Lymphedema in children associated with chronic arthritis

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Lymphedema in children associated with chronic arthritis

Postby patoco » Tue Oct 10, 2006 8:31 am

Idiopathic limb edema in children with chronic arthritis : A multicenter report of 12 cases

Auteur(s) / Author(s)
BARDARE M. ; FALCINI F. ; HERTZBERGER-TEN CATE R. ; SAVOLAINEN A. ; CIMAZ R.

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
First Pediatric Department, University of Milano, ITALIE
Pediatric Department, University of Firenze, ITALIE
University Hospital Leiden, PAYS-BAS
Rheumatism Foundation Hospital, Heinola, FINLANDE

Abstract

Lymphedema, a well known extraarticular manifestation of rheumatoid arthritis, has been rarely described in children with idiopathic chronic arthritis. We describe 12 cases of lymphedema and idiopathic arthritis of childhood seen at 4 different pediatric rheumatology centers. Eight patients were girls, 4 boys; the age at appearance of lymphedema ranged from 2.3 to 17 years. In all patients except one, lymphedema was localized to the lower limbs. The outcome of lymphedema was variable, but not always related to the arthritis course, and was mostly independent of any specific therapy. Lymphography was performed in only one patient, and revealed lack of lymphatic drainage in the affected leg. We conclude that the association of lymphedema and idiopathic arthritis of childhood is not rare; this association is unlikely to be coincidental, even though the pathogenetic mechanisms are currently not well understood.

Revue / Journal Title
Journal of rheumatology (J. rheumatol.) ISSN 0315-162X CODEN JRHUA9
Source / Source
1997, vol. 24, no2, pp. 384-388 (21 ref.)
Langue / Language
Anglais

Editeur / Publisher
Journal of Rheumatology Publishing, Toronto, ON, CANADA (1974) (Revue)

Keywords

Lymphedema ; Lower limb ; Association ; Juvenile rheumatoid arthritis ; Child ; Case study ; Prognosis ; Chronic ; Human ; Cardiovascular disease ; Lymphatic vessel disease ; Diseases of the osteoarticular system ; Inflammatory joint disease

http://cat.inist.fr/?aModele=afficheN&cpsidt=2578769

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Juvenile rheumatoid arthritis and lymphoedema: lymphangiographic aspects.

Schmit P, Prieur AM, Brunelle F.
Service de Radiopediatrie, Groupe Hospitalier Necker-Enfants-Malades, Paris, France.

We report a 5 1/2-year-old boy with juvenile rheumatoid arthritis (JRA) and lower-limb lymphoedema. US, MRI and lymphangiography were performed. Based on the lymphangiographic study, we propose a pathogenesis based on obstruction of normal superficial lymphatic vessels in the affected limb. This is discussed with other pathogenetic factors proposed in the 16 previously reported cases of lymphoedema complicating JRA.

PMID: 10382216 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/quer ... s=10382216

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Lymphedema of the leg associated with rheumatoid arthritis.

Lacroix HR, Gruwez JA, Casteels-Van Daele MC, Dequeker J.
Department of General Surgery, University Hospitals of Leuven, Belgium.

A 14-year-old boy with a two year history of seronegative rheumatoid arthritis developed left leg lymphedema and subsequently a severe episode of lymphangitis. The diagnosis of "rheumatoid lymphedema" was confirmed by lymphscintigraphy and conventional lymphography. Treatment consisted of bedrest and antibiotic drugs. When the signs of inflammation had subsided, therapy with corticosteroids was started with improvement of both joint pain and leg swelling. Whereas lymphedema associated with rheumatoid arthritis has been described in the upper limb of adults, to our knowledge this is the first report of the coexistent condition in the lower leg of a child.

PMID: 1921478 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/quer ... ds=1921478

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Lymphatic disorders in rheumatoid arthritis.

Joos E, Bourgeois P, Famaey JP.
Department of Rheumatology and Physical Medicine, Saint-Pierre Hospital, Universities of Brussels, Belgium.

Lymphedema is a rare complication of rheumatoid arthritis (RA). Diagnosis is clinical: long-standing, painful swelling of a whole limb in association with RA. Cases described in the literature are predominantly of the upper limbs, sometimes bilateral. Diagnosis can be confirmed by biopsy of lymph nodes, lymphography, or preferably lymphoscintigraphy. The etiology of the edema is unknown. Mechanical obstruction and lymphangitis have been suggested. Pharmacological and surgical treatment of the edema have been disappointing, and treatment of the underlying RA does not improve the lymphedema. Physical treatment of the affected limb, such as massage, manual drainage techniques, light compression bandaging, and exercise, has been moderately effective.

PMID: 8342046 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/quer ... ds=1921478

................

Lymphedema of the leg associated with rheumatoid arthritis.

Lacroix HR, Gruwez JA, Casteels-Van Daele MC, Dequeker J.
Department of General Surgery, University Hospitals of Leuven, Belgium.

A 14-year-old boy with a two year history of seronegative rheumatoid arthritis developed left leg lymphedema and subsequently a severe episode of lymphangitis. The diagnosis of "rheumatoid lymphedema" was confirmed by lymphscintigraphy and conventional lymphography. Treatment consisted of bedrest and antibiotic drugs. When the signs of inflammation had subsided, therapy with corticosteroids was started with improvement of both joint pain and leg swelling. Whereas lymphedema associated with rheumatoid arthritis has been described in the upper limb of adults, to our knowledge this is the first report of the coexistent condition in the lower leg of a child.

PMID: 1921478 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/quer ... ds=1921478

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