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Article ; Online: Risk of Psychiatric Disorders in Juvenile Idiopathic Arthritis: Population- and Sibling-Controlled Cohort and Cross-Sectional Analyses.

Delcoigne, Bénédicte / Horne, AnnaCarin / Reutfors, Johan / Askling, Johan

ACR open rheumatology

2023 Volume 5, Issue 5, Page(s) 277–284

Abstract: Objective: The objective of this study was to examine the incidence and accumulated burden of psychiatric disorders in juvenile idiopathic arthritis (JIA) relative to the general population (GP) and to their same-sex siblings.: Methods: We performed ... ...

Abstract	Objective: The objective of this study was to examine the incidence and accumulated burden of psychiatric disorders in juvenile idiopathic arthritis (JIA) relative to the general population (GP) and to their same-sex siblings. Methods: We performed an observational register-based study from July 1, 2006, to December 31, 2020, with three different study population contrasts: 1) patients with incident JIA versus five age- and sex-matched GP individuals (cohort), 2) patients with incident JIA versus full same-sex siblings (cohort), and 3) patients with prevalent JIA at age 18 versus matched GP individuals (cross-sectional). We investigated six groups of psychiatric disorders defined via International Classification of Diseases, Tenth Revision codes: mood and anxiety, suicidal behavior, eating, sleeping, substance use, psychotic, plus an overall combined outcome (ie, at least one of the six). Incidences rates were compared through Cox regression (contrasts 1 and 2) and logistic regression (contrast 3), all adjusted for demographics, comorbidities, and proxies for socioeconomic status. Results: During 25,141 person-years of follow-up of 4939 incident patients with JIA, the incidence of the overall combined outcome was 20.1 per 1000 person-years in patients with JIA versus 13.1 per 1000 person-years in the GP (adjusted hazard ratio [HR] = 1.49 [95% confidence interval: 1.35-1.65]). The three most elevated HRs were obtained for sleeping disorder (1.91 [1.41-2.59]), suicidal behavior (1.60 [1.23-2.07]), and mood and anxiety disorders (1.46 [1.30-1.64]). The comparison of patients with JIA (n = 1815) with their siblings (n = 2050) for the overall combined outcome resulted in a nonstatistically significant HR (1.16 [0.82-1.64]). By age 18, patients with JIA were more likely to have been diagnosed with any psychiatric disorder (adjusted odds ratio = 1.37 [1.25-1.50]). Conclusion: There is an increased burden of psychiatric morbidity in JIA, which holds both individual and familial components.
Language	English
Publishing date	2023-05-12
Publishing country	United States
Document type	Journal Article
ISSN	2578-5745
ISSN (online)	2578-5745
DOI	10.1002/acr2.11549
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Article ; Online: Hyperinflammation hos barn kan ha samband med covid-19.

Horne, AnnaCarin / Nordenhäll, Lotta

Lakartidningen

2020 Volume 117

Abstract: Clinical manifestations of COVID-19 in children are generally mild and many are asymptomatic. However, recent international reports have described clusters of children presenting with an unusual syndrome of high, persistent fever, severe inflammation and ...

Title translation	Severe inflammation in children - cause for awareness during the current pandemic.
Abstract	Clinical manifestations of COVID-19 in children are generally mild and many are asymptomatic. However, recent international reports have described clusters of children presenting with an unusual syndrome of high, persistent fever, severe inflammation and single- or multiorgan dysfunction, with a suspected association to COVID-19 pandemic. It is recommended that clinicians are aware of this rare syndrome and that suspected cases are treated in a multidisciplinary setting.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Child ; Coronavirus Infections/complications ; Coronavirus Infections/immunology ; Humans ; Inflammation ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/immunology ; SARS-CoV-2
Keywords	covid19
Language	Swedish
Publishing date	2020-06-05
Publishing country	Sweden
Document type	Journal Article
ZDB-ID	391010-6
ISSN	1652-7518 ; 0023-7205
ISSN (online)	1652-7518
ISSN	0023-7205
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Article: Severe inflammation in children - cause for awareness during the current pandemic/ Hyperinflammation hos barn kan ha samband med covid-19

Horne, AnnaCarin / Nordenhall, Lotta

Lakartidningen

Abstract: Clinical manifestations of COVID-19 in children are generally mild and many are asymptomatic However, recent international reports have described clusters of children presenting with an unusual syndrome of high, persistent fever, severe inflammation and ... ...

