A Case of Monostotic Fibrous Dysplasia of the Temporal Bone Asso­ciated with Epileptic Seizure

An 11-year-old male with monostotic fibrous dysplasia of the left temporal bone was reported. At the age of seven years, the patient began having epileptic attacks, and a bony swelling of the left temporal region was noticed by his mother. Roentgenologically, there were almost thorough osseous obstruction and osseous proliferation of the external auditory canal and pars petrosa, respectively. Audiologic examinations indicated gradual functional disturbance based on the affected internal ear. A total of 20 cases with monostotic fibrous dysplasia of the temporal bone reported between 1946 and 1980 was analyzed, and the association of fibrous dysplasia and epilepsy was discussed.</p

Onset of polyarticular juvenile idiopathic arthritis with both anti-cyclic citrullinated peptide antibodies and rheumatoid factor in a 3-year-old girl

Abstract This report describes 3 year old girl with the unusual presentation of polyarticular juvenile idiopathic arthritis (JIA) with anti-cyclic citrullinated peptide (anti-CCP) antibodies and a positive rheumatoid factor (RF). She was initially treated with a nonsteroidal anti-inflammatory drug (NSAID; ibuprofen) followed by methotrexate (MTX, 10 mg/m2/week) and prednisolone (0.25 mg/kg/day), but these treatments were ineffective. Administration of tocilizumab, a humanized antihuman interleukin-6 receptor monoclonal antibody, promptly improved her clinical manifestations, and she has been in complete remission (DAS28 <2.6) without bone erosion and/or destruction. Positivity for both antibodies (anti-CCP and RF) can forecast the severity of JIA (radiographic bone destruction). In such cases the administration of biologic remissive therapy may be prudent early in the disease course.</p