digoxin and Arthritis--Juvenile

Topics: Arthritis, Juvenile; Child, Preschool; Digoxin; Female; Humans; Infant; Male; Myocarditis

In pediatrics it is difficult to define indications of drug therapy, appropriate dosage and therapeutic reliability of drugs because experimental pharmacology in this age group has many obstacles. To provide information on optimal drug selection 83 pediatric clinics were asked to define their choice of drug treatment for particular purposes. The results were compared with an investigation of 1969. Trends of pediatric drug treatment during the last decade can be recognized.

Topics: Age Factors; Analgesics; Antitubercular Agents; Arthritis, Juvenile; Child; Digoxin; Diuretics; Drug Therapy; Humans; Lanatosides

Three children are described who have had myocarditis as part of juvenile rheumatoid arthritis (JRA). The diagnosis was established by the appearance of cardiomegaly or congestive heart failure or both in the absence of substantial pericardial effusion or extra cardiac cause. Myocarditis, in these cases, occurred on a background of severe, active systemic disease. No pathologic specimens from hearts of acute cases are available, but an autopsy specimen of one child who died after two months of treatment with high doses of steroids showed diffuse changes typical of the "dilated ventricle" type of cardiomyopathy. Treatment with high doses of adrenocorticosteroids has been rapidly successful in controlling the acute phase, while digoxin must be used with extreme care because of high incidence of toxicity to glycosides.

Topics: Adolescent; Arthritis, Juvenile; Child; Dexamethasone; Digoxin; Echocardiography; Electrocardiography; Female; Gold; Humans; Hydrocortisone; Male; Myocarditis; Prednisone