{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T06:24:16Z","timestamp":1787293456095,"version":"build-2736575974"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Juvenile dermatomyositis (JDM) is a rare autoimmune inflammatory myopathy characterized by inflammation of skeletal muscle and skin, with potential multisystem involvement. Long-term population-based data remain limited, particularly in small countries such as Latvia. This retrospective analysis (2010\u20132025) describes epidemiological, clinical, laboratory, and imaging findings among children with JDM in Latvia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We conducted a single-center retrospective case series of all children diagnosed with JDM at the Children\u2019s Clinical University Hospital, Riga, between 2010 and 2025. Diagnosis was established according to the 2017 EULAR\/ACR classification criteria. Clinical features, laboratory parameters, imaging findings, treatment strategies, and outcomes were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventeen children were identified (58.8% female), with a median age at diagnosis of 6 years (range, 2\u201316 years). The mean annual incidence was 0.32 per 100,000 children. Disease was most frequently diagnosed in winter (52.9%). The median time from symptom onset to diagnosis was 90 days. The most common clinical features were symmetric proximal muscle weakness (70.6%), generalized weakness (70.6%), and characteristic skin manifestations (58.8%), including heliotrope rash and Gottron\u2019s papules. Elevated lactate dehydrogenase (LDH) and erythrocyte sedimentation rate (ESR) were observed in 94% of children, whereas creatine phosphokinase (CPK) elevation occurred in 35%. Muscle magnetic resonance imaging demonstrated inflammatory changes consistent with myositis when clinically indicated. One child with JDM developed interstitial lung disease, one had gastrointestinal vasculitis, and one had clinically amyopathic JDM. All children received pharmacological treatment, most commonly glucocorticosteroids and non-steroidal anti-inflammatory drugs, with methotrexate used as the principal steroid-sparing agent. Remission within the first year was achieved in 70.6% of children using conventional therapy alone. Two children received biologic therapy. No mortality or macrophage activation syndrome was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This retrospective study covering 2010\u20132025 shows that JDM in Latvia generally presents similarly to that described in other cohorts of children. Proximal muscle weakness and characteristic skin findings were common, while CPK elevation was observed in only a subset of children. Most children responded well to treatment with glucocorticosteroids and methotrexate, with remission achieved in the majority within the first year and only rare need for biologic therapy. Muscle MRI was particularly helpful in selected cases when laboratory findings were inconclusive. Overall outcomes were favorable, with few severe complications and no mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1880638","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T05:37:00Z","timestamp":1787290620000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Juvenile dermatomyositis in Latvia: clinical, radiologic, laboratory, and therapeutic findings from 2010 to 2025"],"prefix":"10.3389","volume":"14","author":[{"given":"Lilija","family":"Bancevi\u010da","sequence":"first","affiliation":[{"name":"Faculty of Residency, Riga Stradins University","place":["Riga, Latvia"]},{"name":"Department of Pediatrics, Riga Stradins University","place":["Riga, Latvia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zane","family":"D\u0101vidsone","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Riga Stradins University","place":["Riga, Latvia"]},{"name":"Department of Pediatric Rheumatology, Children\u2019s Clinical University Hospital","place":["Riga, Latvia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krist\u012bna","family":"Budarina","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Riga Stradins University","place":["Riga, Latvia"]},{"name":"Department of Pediatric Rheumatology, Children\u2019s Clinical University Hospital","place":["Riga, Latvia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krist\u012bne","family":"Rasa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Riga Stradins University","place":["Riga, Latvia"]},{"name":"Department of Pediatric Rheumatology, Children\u2019s Clinical University Hospital","place":["Riga, Latvia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e000507","DOI":"10.1136\/rmdopen-2017-000507","article-title":"EULAR\/ACR classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups: a methodology report","volume":"3","author":"Bottai","year":"2017","journal-title":"RMD Open"},{"key":"B2","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1186\/s12969-025-01146-8","article-title":"Juvenile dermatomyositis: new insights into pathogenesis and clinical applications","volume":"23","author":"Chan Ng","year":"2025","journal-title":"Pediatr Rheumatol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1955","DOI":"10.1136\/annrheumdis-2017-211468","article-title":"2017 European league Against Rheumatism\/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups","volume":"76","author":"Lundberg","year":"2017","journal-title":"Ann Rheum Dis"},{"key":"B4","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1093\/rheumatology\/kead186","article-title":"Effect of type I interferon on engineered pediatric skeletal muscle: a promising model for juvenile dermatomyositis","volume":"63","author":"Covert","year":"2024","journal-title":"Rheumatology"},{"key":"B5","doi-asserted-by":"publisher","first-page":"5513544","DOI":"10.1155\/2021\/5513544","article-title":"The significance of autoantibodies in juvenile dermatomyositis","volume":"2021","author":"Kwiatkowska","year":"2021","journal-title":"Biomed Res Int"},{"key":"B6","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1016\/j.annder.2020.04.016","article-title":"Dermatomyosite de l\u2019enfant. S\u00e9rie descriptive de 22 cas [juvenile dermatomyositis: a series of 22 cases]","volume":"147","author":"Moegle","year":"2020","journal-title":"Ann Dermatol Venereol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/s12969-022-00709-3","article-title":"Baseline characteristics of children with juvenile dermatomyositis enrolled in the first year of the new childhood arthritis and rheumatology research alliance registry","volume":"20","author":"Neely","year":"2022","journal-title":"Pediatr Rheumatol Online J"},{"key":"B8","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1002\/art.43057","article-title":"Expert perspective: diagnostic approach to differentiating juvenile dermatomyositis from muscular dystrophy","volume":"77","author":"Madison","year":"2025","journal-title":"Arthritis Rheumatol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1002\/art.42450","article-title":"Improvement in disease activity in refractory juvenile dermatomyositis following Abatacept therapy","volume":"75","author":"Curiel","year":"2023","journal-title":"Arthritis Rheumatol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s12969-023-00893-w","article-title":"Macrophage activation syndrome in juvenile dermatomyositis: a case report and a comprehensive review of the literature","volume":"21","author":"Chang","year":"2023","journal-title":"Pediatr Rheumatol Online J"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1880638\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T05:37:01Z","timestamp":1787290621000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1880638\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":10,"alternative-id":["10.3389\/fped.2026.1880638"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1880638","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"article-number":"1880638"}}