Pediatric granulomatous arthritis: An international registry

Carlos D. Rosé, Carine H. Wouters, Silvia Meiorin, Trudy M. Doyle, Michael Davey, James (Jim) Rosenbaum, Tammy Martin

Research output: Contribution to journalArticle

134 Citations (Scopus)

Abstract

Objective. Blau syndrome and its sporadic counterpart, early-onset sarcoidosis, share an identical phenotype featuring the classic triad of arthritis, dermatitis, and uveitis and are associated with mutations of CARD15 in 50-90% of cases. We chose the term "pediatric granulomatous arthritis" to refer to both. An international registry was established in the spring of 2005 to define the phenotype spectrum and establish the mutation frequency and variants. Methods. Histologically confirmed granuloma and arthritis were required for inclusion. Probands and relatives were genotyped for CARD15. Deidentified clinical information was collected. Results. One year after the inception of the registry, 61 individuals from 22 pedigrees had been entered. Seven pedigrees with 19 individuals (8 affected, 11 unaffected) had clinical disease that was atypical, and none of the individuals in those pedigrees showed mutations. There were 9 classic simplex pediatric granulomatous arthritis pedigrees including 19 individuals (9 affected, 10 unaffected) and 6 classic multiplex pedigrees with 22 individuals (17 affected, 5 unaffected). Cutaneous presentation was the most common. Arthritis was polyarticular in 96% of patients. Isolated eye disease was never the presenting symptom, but significant/severe visual impairment was observed in 41% of patients. Eye disease was bilateral in 21 of 22 patients and was complicated by glaucoma in 6 of 22 patients and by cataracts in 50% of patients. Skin biopsy was the best diagnostic approach (because of accuracy and low invasiveness). Conclusion. In this series, the first combining familial and sporadic pedigrees and, to our knowledge, the largest, we further defined the phenotype and showed that all affected classic (and no nonclassic) pedigrees carry a mutation and that there is no asymptomatic carriage. If these data are confirmed, mutation analysis rather than tissue sampling may prove to be the most efficient diagnostic procedure.

Original languageEnglish (US)
Pages (from-to)3337-3344
Number of pages8
JournalArthritis and Rheumatism
Volume54
Issue number10
DOIs
StatePublished - Oct 2006

Fingerprint

Pedigree
Registries
Arthritis
Mutation
Eye Diseases
Phenotype
Skin
Vision Disorders
Uveitis
Dermatitis
Mutation Rate
Blau syndrome
Granuloma
Glaucoma
Cataract
Biopsy

ASJC Scopus subject areas

  • Immunology
  • Rheumatology

Cite this

Pediatric granulomatous arthritis : An international registry. / Rosé, Carlos D.; Wouters, Carine H.; Meiorin, Silvia; Doyle, Trudy M.; Davey, Michael; Rosenbaum, James (Jim); Martin, Tammy.

In: Arthritis and Rheumatism, Vol. 54, No. 10, 10.2006, p. 3337-3344.

Research output: Contribution to journalArticle

Rosé, Carlos D. ; Wouters, Carine H. ; Meiorin, Silvia ; Doyle, Trudy M. ; Davey, Michael ; Rosenbaum, James (Jim) ; Martin, Tammy. / Pediatric granulomatous arthritis : An international registry. In: Arthritis and Rheumatism. 2006 ; Vol. 54, No. 10. pp. 3337-3344.
@article{e544a37a17204de9a112b7bbcf7c242a,
title = "Pediatric granulomatous arthritis: An international registry",
abstract = "Objective. Blau syndrome and its sporadic counterpart, early-onset sarcoidosis, share an identical phenotype featuring the classic triad of arthritis, dermatitis, and uveitis and are associated with mutations of CARD15 in 50-90{\%} of cases. We chose the term {"}pediatric granulomatous arthritis{"} to refer to both. An international registry was established in the spring of 2005 to define the phenotype spectrum and establish the mutation frequency and variants. Methods. Histologically confirmed granuloma and arthritis were required for inclusion. Probands and relatives were genotyped for CARD15. Deidentified clinical information was collected. Results. One year after the inception of the registry, 61 individuals from 22 pedigrees had been entered. Seven pedigrees with 19 individuals (8 affected, 11 unaffected) had clinical disease that was atypical, and none of the individuals in those pedigrees showed mutations. There were 9 classic simplex pediatric granulomatous arthritis pedigrees including 19 individuals (9 affected, 10 unaffected) and 6 classic multiplex pedigrees with 22 individuals (17 affected, 5 unaffected). Cutaneous presentation was the most common. Arthritis was polyarticular in 96{\%} of patients. Isolated eye disease was never the presenting symptom, but significant/severe visual impairment was observed in 41{\%} of patients. Eye disease was bilateral in 21 of 22 patients and was complicated by glaucoma in 6 of 22 patients and by cataracts in 50{\%} of patients. Skin biopsy was the best diagnostic approach (because of accuracy and low invasiveness). Conclusion. In this series, the first combining familial and sporadic pedigrees and, to our knowledge, the largest, we further defined the phenotype and showed that all affected classic (and no nonclassic) pedigrees carry a mutation and that there is no asymptomatic carriage. If these data are confirmed, mutation analysis rather than tissue sampling may prove to be the most efficient diagnostic procedure.",
author = "Ros{\'e}, {Carlos D.} and Wouters, {Carine H.} and Silvia Meiorin and Doyle, {Trudy M.} and Michael Davey and Rosenbaum, {James (Jim)} and Tammy Martin",
year = "2006",
month = "10",
doi = "10.1002/art.22122",
language = "English (US)",
volume = "54",
pages = "3337--3344",
journal = "Arthritis and Rheumatology",
issn = "2326-5191",
publisher = "John Wiley and Sons Ltd",
number = "10",

