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Infection-Related Death among Persons with Refractory Juvenile Idiopathic Arthritis

Lookup NU author(s): Dr Mario Abinun, Dr Jonathan Lane, Dr Terence Flood, Emerita Professor Helen Foster

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This is the final published version of an article that has been published in its final definitive form by Centers for Disease Control and Prevention, 2016.

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Abstract

Severe infections are emerging as major risk factors for death among children with juvenile idiopathic arthritis (JIA). In particular, children with refractory JIA treated with long-term, multiple, and often combined immunosuppressive and antiinflammatory agents, including the new biological disease-modifying antirheumatic drugs (DMARDs), are at increased risk for severe infections and death. We investigated 4 persons with JIA who died during 1994-2013, three of overwhelming central venous catheter related bacterial sepsis caused by coagulase-negative Staphylococus or a-hemolytic Streptococcus infection and 1 of disseminated adenovirus and Epstein-Barr virus infection). All 4 had active JIA refractory to long-term therapy with multiple and combined conventional and biological DMARDs. Two died while receiving high-dose systemic corticosteroids, methotrexate, and after recent exposure to anti tumor necrosis factor-a biological DMARDs, and 2 during hematopoietic stem cell transplantation procedure. Reporting all cases of severe infections and especially deaths in these children is of paramount importance for accurate surveillance.


Publication metadata

Author(s): Abinun M, Lane JP, Wood M, Friswell M, Flood TJ, Foster HE

Publication type: Article

Publication status: Published

Journal: Emerging Infectious Diseases

Year: 2016

Volume: 22

Issue: 10

Pages: 1720-1727

Print publication date: 01/10/2016

Acceptance date: 15/09/2016

Date deposited: 01/12/2016

ISSN (print): 1080-6040

ISSN (electronic): 1080-6059

Publisher: Centers for Disease Control and Prevention

URL: http://dx.doi.org/10.3201/eid2210.151245

DOI: 10.3201/eid2210.151245


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Funding

Funder referenceFunder name
FSF 121301National Institute for Health Research Financial Management Group Flexibility and Sustainability Funding

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