A Calcagno

Doria Lamba L

E Poggi

M Haupt

MG Alpigiani

P Salvati

R Lorini

T Priolo

Pediatric Rheumatology

English

PubMed

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Thalidomide: efficacy and side effects in juvenile idiopathic arthritis (JIA)

BioMed Central
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Pediatric Rheumatology
Open AccessPoster presentation
Thalidomide: efficacy and side effects in juvenile idiopathic arthritis 
(JIA)
MG Alpigiani*1, Doria Lamba L2, M Haupt1, A Calcagno1, E Poggi1, P Salvati1 
and R Lorini1
Address: 1Institute G. Gaslini, Department of Pediatrics, University of Genova, Genova, Liguria, Italy and 2Institute G. Gaslini, Pediatric 
Neuropsychiatry Unit, University of Genova, Genova, Liguria, Italy
* Corresponding author    
Background
Thalidomide is an immunomodulating agent; although
its action mechanisms are not fully understood, many
authors have described its anti-inflammatory and immu-
nosuppressive properties with Peripheral Neuropathy
(PN) as a significant side effect, which may limit its clini-
cal use.
Methods
We describe a patient with JIA at systemic onset, partial
responding to etanercept, who presented a good control
of articular symptoms after thalidomide, but showed PN
after 16 months of therapy.
Results
Our patient, boy, 19 years old, 63.5 kg (50°centile), 161
cm, (3°centile), is affected by JIA, diagnosed at the age of
7 years. Since he presented many acute phases of illness,
though on therapy with immunosuppressant (methotrex-
ate 10 mg/m2/week), steroid and NSAID, in 2001 we
introduced an anti-TNF drug (etanercept 0.5 mg/kg/twice
a week) while reducing progressively steroid dose. How-
ever the patient showed still numerous articular acute
phases. We decided to associate thalidomide (100 mg/
die). After two months, the boy showed an improvement
of the articular symptoms. After six months JIA was in
remission. After 16 months of thalidomide therapy, he
presented electrophysiological PN, without clinical
signs;we decided to stop the thalidomide therapy. Now,
after 3 years of thalidomide suspension, no acute phases
of JIA were observed and an electrophysiological improve-
ment of PN was confirmed.
Conclusion
Our data show that thalidomide can be administered in
children with resistant forms of JIA, but a long-term
administration can significantly increase the risk of neuro-
toxicity [1]. A regular follow-up every 3 months is neces-
sary to identify and monitor possible side effects
References
1. Priolo T, et al.: Childhood thalidomide neuropathy: a clinical
and neurophysiologic study.  Pediatr Neurol 2008, 38:196-199.
from 15th Paediatric Rheumatology European Society (PreS) Congress
London, UK. 14–17 September 2008
Published: 15 September 2008
Pediatric Rheumatology 2008, 6(Suppl 1):P70 doi:10.1186/1546-0096-6-S1-P70
<supplement> <title> <p>15<sup>th </sup>Paediatric Rheumatology European Society (PreS) Congress</p> </title> <editor>Wietse Kuis, Patricia Woo, Angelo Ravelli, Hermann Girschick, Michaël Hofer, Johannes Roth, Rotraud K Saurenmann, Alberto Martini, Pavla Dolezova, Janjaap van der Net, Pierre Quartier, Lucy Wedderburn and Jan Scott</editor> <note>Meeting abstracts – A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/PDF/1546-0096-6-S1-full.pdf">here</a>.</note> </supplement>
This abstract is available from: http://www.ped-rheum.com/content/6/S1/P70
© 2008 Alpigiani et al; licensee BioMed Central Ltd. 


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Childhood thalidomide neuropathy: a clinical and neurophysiologic study. Pediatr Neurol

from 15th Paediatric Rheumatology European Society (PreS) Congress London,

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Thalidomide: efficacy and side effects in juvenile idiopathic arthritis (JIA)

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