Abstract	Clinical manifestations of COVID-19 in children are generally mild and many are asymptomatic However, recent international reports have described clusters of children presenting with an unusual syndrome of high, persistent fever, severe inflammation and single- or multiorgan dysfunction, with a suspected association to COVID-19 pandemic It is recommended that clinicians are aware of this rare syndrome and that suspected cases are treated in a multidisciplinary setting
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #600998
Database	COVID19

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Article: [Severe inflammation in children - cause for awareness during the current pandemic]

Horne, AnnaCarin / Nordenhall, Lotta

Lakartidningen

Abstract	Clinical manifestations of COVID-19 in children are generally mild and many are asymptomatic However, recent international reports have described clusters of children presenting with an unusual syndrome of high, persistent fever, severe inflammation and single- or multiorgan dysfunction, with a suspected association to COVID-19 pandemic It is recommended that clinicians are aware of this rare syndrome and that suspected cases are treated in a multidisciplinary setting
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #600997
Database	COVID19

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Article ; Online: Juvenile idiopathic arthritis, marriage and parenthood: a nationwide matched cohort study.

Bruze, Gustaf / Askling, Johan / Horne, AnnaCarin / Neovius, Martin

Rheumatology (Oxford, England)

2021 Volume 61, Issue 3, Page(s) 1228–1232

Abstract: Objectives: To compare trajectories of marriage and parenthood in individuals with JIA vs the general population.: Methods: Patients with JIA (n = 4399) were identified in the Swedish National Patient Register (2001-2016) and individually matched to ... ...

Abstract	Objectives: To compare trajectories of marriage and parenthood in individuals with JIA vs the general population. Methods: Patients with JIA (n = 4399) were identified in the Swedish National Patient Register (2001-2016) and individually matched to up to five general population comparators on birthyear, sex and residence county (n = 21 981). Marriage and parenthood data were retrieved from the Total Population Register from age 18 y, and parenthood from the Multigeneration Register from age 15 y, respectively. Hazard ratios (HRs) were estimated using Cox regression adjusted for parental education, parental marital status and number of siblings. Results: During a median of 6.3 years of follow-up, 362 patients with JIA and 1744 comparators got married (12.9 vs. 12.5 per 1000 person-years; HR 1.03, 95%CI 0.93-1.15). During a median of 8.8 years of follow-up, 680 patients with JIA and 3477 matched comparators became parents (17.1 vs 17.8 per 1000 person-years; HR 0.94, 95%CI 0.87-1.01). In the subgroup of patients with systemic onset JIA (SJIA), the adjusted hazard ratios for marriage and parenthood were 0.79 (95%CI 0.53-1.17) and 0.73 (95%CI 0.55-0.97), respectively. Conclusion: The times to first marriage and first parenthood are similar for patients with JIA and the general population, suggesting that adolescents with JIA transition into family life along a trajectory resembling their community peers. One exception is the subgroup of patients with systemic onset JIA, who become parents for the first time at a lower rate than general population comparators.
MeSH term(s)	Adult ; Arthritis, Juvenile/epidemiology ; Cohort Studies ; Female ; Humans ; Male ; Marital Status/statistics & numerical data ; Marriage/statistics & numerical data ; Parents ; Registries ; Sweden/epidemiology ; Young Adult
Language	English
Publishing date	2021-07-07
Publishing country	England
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1464822-2
ISSN	1462-0332 ; 1462-0324
ISSN (online)	1462-0332
ISSN	1462-0324
DOI	10.1093/rheumatology/keab536
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Article ; Online: Juvenile idiopathic arthritis and risk of cancer before and after the introduction of biological therapies.

