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Rosina S, Rebollo-Gimenez AI, Tarantola L, Pistorio A, Vyzhga Y, El Miedany Y, Lotfy HM, Abu-Shady H, Eissa M, Osman NS, Hassan W, Mahgoub MY, Fouad NA, Mosa DM, Adel Y, Mohamed SEM, Radwan AR, Abu-Zaid MH, Tabra SAA, Shalaby RH, Nasef SI, Khubchandani R, Khan A, Maldar NP, Ozen S, Bayindir Y, Alsuweiti M, Alzyoud R, Almaaitah H, Vilaiyuk S, Lerkvaleekul B, Alexeeva E, Dvoryakovskaya T, Kriulin I, Bracaglia C, Pardeo M, De Benedetti F, Licciardi F, Montin D, Robasto F, Minoia F, Filocamo G, Rossano M, Simonini G, Marrani E, Abu-Rumeleih S, Kostik MM, Belozerov KE, Pal P, Bathia JN, Katsicas MM, Villarreal G, Marino A, Costi S, Sztajnbok F, Silva RM, Maggio MC, El-Ghoneimy DH, El Owaidy R, Civino A, Diomeda F, Al-Mayouf SM, Al-Sofyani F, Dāvidsone Z, Patrone E, Saad-Magalhães C, Consolaro A, Ravelli A. Defining criteria for disease activity states in systemic juvenile idiopathic arthritis based on the systemic Juvenile Arthritis Disease Activity Score. Arthritis Rheumatol 2024. [PMID: 38682570 DOI: 10.1002/art.42865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/06/2024] [Accepted: 04/03/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE To develop and validate cutoff values in the systemic Juvenile Arthritis Disease Activity Score 10 (sJADAS10) that distinguish the states of inactive disease (ID), minimal disease activity (MiDA), moderate disease activity (MoDA), and high disease activity (HDA) in children with systemic juvenile idiopathic arthritis (sJIA), based on subjective disease state assessment by the treating pediatric rheumatologist. METHODS The cutoffs definition cohort was composed of 400 patients enrolled at 30 pediatric rheumatology centers in 11 countries. Using the subjective physician rating as an external criterion, 6 methods were applied to identify the cutoffs: mapping, calculation of percentiles of cumulative score distribution, Youden index, 90% specificity, maximum agreement, and ROC curve analysis. Sixty percent of the patients were assigned to the definition cohort and 40% to the validation cohort. Cutoff validation was conducted by assessing discriminative ability. RESULTS The sJADAS10 cutoffs that separated ID from MiDA, MiDA from MoDA, and MoDA from HDA were ≤ 2.9, ≤ 10, and > 20.6. The cutoffs discriminated strongly among different levels of pain, between patients with or without morning stiffness, and between patients whose parents judged their disease status as remission or persistent activity/flare or were satisfied or not satisfied with current illness outcome. CONCLUSION The sJADAS cutoffs revealed good metrologic properties in both definition and validation cohorts, and are therefore suitable for use in clinical trials and routine practice.
