Background: Influenza vaccination in children with juvenile idiopathic arthritis is often recommended, but not frequently performed. The aim of the study was to assess the efficacy of annual influenza vaccination and adverse events after vaccination. Influence of influenza vaccination on diseases activity was evaluated. According to results of the study on induction of autoantibodies in apparently healthy adults after influenza vaccination, the second aim was also to asses the induction of autoantibodies after influenza vaccination in children with juvenile idiopathic arthritis. Methods: Thirty-one children with stable juvenile idiopathic arthritis (10 boys, 21 girls, mean age 11.0 years) receiving various therapies and 14 children in a control group (10 boys, 4 girls, mean age 11.9 years), followed at Cardiology outpatient service at University children’s hospital Ljubljana for congenital cardiac disease or investigated for suspected cardiac disease, were vaccinated with the annual influenza vaccine Begrivac® 2008/2009. The efficacy of influenza vaccination was evaluated by determination of the number of infectious episodes with influenza during the 6-month period after the vaccination and by the immunogenicity of the influenza vaccine. Viral infections were followed by oral and nasal swabs analysis. In a case of infectious episode swabs were taken by parents according to precise instructions. Protective antibodies against three vaccine viruses were determined in serial samples taken before, 1 month and 6 months after vaccination. Children in both groups were followed for adverse events 6 months after vaccination. ANA, anti-ENA, ANCA, IgG/IgM aCL, IgG/IgM/IgA anti-β2-GPI autoantibodies and LA production was determined in serial samples taken before, 1 month and 6 months after vaccination. The activity of juvenile idiopathic arthritis was followed in an observational time of 6 months after vaccination. To better asses the impact of influenza vaccination on disease activity, group of 31 unvaccinated children with juvenile idiopathic arthritis (13 boys, 18 girls, mean age 8.0 years) was included in the study. Results: There was no statistically significant difference in the rate of influenza infection between the children with juvenile idiopathic arthritis and children in the control group. Three children got influenza infection in the observational period of 6 months after vaccination. The response to vaccination after one month was significant for all three influenza vaccine viruses in the control group and in the group of children with JIA as a whole, but not in a subgroup of 4 children receiving anti-TNFα therapy. After six months, no significant differences in the protective titers against vaccine viruses among the patient and control groups were observed. Eleven (35%) children with juvenile idiopathic arthritis and five (36%) children in the control group reported short-term adverse events. Changes in the mean values of autoantibodies after vaccination were found only for IgG anticardiolipin antibodies in the study group of children with juvenile idiopathic arthrtitis but the difference was not statistically significant (p=0.05). A juvenile idiopathic arthritis flare was observed one month after vaccination in 4 (13%) patients, and in the following five months in 7 (23%) patients. Conclusion: Vaccination against influenza was effective in a study group of children with juvenile idiopathic arthritis. Protective antibodies against at least two vaccine viruses 6 months after vaccination were detected in all patients. Protective antibodies against three vaccine viruses 6 months after vaccination were detected in 24 (77%) children with juvenile idiopathic arthritis. Thirty-five percent of children with juvenile idiopathic arthritis experienced flare of the disease in an observational time of 6 months after vaccination.
D.09 Tutoring for postgraduate students
COBISS.SI-ID: 265013248Objective: To propose a common nomenclature to refer to individuals who fulfillthe American College of Rheumatology classification criteria for systemic lupus erythematosus (SLE) during childhood or adolescence. Methods: The medical literature was reviewed for studies conducted in the target population between 1960 and December 2011 to obtain information about the terms used to refer to such children and adolescents. We reviewed the threshold ages used and disease features considered to discriminate these individuals from patients with onset of SLE during adulthood. Furthermore, thenomenclature used in other chronic diseases with onset during both childhood and adulthood was assessed. Results: There was an astonishing variability in the age cutoffs used to define SLE onset prior to adulthood, ranging from 14-21 years, but most studies used age 18 years. The principal synonyms in the medical literature were SLE without reference to the age at onset of disease, childhood-onset SLE, juvenile SLE, and pediatric (or paediatric) SLE. Conclusion: Based on the definition of childhood, in analogy with other complex chronic diseases commencing prior to adulthood, and given the current absence of definite genetic variations that discriminate adults from children, the term childhood-onset SLE is proposed when referring to individuals with onset of SLE prior to age 18 years.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 657836