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Article ; Online: Complement inhibitor for therapy of CHAPLE.

Yu, Chack-Yung / Ardoin, Stacy P

2021 Volume 22, Issue 2, Page(s) 106–108

MeSH term(s)	Complement Inactivating Agents ; Immunologic Factors
Chemical Substances	Complement Inactivating Agents ; Immunologic Factors
Language	English
Publishing date	2021-01-04
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	2016987-5
ISSN	1529-2916 ; 1529-2908
ISSN (online)	1529-2916
ISSN	1529-2908
DOI	10.1038/s41590-020-00842-9
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Article ; Online: Transitions in Rheumatic Disease: Pediatric to Adult Care.

Ardoin, Stacy P

Pediatric clinics of North America

2018 Volume 65, Issue 4, Page(s) 867–883

Abstract: Although it has been widely acknowledged for more than two decades that transition from pediatric to adult care is a vulnerable time for adolescents and young adults with rheumatic diseases, current primary and subspecialty care transition and transfer ... ...

Abstract	Although it has been widely acknowledged for more than two decades that transition from pediatric to adult care is a vulnerable time for adolescents and young adults with rheumatic diseases, current primary and subspecialty care transition and transfer processes remain inadequate. Barriers to improving transition include complex health care systems, neurodevelopmental challenges of adolescents and young adults, and insufficient transition-related education and resources for health care providers. Standardized, evidence-based transition interventions are sorely needed to establish best practices. Quality improvement approaches such as the Six Core Elements of Health Care Transition offer opportunities to improve transition care for teens and young adults.
MeSH term(s)	Adolescent ; Europe ; Guidelines as Topic ; Humans ; Primary Health Care ; Quality Improvement ; Rheumatic Diseases/therapy ; Rheumatology ; Self-Management ; Transition to Adult Care/standards ; Young Adult
Language	English
Publishing date	2018-07-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	215711-1
ISSN	1557-8240 ; 0031-3955
ISSN (online)	1557-8240
ISSN	0031-3955
DOI	10.1016/j.pcl.2018.04.007
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Article ; Online: Outcome Measures in Pediatric Rheumatic Disease.

Ringold, Sarah / Consolaro, Alessandro / Ardoin, Stacy P

Rheumatic diseases clinics of North America

2021 Volume 47, Issue 4, Page(s) 655–668

Abstract: Reliable and responsive outcome measures that accurately detect changes in disease state, activity, and damage are crucial to conducting observational and interventional trials that can directly transform care for children with rheumatic disease. A ... ...

Abstract	Reliable and responsive outcome measures that accurately detect changes in disease state, activity, and damage are crucial to conducting observational and interventional trials that can directly transform care for children with rheumatic disease. A combination of consensus-based and direct measurement approaches has led to the development of several validated, composite outcome measures in juvenile idiopathic arthritis, juvenile dermatomyositis, childhood-onset systemic lupus erythematosus, and pediatric vasculitis. This review outlines clinician-reported, disease-specific outcome measures developed for these conditions.
MeSH term(s)	Arthritis, Juvenile/therapy ; Child ; Dermatomyositis/diagnosis ; Dermatomyositis/therapy ; Humans ; Lupus Erythematosus, Systemic/diagnosis ; Lupus Erythematosus, Systemic/therapy ; Outcome Assessment, Health Care ; Rheumatic Diseases/therapy
Language	English
Publishing date	2021-09-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	92118-x
ISSN	1558-3163 ; 0889-857X
ISSN (online)	1558-3163
ISSN	0889-857X
DOI	10.1016/j.rdc.2021.07.013
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Article ; Online: Assessing Bleeding Symptoms in Pediatric Patients With Generalized Joint Hypermobility.

Kendel, Nicole E / Stanek, Joseph R / Thomas, Bethanne B / Ardoin, Stacy P / O'Brien, Sarah H

Arthritis care & research

2023 Volume 75, Issue 8, Page(s) 1788–1794

Abstract: ... controls, defined as those without bleeding symptoms or a previously diagnosed bleeding disorder (P < 0.001 ...

