| Abstract | Rheumatoid nodules are a rare extraarticular manifestation of juvenile rheumatoid arthritis (JRA), usually detected in patients with polyarticular-onset disease and positive rheumatoid factor (RF). To date, there has not been a published report of rheumatoid nodules in systemic-onset JRA. Low-dose methotrexate (MTX) is generally considered to be the most useful second-line drug in the treatment of polyarticular JRA. In adult RA, MTX has been shown to be associated with appearance and progression of rheumatoid nodules. This report describes a 3-year-old girl with RF-negative, antinuclear antibody-negative systemic JRA who developed multiple rheumatoid nodules on the scalp and trunk during MTX therapy. The first nodule developed on the scalp 6 months after MTX treatment was initiated. Previous treatment with azathioprine was not associated with nodulosis. This represents an atypical case of MTX-associated accelerated nodulosis in systemic JRA, and raises the problem of treatment plan modification in the presence of this side effect. |
| Authors | F Falcini, G Taccetti, M Ermini, S Trapani, A Calzolari, A Franchi, M M Cerinic
(Affiliation: University of Florence, Italy.)
|
| Journal | Arthritis and rheumatism
(Arthritis Rheum)
Vol. 40
Issue 1
Pg. 175-8
(Jan 1997)
ISSN: 0004-3591 UNITED STATES |
| PMID | 9008613
(Publication Type: Case Reports, Journal Article, Review)
|
| Chemical References |
- Antirheumatic Agents
- Methotrexate
|
| Topics |
- Antirheumatic Agents
(adverse effects)
- Arthritis, Juvenile Rheumatoid
(drug therapy)
- Child, Preschool
- Clinical Protocols
- Female
- Humans
- Methotrexate
(adverse effects)
- Necrosis
- Rheumatoid Nodule
(chemically induced, pathology)
|