}

TY - JOUR

T1 - Pediatric granulomatous arthritis

T2 - An international registry

AU - Rosé, Carlos D.

AU - Wouters, Carine H.

AU - Meiorin, Silvia

AU - Doyle, Trudy M.

AU - Davey, Michael

AU - Rosenbaum, James (Jim)

AU - Martin, Tammy

PY - 2006/10

Y1 - 2006/10

N2 - Objective. Blau syndrome and its sporadic counterpart, early-onset sarcoidosis, share an identical phenotype featuring the classic triad of arthritis, dermatitis, and uveitis and are associated with mutations of CARD15 in 50-90% of cases. We chose the term "pediatric granulomatous arthritis" to refer to both. An international registry was established in the spring of 2005 to define the phenotype spectrum and establish the mutation frequency and variants. Methods. Histologically confirmed granuloma and arthritis were required for inclusion. Probands and relatives were genotyped for CARD15. Deidentified clinical information was collected. Results. One year after the inception of the registry, 61 individuals from 22 pedigrees had been entered. Seven pedigrees with 19 individuals (8 affected, 11 unaffected) had clinical disease that was atypical, and none of the individuals in those pedigrees showed mutations. There were 9 classic simplex pediatric granulomatous arthritis pedigrees including 19 individuals (9 affected, 10 unaffected) and 6 classic multiplex pedigrees with 22 individuals (17 affected, 5 unaffected). Cutaneous presentation was the most common. Arthritis was polyarticular in 96% of patients. Isolated eye disease was never the presenting symptom, but significant/severe visual impairment was observed in 41% of patients. Eye disease was bilateral in 21 of 22 patients and was complicated by glaucoma in 6 of 22 patients and by cataracts in 50% of patients. Skin biopsy was the best diagnostic approach (because of accuracy and low invasiveness). Conclusion. In this series, the first combining familial and sporadic pedigrees and, to our knowledge, the largest, we further defined the phenotype and showed that all affected classic (and no nonclassic) pedigrees carry a mutation and that there is no asymptomatic carriage. If these data are confirmed, mutation analysis rather than tissue sampling may prove to be the most efficient diagnostic procedure.

AB - Objective. Blau syndrome and its sporadic counterpart, early-onset sarcoidosis, share an identical phenotype featuring the classic triad of arthritis, dermatitis, and uveitis and are associated with mutations of CARD15 in 50-90% of cases. We chose the term "pediatric granulomatous arthritis" to refer to both. An international registry was established in the spring of 2005 to define the phenotype spectrum and establish the mutation frequency and variants. Methods. Histologically confirmed granuloma and arthritis were required for inclusion. Probands and relatives were genotyped for CARD15. Deidentified clinical information was collected. Results. One year after the inception of the registry, 61 individuals from 22 pedigrees had been entered. Seven pedigrees with 19 individuals (8 affected, 11 unaffected) had clinical disease that was atypical, and none of the individuals in those pedigrees showed mutations. There were 9 classic simplex pediatric granulomatous arthritis pedigrees including 19 individuals (9 affected, 10 unaffected) and 6 classic multiplex pedigrees with 22 individuals (17 affected, 5 unaffected). Cutaneous presentation was the most common. Arthritis was polyarticular in 96% of patients. Isolated eye disease was never the presenting symptom, but significant/severe visual impairment was observed in 41% of patients. Eye disease was bilateral in 21 of 22 patients and was complicated by glaucoma in 6 of 22 patients and by cataracts in 50% of patients. Skin biopsy was the best diagnostic approach (because of accuracy and low invasiveness). Conclusion. In this series, the first combining familial and sporadic pedigrees and, to our knowledge, the largest, we further defined the phenotype and showed that all affected classic (and no nonclassic) pedigrees carry a mutation and that there is no asymptomatic carriage. If these data are confirmed, mutation analysis rather than tissue sampling may prove to be the most efficient diagnostic procedure.

UR - http://www.scopus.com/inward/record.url?scp=33750345391&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750345391&partnerID=8YFLogxK

U2 - 10.1002/art.22122

DO - 10.1002/art.22122

M3 - Article

C2 - 17009307

AN - SCOPUS:33750345391

VL - 54

SP - 3337

EP - 3344

JO - Arthritis and Rheumatology

JF - Arthritis and Rheumatology

SN - 2326-5191

IS - 10

ER -