TY - JOUR T1 - Subcutaneous Granuloma Annulare: A Diagnostic Conundrum-Learning From Mistakes. JF - Pediatr Emerg Care Y1 - 2017 A1 - Pederiva, Federica A1 - Paloni, Giulia A1 - Berti, Irene KW - Arm KW - Child, Preschool KW - Connective Tissue Diseases KW - Diagnosis, Differential KW - Female KW - Granuloma Annulare KW - Humans KW - Infant KW - Leg KW - Male KW - Ultrasonography, Doppler, Color AB -

Subcutaneous granuloma annulare is an inflammatory lesion occurring in otherwise healthy children. We present 3 pediatric patients with different diagnostic-therapeutic paths depending on the ward they were referred to. The lesions regress spontaneously, and medical or surgical treatments are generally not necessary.

VL - 33 IS - 8 U1 - http://www.ncbi.nlm.nih.gov/pubmed/26785090?dopt=Abstract ER - TY - JOUR T1 - Serum amyloid protein A concentration in cryopyrin-associated periodic syndromes patients treated with interleukin-1 beta antagonist. JF - Clin Exp Rheumatol Y1 - 2014 A1 - Pastore, Serena A1 - Paloni, Giulia A1 - Caorsi, Roberta A1 - Ronfani, Luca A1 - Taddio, Andrea A1 - Lepore, Loredana KW - Adolescent KW - Adult KW - Amyloidosis KW - Child KW - Child, Preschool KW - Cryopyrin-Associated Periodic Syndromes KW - Drug Monitoring KW - Female KW - Humans KW - Immunosuppressive Agents KW - Interleukin-1beta KW - Male KW - Middle Aged KW - Serum Amyloid A Protein KW - Treatment Outcome KW - Young Adult AB -

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.

VL - 32 IS - 4 Suppl 84 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25069027?dopt=Abstract ER -