Abstract	Objective: To assess bleeding symptoms in patients with generalized/benign joint hypermobility (GJH), compare bleeding scores to healthy historical pediatric controls, and determine whether a correlation exists between Beighton scores and bleeding scores. Methods: Patients with GJH ages 6-21 years seen by the rheumatology department at Nationwide Children's Hospital in Columbus, Ohio were eligible. Participants/guardians completed the International Society on Thrombosis and Haemostasis Bleeding Assessment Tool, a validated questionnaire defining the presence, severity, and frequency of bleeding symptoms. Scores of ≥3 have been associated with an underlying bleeding disorder in pediatric patients. Results: Eighty-one patients agreed to participate. The median age was 13 years (interquartile range 10-16 years), and the mean Beighton score was 6.3 (range 4-9). Commonly observed bleeding symptoms were oral bleeding (74%), easy bruising (59%), and bleeding with minor wounds (42%). Mean and median bleeding scores were 5.2 and 4, respectively, and were significantly higher than reported bleeding scores in pediatric controls, defined as those without bleeding symptoms or a previously diagnosed bleeding disorder (P < 0.001). Although 75% of patients (95% confidence interval 64-84) had an abnormal bleeding score, only 12.3% were previously assessed by hematology for bleeding symptoms. Among patients with GJH, higher Beighton scores were not associated with higher bleeding scores (Spearman's correlation -0.08). Conclusion: In a cohort of pediatric patients with GJH, three-fourths of participants had abnormal bleeding scores, with the mean bleeding score significantly elevated compared to healthy controls. We propose that screening for bleeding symptoms be integrated into routine care for GJH patients, with referral to hematology for patients with bleeding concerns.
MeSH term(s)	Humans ; Child ; Adolescent ; Joint Instability/complications ; Joint Instability/diagnosis ; Hemorrhage/diagnosis ; Hemorrhage/etiology ; Surveys and Questionnaires
Language	English
Publishing date	2023-02-18
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	645059-3
ISSN	2151-4658 ; 0893-7524 ; 2151-464X
ISSN (online)	2151-4658
ISSN	0893-7524 ; 2151-464X
DOI	10.1002/acr.25074
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Article ; Online: The potential role of Colchicine in preventing coronary vascular disease in childhood-onset lupus: a new view on an old drug.

Abel, Dori / Ardoin, Stacy P / Gorelik, Mark

Pediatric rheumatology online journal

2021 Volume 19, Issue 1, Page(s) 15

Abstract: Background: Patients with systemic lupus erythematous have a significantly increased risk of cardiovascular disease, which is not fully explained by traditional cardiovascular disease risk factors. Despite increasing life expectancy in patients with ... ...

Abstract	Background: Patients with systemic lupus erythematous have a significantly increased risk of cardiovascular disease, which is not fully explained by traditional cardiovascular disease risk factors. Despite increasing life expectancy in patients with systemic lupus erythematous, mortality due to cardiovascular disease, the major cause of death in these patients, has not changed. Children with lupus suffer from more aggressive disease compared to their adult counterparts, and there is a growing concern for their increased risk of cardiovascular disease as they age. BODY: There is an unmet need for therapies to address the increased risk of cardiovascular disease in childhood-onset lupus. Colchicine has many anti-inflammatory and cardiovascular protective properties, including inhibition of IL-1β and IL-18 activity, key proinflammatory cytokines that are predictive of future adverse cardiovascular events. In the Colchicine Cardiovascular Outcomes Trial (COLCOT), colchicine was recently found to have significant benefit with minimal risk in adults with previous myocardial infarction for prevention of secondary vascular disease. While adult studies are promising, no studies have been conducted in pediatric patients to investigate colchicine's potential for cardiovascular protection in children and adolescents with lupus. Conclusions: Studies investigating colchicine's potential role for cardiovascular protection are needed in pediatric patients with systemic lupus erythematous.
MeSH term(s)	Age of Onset ; Child ; Colchicine/pharmacology ; Coronary Artery Disease/etiology ; Coronary Artery Disease/prevention & control ; Heart Disease Risk Factors ; Humans ; Lupus Erythematosus, Systemic/complications ; Lupus Erythematosus, Systemic/drug therapy ; Lupus Erythematosus, Systemic/epidemiology ; Protective Agents/pharmacology
Chemical Substances	Protective Agents ; Colchicine (SML2Y3J35T)
Language	English
Publishing date	2021-02-16
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2279468-2
ISSN	1546-0096 ; 1546-0096
ISSN (online)	1546-0096
ISSN	1546-0096
DOI	10.1186/s12969-021-00504-6
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Article ; Online: Adolescents' and Young Adults' Recommendations for Implementing Healthcare Transition in Rheumatology: A Mixed Methods Study.