Horne, AnnaCarin / Delcoigne, Bénédicte / Palmblad, Karin / Askling, Johan

RMD open

2019 Volume 5, Issue 2, Page(s) e001055

Abstract: Background: The risk of cancer, including any secular trends in risk, in patients with juvenile idiopathic arthritis (JIA) is incompletely understood.: Methods: We performed a register-based cohort study of patients with JIA from 2001 until 2017, ... ...

Abstract	Background: The risk of cancer, including any secular trends in risk, in patients with juvenile idiopathic arthritis (JIA) is incompletely understood. Methods: We performed a register-based cohort study of patients with JIA from 2001 until 2017, identified via the Swedish Patient Register. Patients with JIA were matched to five population reference subjects. Patients and referents were followed up for incident cancers (via linkage to the Swedish Cancer Register) until 18 years of age or 31 December 2016. Results: Among the 6721 patients with JIA, we observed 10 incident malignancies (5 lymphoproliferative cancers) during 34 951 person-years of follow-up, corresponding to an excess incidence of 0.09 cancers per 1000 person-years (one extra case per 11 000 patients per year), an HR for cancer (all sites) of 1.4 (95% CI 0.7 to 2.9) and an HR for lymphoproliferative malignancies of 3.6 (95% CI 1.1 to 11.2). The rates of cancer in JIA did not increase over the study period. We noted no differences in the excess risk comparing periods before and after the introduction of biologic disease-modifying antirheumatic drugs (bDMARDs). Discussion: Children and adolescents with JIA are at a slightly increased risk of lymphoproliferative (but not of other) malignancies. At the group level, there is no sign that this risk has increased further after the introduction of bDMARDs.
MeSH term(s)	Adolescent ; Antirheumatic Agents/therapeutic use ; Arthritis, Juvenile/complications ; Arthritis, Juvenile/drug therapy ; Arthritis, Juvenile/immunology ; Biological Products/therapeutic use ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Hematologic Neoplasms/epidemiology ; Hematologic Neoplasms/immunology ; Humans ; Incidence ; Lymphoproliferative Disorders/epidemiology ; Lymphoproliferative Disorders/immunology ; Male ; Registries/statistics & numerical data ; Sweden/epidemiology
Chemical Substances	Antirheumatic Agents ; Biological Products
Language	English
Publishing date	2019-11-13
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2812592-7
ISSN	2056-5933 ; 2056-5933
ISSN (online)	2056-5933
ISSN	2056-5933
DOI	10.1136/rmdopen-2019-001055
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Article ; Online: A Two-to-Five Year Follow-Up of a Pediatric Acute-Onset Neuropsychiatric Syndrome Cohort.

Gromark, Caroline / Hesselmark, Eva / Djupedal, Ida Gebel / Silverberg, Maria / Horne, AnnaCarin / Harris, Robert A / Serlachius, Eva / Mataix-Cols, David

Child psychiatry and human development

2021 Volume 53, Issue 2, Page(s) 354–364

Abstract: Little is known about the long-term prognosis of children with pediatric acute-onset neuropsychiatric syndrome (PANS). Out of the 46 eligible patients from the Karolinska PANS cohort, 34 consented to participate in a follow-up (median 3.3 years). ... ...

