Citations 2
EULAR /American College of Rheumatology Classification Criteria for Pediatric Chronic Nonbacterial Osteomyelitis
Zhao, Yongdong , Oliver, Melissa , Schnabel, Anja , Wang, Zhaoyi , Marino, Achille , Aguiar, Cassyanne L. , Akikusa, Jonathan , Akça, Ümmüşen Kaya , Almeida, Beverley, Appenzeller, Simone , Balay‐Dustrude, Erin , Bilginer, Yelda , Cabral, David A. , Capponi, Martina , Donaldson, Nathan , Egeli, Buğra Han , Iyer, Ramesh S. , Jansson, Annette, Kostik, Inna , Kostik, Mikhail M. , Kovalick, Leonard K., Kozu, Kátia Tomie , Lee, Tzielan , Mahmood, Kamran , Muse, Ian, Mushkin, Alexander, Nowicki, Katherine D. , Nuruzzaman, Farzana , Pham, Trang Sophia, Potts, Lauren, Ramanan, Athimalaipet V., Rogers, Nathan D. , Grim, Andrew W. , Romano, Micol , Rosenwasser, Natalie , Sato, T. Shawn , Soep, Jennifer B. , Stern, Sara , Strauß, Timmy , Taneja, A. , Theos, Alexander C. , Tucker, Lori B. , Vogel, Lisa, Yasin, Shima , Wong, Stephen C. , Bouchalová, Kateřina , Hendry, Alison M., Cain, Kevin C. , Girschick, Hermann , Hedrich, Christian M. , Laxer, Ronald M. , Ferguson, Polly J. , Naden, Raymond P., Özen, Seza , Oliver, Melissa S , Akca, Ummusen Kaya , Appenzeller, Simone , Balay-Dustrude, Erin , Basiaga, Matthew L. , Kostik, Mikhail , Lapidus, Sivia K , Marrani, Edoardo , Mosa, Doaa Mosad , Nowicki, Katherine D , Pardeo, Manuela , Potts, Lauren , Ravelli, Angelo , Tucker, Lori B , Dedeoglu, Fatma , Hedrich, Christian M , Ozen, Seza , Wu, Eveline Y. , Başaran, Özge , Fox, Emily J., Insalaco, Antonella , Lapidus, Sivia , Lenert, Aleksander , Mahmood, Kamran, Mushkin, Alexander, Onel, Karen , Pham, Trang Sophia, Ramanan, Athimalaipet Vaidyanathan , Simonini, Gabriele , Dedeoğlu, Fatma
Arthritis & Rheumatology | May 8, 2025 | Volume: 78 | Issue: 3 | Pages: 537-547
Objective To develop and validate classification criteria for pediatric chronic nonbacterial osteomyelitis (CNO) jointly supported by EULAR and the American College of Rheumatology (ACR). Methods This international initiative had 4 phases: (1) candidate items were proposed in a survey of pediatric rheumatologists, (2) criteria definition and reduction by Delphi and nominal group technique exercises, (3) criteria weighting using multicriteria decision analysis, and (4) refinement of weights and threshold score in a development cohort of 441 patients and validation in another cohort of 514 patients. Results The new EULAR/ACR classification criteria for CNO require typical radiographic or magnetic resonance imaging findings and bone pain as an obligatory entry criterion and exclusion criteria of malignancy, infection, vitamin C deficiency, and hypophosphatasia, followed by additive weighted criteria in 5 clinical (site of bone lesions, pattern of bone lesions, age at onset, coexisting conditions, fever) and 4 pathology/laboratory domains (bone biopsy findings if done, anemia, C‐reactive protein level, and erythrocyte sedimentation rate). A total score ≥55 is required for classification as CNO. The new criteria had a sensitivity of 82% and specificity of 98% in the validation cohort. Conclusion These new classification criteria for pediatric CNO developed with international input reflect current views about CNO, have high specificity and good sensitivity, and provide a key foundation for future CNO research.
Childhood Sjögren syndrome: features of an international cohort and application of the 2016 ACR/EULAR classification criteria
Basiaga, Matthew L. , Stern, Sara , Edens, Cuoghi , Randell, Rachel L. , Pomorska, Anna , Ibarra, Maria, Nicolai, Rebecca , Sušić, Gordana , Boneparth, Alexis , Dizon, Brian , Kamdar, Ankur, Goldberg, Baruch R., Knupp-Oliveira, Sheila, Mosquera, Juan Manuel , Appenzeller, Simone , O’Neil, Kathleen M., Protopapas, Stella , Saad‐Magalhães, Claudia , Akikusa, Jonathan , Thatayatikom, Akaluck , Cha, Seunghee , Nieto‐González, Juan Carlos , Lo, Mindy S. , Lieberman, Scott M. , Randell, Rachel L , Mehta, Jay , Irga‐Jaworska, Ninela , Bracaglia, Claudia , Srinivasalu, Hemalatha , Antón, Jordi , Treemarcki, Erin , Yokogawa, Naoto
Rheumatology | October 28, 2020 | Volume: 60 | Issue: 7 | Pages: 3144-3155
Abstract Objective Sjögren syndrome in children is a poorly understood autoimmune disease. We aimed to describe the clinical and diagnostic features of children diagnosed with Sjögren syndrome and explore how the 2016 ACR/EULAR classification criteria apply to this population. Methods An international workgroup retrospectively collected cases of Sjögren syndrome diagnosed under 18 years of age from 23 centres across eight nations. We analysed patterns of symptoms, diagnostic workup, and applied the 2016 ACR/EULAR classification criteria. Results We identified 300 children with Sjögren syndrome. The majority of patients n = 232 (77%) did not meet 2016 ACR/EULAR classification criteria, but n = 110 (37%) did not have sufficient testing done to even possibly achieve the score necessary to meet criteria. Even among those children with all criteria items tested, only 36% met criteria. The most common non-sicca symptoms were arthralgia [n = 161 (54%)] and parotitis [n = 140 (47%)] with parotitis inversely correlating with age. Conclusion Sjögren syndrome in children can present at any age. Recurrent or persistent parotitis and arthralgias are common symptoms that should prompt clinicians to consider the possibility of Sjögren syndrome. The majority of children diagnosed with Sjögren syndromes did not meet 2016 ACR/EULAR classification criteria. Comprehensive diagnostic testing from the 2016 ACR/EULAR criteria are not universally performed. This may lead to under-recognition and emphasizes a need for further research including creation of paediatric-specific classification criteria.