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Affiliation(s)
- Silvia Rosina
- UOC Reumatologia e Malattie Autoinfiammatorie, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Ana I Rebollo-Gimenez
- UOC Reumatologia e Malattie Autoinfiammatorie, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Letizia Tarantola
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno Infantili (DINOGMI), Università degli Studi di Genova, Genoa, Italy
| | - Angela Pistorio
- Direzione Scientifica - Unità di Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Yulia Vyzhga
- UOC Reumatologia e Malattie Autoinfiammatorie, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Yasser El Miedany
- Canterbury Christ Church University, UK and Egyptian College of Pediatric Rheumatology, Egypt
| | - Hala M Lotfy
- Pediatric Rheumatology Department, Abu- el Reesh Hospital, Cairo University, Cairo, Egypt
| | - Hend Abu-Shady
- Pediatric Rheumatology Department, Abu- el Reesh Hospital, Cairo University, Cairo, Egypt
| | - Mervat Eissa
- Rheumatology, Kasr Elainy Cairo University, Cairo, Egypt
| | | | - Waleed Hassan
- Rheumatology, Rehabilitation and Physical Medicine, Benha University, Benha, Egypt
| | - Marwa Y Mahgoub
- Rheumatology, Rehabilitation and Physical Medicine, Benha University, Benha, Egypt
| | - Nermeen A Fouad
- Rheumatology and Rehabilitation, Fayoum University, Fayoum, Egypt
| | - Doaa M Mosa
- Rheumatology, Rehabilitation and Physical Medicine, Mansoura University, Mansoura, Egypt
| | - Yasmin Adel
- Rheumatology, Rehabilitation and Physical Medicine, Mansoura University, Mansoura, Egypt
| | | | - Ahmed R Radwan
- Rheumatology and Rehabilitation, Sohag University, Sohag, Egypt
| | | | - Samar A A Tabra
- Rheumatology and Rehabilitation Tanta University, Tanta, Egypt
| | - Radwa H Shalaby
- Rheumatology and Rehabilitation Tanta University, Tanta, Egypt
| | - Samah I Nasef
- Rheumatology & Rehabilitation, Faculty of Medicine Suez Canal University, Ismailia, Egypt
| | | | | | | | - Seza Ozen
- Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey
| | - Yagmur Bayindir
- Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey
| | - Motasem Alsuweiti
- Pediatric Immunology and Rheumatology division, Queen Rania Children's Hospital, King Hussein Medical Center, Royal Medical Services, Amman, Jordan
| | - Raed Alzyoud
- Pediatric Immunology and Rheumatology division, Queen Rania Children's Hospital, King Hussein Medical Center, Royal Medical Services, Amman, Jordan
| | - Hiba Almaaitah
- Pediatric Immunology and Rheumatology division, Queen Rania Children's Hospital, King Hussein Medical Center, Royal Medical Services, Amman, Jordan
| | - Soamarat Vilaiyuk
- Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Butsabong Lerkvaleekul
- Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ekaterina Alexeeva
- National Medical Research Center of Children's Health, Moscow, Russian Federation
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Tatyana Dvoryakovskaya
- National Medical Research Center of Children's Health, Moscow, Russian Federation
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Ivan Kriulin
- National Medical Research Center of Children's Health, Moscow, Russian Federation
| | - Claudia Bracaglia
- Division of Rheumatology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Manuela Pardeo
- Division of Rheumatology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Francesco Licciardi
- Città della Salute e della Scienza, Pediatria specialistica Universitaria, Immunoreumatologia, Torino, Italy
| | - Davide Montin
- Città della Salute e della Scienza, Pediatria specialistica Universitaria, Immunoreumatologia, Torino, Italy
| | - Francesca Robasto
- Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli studi di Torino, Torino, Italy
| | - Francesca Minoia
- SC Pediatria e Immunoreumatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Filocamo
- SC Pediatria e Immunoreumatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Martina Rossano
- SC Pediatria e Immunoreumatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gabriele Simonini
- Rheumatology Unit, IRCCS Meyer Children's Hospital, Florence, Italy
- NEUROFARBA Department, University of Florence, Florence, Italy
| | - Edoardo Marrani
- Rheumatology Unit, IRCCS Meyer Children's Hospital, Florence, Italy
| | | | - Mikhail M Kostik
- Department of Pediatrics, Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russian Federation
| | - Konstantin E Belozerov
- Department of Pediatrics, Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russian Federation
| | - Priyankar Pal
- Pediatric Rheumatology Institute of Child Health, Kolkata, India
| | - Jigna N Bathia
- Pediatric Rheumatology Institute of Child Health, Kolkata, India
| | - María M Katsicas