Carandang, Kristine / Wells, Courtney K / Guglielmo, Dana / Melcher, Katelyn / Trimble, Meghan / Ardoin, Stacy P / Chira, Peter

Arthritis care & research

2023 Volume 75, Issue 6, Page(s) 1228–1237

Abstract: Objective: The goal was to elicit adolescents' and young adults' (AYAs) perspectives about how to implement the Six Core Elements of Healthcare Transition within rheumatology care.: Methods: AYAs (ages 16-28 years old) with self-reported rheumatic ... ...

Abstract	Objective: The goal was to elicit adolescents' and young adults' (AYAs) perspectives about how to implement the Six Core Elements of Healthcare Transition within rheumatology care. Methods: AYAs (ages 16-28 years old) with self-reported rheumatic conditions were recruited through patient organizations and social media. In Phase One (qualitative [QUAL]), 90-minute focus groups were facilitated to elicit AYAs' reactions to Six Core Elements content. In Phase Two (quantitative; QUAN), a national survey was conducted to determine generalizability of recommendations extracted from Phase One. Mixed methods analyses were conducted by a multidisciplinary team of social science researchers, pediatric rheumatologists, and patients. Results: Although focus group participants (n = 39) were previously unfamiliar with the Six Core Elements, they reacted favorably to its format and content. Participants provided suggestions for how to logistically execute each component in the clinic. Additionally, 3 overarching recommendations emerged that focused on motivating AYAs to engage: 1) frame health care transition as an opportunity for empowerment; 2) implement a structured education plan; and 3) consider the role of parents. In line with qualitative findings, survey participants (n = 137) reported that they would prefer to learn most transitional skills from and discuss developmentally specific topics with their rheumatology team. Participants reported they would likely complete programs to learn transitional skills from allied professionals, via patient portals, or in group settings. Conclusion: Incorporating patient perspectives into research and clinical practice is an opportunity to strengthen educational programs. AYAs emphasized the importance of gaining independence and becoming empowered through the health care transition process with structured support from their rheumatology teams.
MeSH term(s)	Child ; Humans ; Young Adult ; Adolescent ; Adult ; Rheumatology ; Transition to Adult Care ; Patient Transfer ; Rheumatic Diseases/diagnosis ; Rheumatic Diseases/therapy ; Surveys and Questionnaires
Language	English
Publishing date	2023-02-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	645059-3
ISSN	2151-4658 ; 0893-7524 ; 2151-464X
ISSN (online)	2151-4658
ISSN	0893-7524 ; 2151-464X
DOI	10.1002/acr.24977
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Article ; Online: Atherosclerosis Progression in the APPLE Trial Can Be Predicted in Young People With Juvenile-Onset Systemic Lupus Erythematosus Using a Novel Lipid Metabolomic Signature.

Peng, Junjie / Dönnes, Pierre / Ardoin, Stacy P / Schanberg, Laura E / Lewandowski, Laura / Robinson, George / Jury, Elizabeth C / Ciurtin, Coziana

Arthritis & rheumatology (Hoboken, N.J.)

2023 Volume 76, Issue 3, Page(s) 455–468

Abstract: ... versus low CIMT progression had higher total (P = 0.001) and low-density lipoprotein (LDL) (P = 0.002 ...

Abstract	Objective: Patients with juvenile-onset systemic lupus erythematosus (JSLE) have increased atherosclerosis risk. This study investigated novel atherosclerosis progression biomarkers in the Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) trial, the largest investigator-led randomized control trial of atorvastatin versus placebo for atherosclerosis progression in JSLE, using carotid intima-media thickness (CIMT) as the primary outcome. Methods: Unsupervised clustering of baseline CIMT and CIMT progression over 36 months was used to stratify patients with JSLE. Disease characteristics, cardiovascular risk scores, and baseline serum metabolome were investigated in CIMT-stratified patients. Machine learning techniques were used to identify and validate a serum metabolomic signature of CIMT progression. Results: Baseline CIMT stratified patients with JSLE (N = 151) into three groups with distinct high, intermediate, and low CIMT trajectories irrespective of treatment allocation, despite most patients having low cardiovascular disease risk based on recommended assessment criteria. In the placebo group (n = 60), patients with high versus low CIMT progression had higher total (P = 0.001) and low-density lipoprotein (LDL) (P = 0.002) cholesterol levels, although within the reference range. Furthermore, a robust baseline metabolomic signature predictive of high CIMT progression was identified in the placebo arm (area under the curve, 80.7%). Patients treated with atorvastatin (n = 61) had reduced LDL cholesterol levels after 36 months, as expected; however, despite this, 36% still had high atherosclerosis progression, which was not predicted by metabolomic biomarkers, suggesting nonlipid drivers of atherosclerosis in JSLE with management implications for this subset of patients. Conclusion: Significant baseline heterogeneity and distinct subclinical atherosclerosis progression trajectories exist in JSLE. Metabolomic signatures can predict atherosclerosis progression in some patients with JSLE with relevance for clinical trial stratification.
MeSH term(s)	Humans ; Child ; Adolescent ; Atorvastatin/therapeutic use ; Carotid Intima-Media Thickness ; Atherosclerosis ; Lupus Erythematosus, Systemic/drug therapy ; Biomarkers ; Risk Factors ; Carotid Artery Diseases
Chemical Substances	Atorvastatin (A0JWA85V8F) ; Biomarkers
Language	English
Publishing date	2023-12-19
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2756371-6
ISSN	2326-5205 ; 2326-5191
ISSN (online)	2326-5205
ISSN	2326-5191
DOI	10.1002/art.42722
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Article ; Online: Hemophagocytic Lymphohistiocytosis, a Rare Presentation in Lupus Nephritis.

