {2010 Oct}, pages = {693}, keywords = {Antigens, CD, Antigens, CD31, Antigens, CD34, Antigens, Differentiation, Myelomonocytic, Biopsy, Child, Factor VIII, Fingers, Hand Injuries, Hemangioendothelioma, Humans, Immunohistochemistry, Injury Severity Score, Male, Osteolysis, Pain, Pain Measurement, S100 Proteins, Vascular Neoplasms}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2010.04.028}, author = {Londero, Margherita and Pastore, Serena and Zanazzo, Giulio A and Bruno, Irene and Ventura, Alessandro} }