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Infection-Related Death among Persons with Refractory Juvenile Idiopathic Arthritis

Lookup NU author(s): Dr Mario Abinun, Dr Jonathan Lane, Dr Terence Flood, Emerita Professor Helen Foster



This is the final published version of an article that has been published in its final definitive form by Centers for Disease Control and Prevention, 2016.

For re-use rights please refer to the publisher's terms and conditions.


Severe infections are emerging as major risk factors for death among children with juvenile idiopathic arthritis (JIA). In particular, children with refractory JIA treated with long-term, multiple, and often combined immunosuppressive and antiinflammatory agents, including the new biological disease-modifying antirheumatic drugs (DMARDs), are at increased risk for severe infections and death. We investigated 4 persons with JIA who died during 1994-2013, three of overwhelming central venous catheter related bacterial sepsis caused by coagulase-negative Staphylococus or a-hemolytic Streptococcus infection and 1 of disseminated adenovirus and Epstein-Barr virus infection). All 4 had active JIA refractory to long-term therapy with multiple and combined conventional and biological DMARDs. Two died while receiving high-dose systemic corticosteroids, methotrexate, and after recent exposure to anti tumor necrosis factor-a biological DMARDs, and 2 during hematopoietic stem cell transplantation procedure. Reporting all cases of severe infections and especially deaths in these children is of paramount importance for accurate surveillance.

Publication metadata

Author(s): Abinun M, Lane JP, Wood M, Friswell M, Flood TJ, Foster HE

Publication type: Article

Publication status: Published

Journal: Emerging Infectious Diseases

Year: 2016

Volume: 22

Issue: 10

Pages: 1720-1727

Print publication date: 01/10/2016

Acceptance date: 15/09/2016

Date deposited: 01/12/2016

ISSN (print): 1080-6040

ISSN (electronic): 1080-6059

Publisher: Centers for Disease Control and Prevention


DOI: 10.3201/eid2210.151245


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Funder referenceFunder name
FSF 121301National Institute for Health Research Financial Management Group Flexibility and Sustainability Funding