Maria Francesca Gicchino

Association between cannabinoid receptor type 2 Q63R variant and oligo/polyarticular juvenile idiopathic arthritis

Objectives: To investigate whether the functional variant Q63R of the cannabinoid 2 (CB2) receptor is associated with susceptibility to oligo/poly-articular juvenile idiopathic arthritis (JIA) and with its clinical features. Method: A total of 171 Italian children with oligoarticular/rheumatoid factor negative poly-articular JIA and 600 healthy controls were enrolled in the study and genotyped. Results: A significant difference in genotype distribution of the CB2 Q63R variant (CNR2 rs35761398) between oligo/poly-articular JIA patients and controls was found (p = 0.001). The R63 variant was associated with increased rates of relapse (p = 0.0001). Conclusions: This study indicates that the CB2 receptor contributes to susceptibility to oligo/polyarticular JIA and to the severity of its clinical course.

Refractory rheumatoid factor positive polyarthritis in a female adolescent already suffering from type 1 diabetes mellitus and Hashimoto's thyroiditis successfully treated with etanercept.

Type 1 diabetes mellitus may be associated with many autoimmune diseases with the common autoimmune pathogenesis. We describe the case of a girl suffering from Type 1 diabetes mellitus and autoimmune Hashimotos thyroiditis since the childhood and, due to the onset of Juvenile Idiopathic Arthritis during adolescence, for three years practiced therapy with an anti-TNF drug, etanercept . Currently her inflammatory markers are normal, arthritis is inactive and diabetes is well controlled. During the treatment with anti-TNF drug we observed a significative reduction of insulin dose, probably due to an increased tissue sensitivity secondary to the suppression of the activity of TNF-alpha. Several clinical trials that have evaluated the effect of immunomodulatory agents in diabetic patients, especially in those with recent onset of disease, were already performed but further studies of longer duration on a larger population are needed to assess the role of biologic drugs and immunotherapy in this group of patients.

Refractory systemic juvenile idiopathic arthritis complicated by coxarthrosis

S-JIA has the worst long-term prognosis compared to other types of JIA. Corticosteroids, methotrexate and anti - tumor necrosis factor (TNF) are the most commonly used drugs for it. Recently, newer biologic agents targeting IL-1 and IL-6 have proven their effectiveness in treating s-JIA and in minimizing corticosteroid exposure.

Eosinophilic granuloma: case report

Lameness is a symptom very common in childhood, it depends on inflammatory, neoplastic, infective, orthopedic diseases.

The role of cannabinoid receptor 2 in oligo/poly-articular juvenile idiopathic arthritis

Juvenile Idiopathic Arthritis(JIA) is an inflammatory chronic disease concerning joints and others structures. According to International League of Association for Rheumatology (ILAR) seven subtypes of arthritis can be defined in relation with the number of joints and the extra-articular involvement occurring in the first six months of disease. Although JIA pathogenesis is not completely clear is known that T-cell activation is a feature of oligoarticular and polyarticular JIA. The endocannabinoid system is involved in immune regulation by reducing cells activation, modulating Th1 and Th2 balance, inhibiting proinflammatory cytokine production. T-cell and other cellular components of immune system express cannabinoid receptor 1 and 2 (CB1-CB2).

Five cases of rheumatic fever diagnosed after onset of Sydenham chorea

Acute Rheumatic fever is still a challenge for physicians, it is often not diagnosed at onset and adequately treated.

PReS-FINAL-2197: Teenage boy suffering from diabetes mellitus type 1 and heterozygous Familial Mediterranean Fever: a case report

It is known that type 1 diabetes mellitus (type 1 DM) maybe associated with other autoimmune diseases, such as autoimmune thyroid disease (ATD), celiac disease (CD) and Addisons disease (AD). We report the case of a patient with type 1 DM associated with familial mediterranean fever (FMF). It is the third association of these two diseases described in the medical literature to our knowledge so far.