Joseph E. Levinson

Sarcoid arthritis in children.

Abstract The clinical features of the six cases of sarcoid arthritis here reported, and of the five previously recorded cases of sarcoid arthritis in childhood, appear to form a syndrome characterized by large, painless, boggy synovial and tendon sheath effusions with little limitation of motion, by typical eye and skin changes, and by an indolent clinical course with minimal or absent constitutional symptoms. These manifestations make it possible to distinguish sarcoid arthritis clinically from juvenile rheumatoid arthritis.

Nailfold capillary abnormalities in childhood rheumatic diseases

The nailfold capillary patterns of 84 patients with a variety of childhood rheumatic diseases and 34 normal control subjects were observed. Distinctive morphologic abnormalities with capillary dilation and dropout of surrounding structures were noted in two groups: patients with childhood dermatomyositis and with scleroderma (P less than 0.001). Among those with scleroderma, capillary abnormalities were found in all nine patients with systemic disease and in none of 10 patients with cutaneous disease only (Fishers exact P less than 0.001). Of 25 patients with dermatomyositis for whom muscle biopsies were available for analysis, abnormal nailfold capillary pattern was found with highest prevalence in patients with two or more specific vascular lesions noted on biopsy (Fishers exact P = 0.041). Nailfold capillary abnormalities are present in distinct populations of childhood rheumatic diseases, reflect the underlying vasculopathy of childhood dermatomyositis, and may be of diagnostic value in distinguishing localized from systemic scleroderma.

Anterior Uveitis in Kawasaki's Disease

Kawasakis disease (mucocutaneous lymph node syndrome) is an acute febrile illness primarily affecting children. Slit-lamp examinations of six children with kawasakis disease, ranging in age from 22 months to 16 years, showed that five had anterior uveitis during the acute phase of the illness. Two of the children were treated with corticosteroids and cycloplegic drugs and three received no treatment. In all five, the anterior uveitis resolved completely within a few weeks.

Follow-Up Ophthalmologic Examinations in Children with Kawasaki's Disease

We recalled 15 patients who had had Kawasakis disease with documented bilateral conjunctival injection but who had not undergone slit-lamp examinations during the acute phase of the illness. Although anterior uveitis has been found in the acute phase of Kawasakis disease, results of the follow-up studies (including slit-lamp examination, visual acuity testing, and assessment of pupillary reaction, muscle balance, and intraocular pressure) were normal in all 14 children.