1 Department of Pediatric Nephrology and Rheumatology, Medical School of Afyon Kocatepe University; 2 Department of Pediatric Nephrology and Rheumatology, Dr. Sami Ulus Children’s Hospital; 3 TOBB ETÜ Hospital; 4 Department of Pediatric Nephrology, Medical School of Mersin University; 5 Department of Pediatric Nephrology, Medical School of Kocaeli University, TURKEY Corresponding author: Gülay Demircin, Afyon Kocatepe University, Medical School, Pediatric Nephrology and Rheumatology Department, Ümitkent Sitesi, A8 Blok, No:10, Ümitköy, Ankara, Turkey. e-mail: gulaydemircin@ hotmail.com Received: July 18,2011 Accepted: November 05,2011 Ann Paediatr Rheum 2012; 1:65-70 DOI: 10.5455/apr. 110520111313 Short Communication Calcinosis; a Difcult Problem in Juvenile Dermatomyositis Gulay Demircin 1 , Ozlem Erdogan 2 , Mehmet Bulbul 2 , Sahika Baysun 3 , Ali Delibas 4 , Kenan Bek 5 , Ayse Oner 2 Abstract Objective: Juvenile dermatomyositis (JDM) is a rare disease of childhood characterized by nonsuppurative infammation of striated muscle and skin and calcinosis is one of the most important sequelae of the disease. Methods: In this study we investigated the clinical fndings, complications and prognosis of 13 patients (9 girls, 4 boys) aged between 6-14 years and diagnosed to have JDM in a period of 10 years. We documented the data of the patients that had calcinosis in detail and discussed the risk factors for the development of this complication and its management. Results: Tree patients (23%) developed calcinosis afer 1.5-7 years during the therapy with prednisolone and one with additional methotrexate. Tey did not show any improvement despite aggressive therapy with anti-infammatory drugs including prednisolone, methotrexate and colchicine together with biphophonates and diltiazem. Conclusion: Since calcinosis may develop and progress despite appropriate therapy, controlled trials includ- ing large number of patients are needed to show the optimal management of JDM to prevent the development and progression of this complication. Key words: Juvenile dermatomyositis, calcinosis, risk factors, therapy Introduction Juvenile dermatomyositis ( JDM) is a rare dis- ease in childhood defned as a multisystem disease of uncertain origin that results in nonsuppurative infammation of striated muscle and skin [1]. It af- fects children between 5-14 years and resembles the adult form, but it has some distinct clinical and pathologic features [1-3]. Te disease course can be variable, with recurrences and various degrees of response to therapy [4,5]. Calcinosis is one of the most important se- quelae of JDM and despite recent progress in the therapy of the disease, dystrophic calcifcation still occurs in up to 30 % of the patients [6,7]. In this study we documented the clinical fndings and outcome of patients diagnosed to have JDM dur-