Li, Nicholas L / Kang, Rima / Ardoin, Stacy P / Ayoub, Isabelle

Kidney international reports

2020 Volume 6, Issue 3, Page(s) 842–845

Language	English
Publishing date	2020-12-13
Publishing country	United States
Document type	Case Reports
ISSN	2468-0249
ISSN (online)	2468-0249
DOI	10.1016/j.ekir.2020.11.036
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Article: Storming the castle: A case report of multi-system dysregulation in a child with Castleman disease.

DeMarsh, Samantha J / Kendel, Nicole E / Bacha, Christine / Ardoin, Stacy P / Kahwash, Samir / Rose, Melissa J

Clinical case reports

2022 Volume 10, Issue 2, Page(s) e05491

Abstract: Castleman disease is a non-clonal, lymphoproliferative disorder rarely seen in children. Presented is a 12-year-old male with progressive abdominal pain, vomiting, and fever. Diagnostic testing revealed multi-organ system involvement and the diagnosis ... ...

Abstract	Castleman disease is a non-clonal, lymphoproliferative disorder rarely seen in children. Presented is a 12-year-old male with progressive abdominal pain, vomiting, and fever. Diagnostic testing revealed multi-organ system involvement and the diagnosis was ultimately made with tissue biopsy. Marked disease regression occurred after high-dose steroids and continued interleukin-6 inhibition.
Language	English
Publishing date	2022-02-20
Publishing country	England
Document type	Case Reports
ZDB-ID	2740234-4
ISSN	2050-0904
ISSN	2050-0904
DOI	10.1002/ccr3.5491
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Article ; Online: Multisystem Inflammatory Syndrome in Children and Cardiac Involvement: A Quaternary Center Experience.

Cruz Vidal, Diego / Lee, Simon / Ardoin, Stacy P / Dalmacy, Djhenne / Chaparro, Juan / Blaney, Cristin / Rodriguez, Vilmarie / Sankar, Amanda / Akoghlanian, Shoghik / Lisciandro, Richard / Washam, Matthew / Abraham, Roshini S / Leber, Amy / Eby, Meika / Bennett, Berkeley / Erdem, Guliz

The Pediatric infectious disease journal

2024 Volume 43, Issue 5, Page(s) e160–e163

Abstract: We prospectively analyzed clinical and laboratory characteristics associated with cardiac involvement and severe presentation in multisystem inflammatory syndrome in children. Of 146 patients, 66 (45.2%) had cardiac dysfunction and 26 (17.8%) had ... ...

Abstract	We prospectively analyzed clinical and laboratory characteristics associated with cardiac involvement and severe presentation in multisystem inflammatory syndrome in children. Of 146 patients, 66 (45.2%) had cardiac dysfunction and 26 (17.8%) had coronary artery abnormalities. Lower serum albumin levels, absolute lymphocyte and platelet counts, and elevated ferritin, fibrinogen, d-dimer and interleukin-6 levels were associated with cardiac dysfunction. Possible treatment complications were identified.
MeSH term(s)	Child ; Humans ; COVID-19/complications ; Interleukin-6 ; Laboratories ; Heart Diseases ; Systemic Inflammatory Response Syndrome/diagnosis
Chemical Substances	Interleukin-6
Language	English
Publishing date	2024-02-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	392481-6
ISSN	1532-0987 ; 0891-3668
ISSN (online)	1532-0987
ISSN	0891-3668
DOI	10.1097/INF.0000000000004266
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