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Table 3 Temporal association between acute respiratory infections and reactivation or worsening of JIA activity parameters in 10 of 70 patients who participated in the epidemiological surveillance 1 and/or 2 for respiratory virus

From: Prospective surveillance study of acute respiratory infections, influenza-like illness and seasonal influenza vaccine in a cohort of juvenile idiopathic arthritis patients

Vírus detected ARI Onset type Signs of disease worsening or flare Temporal relationship Therapeutic decision
RSVA NILI** S 10% increase in the number of active joints, 50% worsening of the patient’s subjective evaluation Concomitant Increase the dose of cyclosporine
HAdv ILI*** S 60% increase in the number of active joints and 200% worsening of the patient’s subjective evaluation 3 weeks Intra-articular infection
HPIV1 ILI S Flare# Concomitant None. Symptoms improved with resolution of Flu-like symptoms
NC* ILI S Flare 5 days Increase the dose of methotrexate and oral prednisone course
HPIV3 ILI S Flare with systemic symptoms 7 days Pulse of prednisone
HAdv ILI O Flare 12 days Restart methotrexate
NC NILI P 200% increase in number of active joints and 50% increase in ESR 7 days Start nonsteroidal antiinflammatory
RSVA/HMPV NILI P Flare Concomitant Increase prednisone dose
Flu A ILI P Worsening of morning stiffness and joint effusion. Appearance of cysts on wrists. Concomitant Start etanercept and leflunomide
Confounding factor: varicella 8 days before
NC ILI S Flare 1 week Confounding factor: methotrexate suspended 30 days before Pulse of prednisone
Restart methotrexate
  1. Flu: Influenza virus A and B, HRSV: respiratory syncytial virus A and B, HMPV: metapneumovirus, HPIV: parainfluenza virus 1 and 3, HBov: bocavirus, HAdv: adenovirus, HRV: rhinovirus, HCov: coronavirus OC43 and 229E. O: oligoarticular, P: polyarticular, S: systemic *NC: not collected. **NILI: ARI not Flu-like. ***ILI: Flu-like illness # Flare: defined as worsening by 40% in two or more of the six ACRPed criteria with simultaneous improvement of up to one criterion above 30%. Surveillance 1: from March to August 2007. Surveillance 2: from March to August 2008, influenza vaccine was given in this period.