Abstract	Little is known about the long-term prognosis of children with pediatric acute-onset neuropsychiatric syndrome (PANS). Out of the 46 eligible patients from the Karolinska PANS cohort, 34 consented to participate in a follow-up (median 3.3 years). Participants underwent a thorough clinical evaluation and were classified according to their clinical course. Resulting groups were compared on clinical characteristics and laboratory test results. We observed significant reductions in clinician-rated PANS symptom severity and improved general function. Two patients were classified as remitted, 20 as relapsing-remitting, and 12 as having a chronic-static/progressive course. The latter group had an earlier onset, greater impairment and received more pharmacological and psychological treatments. Although remission was rare, the majority of children with PANS were significantly improved over the follow-up period but a non-negligible minority of patients displayed a chronic-static/progressive course and required additional treatments. The proposed definitions of flare and clinical course may be useful in future clinical trials.
MeSH term(s)	Autoimmune Diseases/diagnosis ; Autoimmune Diseases/drug therapy ; Child ; Follow-Up Studies ; Humans ; Obsessive-Compulsive Disorder/diagnosis ; Streptococcal Infections/diagnosis ; Streptococcal Infections/drug therapy
Language	English
Publishing date	2021-02-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	223895-0
ISSN	1573-3327 ; 0009-398X
ISSN (online)	1573-3327
ISSN	0009-398X
DOI	10.1007/s10578-021-01135-4
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Article ; Online: Establishing a Pediatric Acute-Onset Neuropsychiatric Syndrome Clinic: Baseline Clinical Features of the Pediatric Acute-Onset Neuropsychiatric Syndrome Cohort at Karolinska Institutet.

Gromark, Caroline / Harris, Robert A / Wickström, Ronny / Horne, AnnaCarin / Silverberg-Mörse, Maria / Serlachius, Eva / Mataix-Cols, David

Journal of child and adolescent psychopharmacology

2019 Volume 29, Issue 8, Page(s) 625–633

Abstract: Objectives: ...

Abstract	Objectives:
MeSH term(s)	Ambulatory Care Facilities ; Autoimmune Diseases/diagnosis ; Child ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Obsessive-Compulsive Disorder/complications ; Obsessive-Compulsive Disorder/diagnosis ; Sweden
Language	English
Publishing date	2019-06-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	1055410-5
ISSN	1557-8992 ; 1044-5463
ISSN (online)	1557-8992
ISSN	1044-5463
DOI	10.1089/cap.2018.0127
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Article ; Online: Macrophage activation syndrome in the era of biologic therapy.

Grom, Alexei A / Horne, AnnaCarin / De Benedetti, Fabrizio

Nature reviews. Rheumatology

2016 Volume 12, Issue 5, Page(s) 259–268

Abstract: Macrophage activation syndrome (MAS) refers to acute overwhelming inflammation caused by a 'cytokine storm'. Although increasingly recognized as a life-threatening complication of various rheumatic diseases, clinically, MAS is strikingly similar to ... ...

Abstract	Macrophage activation syndrome (MAS) refers to acute overwhelming inflammation caused by a 'cytokine storm'. Although increasingly recognized as a life-threatening complication of various rheumatic diseases, clinically, MAS is strikingly similar to primary and secondary forms of haemophagocytic lymphohistiocytosis (HLH). Not surprisingly, many rheumatologists prefer the term secondary HLH rather than MAS to describe this condition, and efforts to change the nomenclature are in progress. The pathophysiology of MAS remains elusive, but observations in animal models, as well as data on the effects of new anticytokine therapies on rates and clinical presentations of MAS in patients with systemic juvenile idiopathic arthritis (sJIA), provide clues to the understanding of this perplexing clinical phenomenon. In this Review, we explore the latest available evidence and discuss potential diagnostic challenges in the era of increasing use of biologic therapies.
MeSH term(s)	Animals ; Antibodies, Monoclonal/therapeutic use ; Antibodies, Monoclonal, Humanized/therapeutic use ; Antirheumatic Agents/therapeutic use ; Arthritis, Juvenile/drug therapy ; Arthritis, Juvenile/immunology ; Biological Products/therapeutic use ; Disease Models, Animal ; Humans ; Interferon-gamma/immunology ; Interleukin 1 Receptor Antagonist Protein/therapeutic use ; Interleukin-18/immunology ; Interleukin-1beta/immunology ; Interleukin-6/immunology ; Lymphohistiocytosis, Hemophagocytic/drug therapy ; Lymphohistiocytosis, Hemophagocytic/immunology ; Macrophage Activation Syndrome/drug therapy ; Macrophage Activation Syndrome/immunology ; Recombinant Fusion Proteins/therapeutic use
Chemical Substances	Antibodies, Monoclonal ; Antibodies, Monoclonal, Humanized ; Antirheumatic Agents ; Biological Products ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-18 ; Interleukin-1beta ; Interleukin-6 ; Recombinant Fusion Proteins ; canakinumab (37CQ2C7X93) ; Interferon-gamma (82115-62-6) ; rilonacept (8K80YB5GMG) ; tocilizumab (I031V2H011)
Language	English
Publishing date	2016-03-24
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural
ZDB-ID	2491532-4
ISSN	1759-4804 ; 1759-4790
ISSN (online)	1759-4804
ISSN	1759-4790
DOI	10.1038/nrrheum.2015.179
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Article ; Online: Risk factors for multisystem inflammatory syndrome in children - A population-based cohort study of over 2 million children.

