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Objective:To evaluate the impact of duration of untreated symptoms in childre n with juvenile dermatomyositis(JDM)on clinical and laboratory status at diagn osis.Study design:We examined physical and laboratory data from the first phys ician visit for 166 untreated children with JDM.Disease activity scores(DASs)assessed skin and muscle involvement.Height and weight were compared with the N ational Health and Nutrition Examination Survey III dataset.Duration of untreat ed illness was designated as the time from first sign of rash or weakness to dia gnostic visit.Results:Boys and girls with untreated JDM were shorter and light er than national norms(P >.0005 for both),and nonwhite children were weaker than wh ite children(P >.0005).Older children had more dysphagia(P =.017)and arthr itis(P >.001).Duration of untreated JDM was negatively associated with DAS we akness(P >.0005),unrelated to DAS skin,and positively associated with pathol ogical calcifications(P =.006).With untreated disease < 4.7 months,serum lev els of 4 muscle enzymes(aldolase,lactic dehydrogenase,creatine kinase,serum glutamic-oxaloacetic transaminase/aspartate aminotransferase)tended toward nor mal(P >.01 for each).Conclusions:Duration of untreated symptoms is an import ant variable and should be included in decisions concerning both diagnostic crit eria and intensity of therapy for children with JDM.
Objective: To evaluate the impact of duration of untreated symptoms in childre n with juvenile dermatomyositis (JDM) on clinical and laboratory status at diagnosis. Study design: We examined physical and laboratory data from the first physician visit for 166 untreated children with JDM . Disease activity scores (DASs) of skin and muscle involvement. Height and weight were compared with the Nutritional Health and Nutrition Examination Survey III dataset. Duration of untreat ed illness was designated as the time from first sign of rash or weakness to dia gnostic visit. Results: Boys and girls with untreated JDM were shorter and light er than national norms (P> .0005 for both), and nonwhite children were weaker than wh ite children (P> .0005). Older children had more dysphagia (P = .017) and arthritis (P> .001). Duration of untreated JDM was negatively associated with DAS we akness (P> .0005), unrelated to DAS skin, and positively associated with pathol ogical calcifications (P = .006) .With untreated disease <4.7 months, serum lev els of 4 muscle enzymes (aldolase, lactic dehydrogenase, creatine kinase, serum glutamic-oxaloacetic transaminase / aspartate aminotransferase) tended toward nor mal (P> .01 for each) .Conclusions: Duration of untreated symptoms is an import ant variable and should be included in the dispute on both diagnostic crit eria and intensity of therapy for children with JDM.