Rhedin, Samuel / Lundholm, Cecilia / Horne, AnnaCarin / Smew, Awad I / Osvald, Emma Caffrey / Haddadi, Araz / Alfvén, Tobias / Kahn, Robin / Król, Petra / Brew, Bronwyn Haasdyk / Almqvist, Catarina

The Lancet regional health. Europe

2022 Volume 19, Page(s) 100443

Abstract: Background: Although severe acute COVID-19 is rare in children, SARS-CoV-2 infection can trigger the novel post-infectious condition multisystem inflammatory syndrome in children (MIS-C). Increased knowledge on risk factors for MIS-C could improve our ... ...

Abstract	Background: Although severe acute COVID-19 is rare in children, SARS-CoV-2 infection can trigger the novel post-infectious condition multisystem inflammatory syndrome in children (MIS-C). Increased knowledge on risk factors for MIS-C could improve our understanding of the pathogenesis of the condition and better guide targeted public health interventions. The aim of the study was to assess risk factors for MIS-C with the aim to identify vulnerable children. Methods: A register-based cohort study including all children and adolescents <19 years born in Sweden between March 1, 2001- December 31, 2020 was performed. Data on sociodemographic risk factors and comorbidities (sex, age, parental region of birth, parental education, asthma, autoimmune disease, chromosomal anomalies, chronic heart disease, chronic lung disease, obesity, life-limiting condition) were retrieved from national health and population registers. The outcome was MIS-C diagnosis according to the Swedish Pediatric Rheumatology Quality Register during March 1, 2020 - December 8, 2021.Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox regression analysis. Incidence rates per 100 000 person-years were calculated assuming a Poisson distribution. Findings: Among 2 117 443 children included in the study, 253 children developed MIS-C, corresponding to an incidence rate of 6·8 (95% CI: 6·0-7·6) per 100 000 person-years. Male sex (HR 1·65, 95% CI: 1·28-2·14), age 5-11 years (adjusted HR 1·44, 95% CI: 1·06-1·95 using children 0-4 years as reference), foreign-born parents (HR 2·53, 95% CI: 1·93-3·34), asthma (aHR 1·49, 95% CI: 1·00-2·20), obesity (aHR 2·15, 95% CI: 1·09-4·25) and life-limiting conditions (aHR 3·10, 95% CI: 1·80-5·33) were associated with MIS-C. Children 16-18 years had a reduced risk for MIS-C (aHR 0·45, 95% CI: 0·24-0·85). Interpretation: We report increased risks for MIS-C in children with male sex, age 5-11 years, foreign-born parents, asthma, obesity, and life-limiting condition. Knowing these risk populations might facilitate identification of children with MIS-C and potentially guide targeted public health interventions. Nevertheless, the absolute risks for MIS-C were very low. Funding: Financial support was provided from the Swedish Research Council (grant no 2018-02640), the Swedish Heart-Lung Foundation (grant no 20210416), the Asthma and Allergy Association, Ake Wiberg foundation, the Samariten Foundation, the Society of Child Care, and Region Stockholm.
Language	English
Publishing date	2022-06-22
Publishing country	England
Document type	Journal Article
ISSN	2666-7762
ISSN (online)	2666-7762
DOI	10.1016/j.lanepe.2022.100443
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