- Service of Rheumatology. Hospital de Pediatría Prof Dr JP Garrahan, Buenos Aires, Argentina
| | - Giselle Villarreal
- Service of Rheumatology. Hospital de Pediatría Prof Dr JP Garrahan, Buenos Aires, Argentina
| | - Achille Marino
- Unit of Pediatric Rheumatology, ASST G.Pini-CTO, Milan, Italy
| | - Stefania Costi
- Unit of Pediatric Rheumatology, ASST G.Pini-CTO, Milan, Italy
| | - Flavio Sztajnbok
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Division of Pediatric Rheumatology, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rodrigo M Silva
- Division of Pediatric Rheumatology, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria C Maggio
- Department PROMISE "G. D'Alessandro", University of Palermo, Italy
| | - Dalia H El-Ghoneimy
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Rasha El Owaidy
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Adele Civino
- Pediatric Rheumatology and Immunology Unit, "Vito Fazzi" Hospital, Lecce, Italy
| | - Federico Diomeda
- Pediatric Rheumatology and Immunology Unit, "Vito Fazzi" Hospital, Lecce, Italy
| | - Sulaiman M Al-Mayouf
- Pediatric Rheumatology, King Faisal Specialist Hospital and Research Center, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Fuad Al-Sofyani
- Pediatric Rheumatology, King Faisal Specialist Hospital and Research Center, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Zane Dāvidsone
- Department of Pediatrics, University Children Hospital, Riga, Latvia
| | - Elisa Patrone
- Servizio di Sperimentazioni Cliniche Pediatriche, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Alessandro Consolaro
- UOC Reumatologia e Malattie Autoinfiammatorie, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno Infantili (DINOGMI), Università degli Studi di Genova, Genoa, Italy
| | - Angelo Ravelli
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno Infantili (DINOGMI), Università degli Studi di Genova, Genoa, Italy
- Direzione Scientifica, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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Alzyoud R, Alsuweiti M, Maaitah H, Aladaileh B, Noubani M, Nsour H. Inborn Errors of Immunity in Jordan: First Report from a Tertiary Referral Center. J Clin Immunol 2024; 44:101. [PMID: 38630413 DOI: 10.1007/s10875-024-01709-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/11/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Inborn errors of immunity (IEI) are a heterogeneous group of diseases with variable clinical phenotypes. This study was conducted to describe the epidemiology, clinical presentations, treatment, and outcome of IEI in Jordanian children. METHODS A retrospective data analysis was conducted for children under 15 years diagnosed with IEI from the pediatric Allergy, Immunology, and Rheumatology Division-based registry at Queen Rania Children's Hospital, Amman, Jordan, between 2010 and 2022. RESULTS A total of 467 patients, 263 (56.3%) males and 204 (43.7%) females, were diagnosed with IEI. The mean age at symptom onset was 18 months (1 week to 144 months), a positive family history of IEI was reported in 43.5%, and the consanguinity rate was 47.9%. The most common IEI category was immunodeficiencies affecting cellular and humoral immunity at 33.2%, followed by predominantly antibody deficiencies at 16.9%. The overall median diagnostic delay (range) was 6 (0-135) months; patients with a positive family history of IEI had a statistically significant shorter diagnostic delay. Pulmonary and gastrointestinal clinical features were the most common at 55.2% and 45.6%, respectively. The overall mortality was 33.2%; the highest rate was reported in severe combined immunodeficiency at 56.2%. CONCLUSIONS The high minimal estimated IEI prevalence at 16.2/100,000 Jordanian children compared to the regional and worldwide data, with the diversities in clinical presentation and distribution of IEI categories in our cohort point to unique features of IEI in Jordanian children, call for national registry establishment, regional and international collaborative networks.
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Affiliation(s)
- Raed Alzyoud
- Pediatric Allergy, Immunology, and Rheumatology Division, Queen Rania Children's Hospital, Jordanian Royal Medical Service, Amman, Jordan.
| | - Motasem Alsuweiti
- Pediatric Allergy, Immunology, and Rheumatology Division, Queen Rania Children's Hospital, Jordanian Royal Medical Service, Amman, Jordan
| | - Heba Maaitah
- Pediatric Allergy, Immunology, and Rheumatology Division, Queen Rania Children's Hospital, Jordanian Royal Medical Service, Amman, Jordan
| | - Boshra Aladaileh
- Pediatric Allergy, Immunology, and Rheumatology Division, Queen Rania Children's Hospital, Jordanian Royal Medical Service, Amman, Jordan
| | - Mohammed Noubani
- Pediatric Allergy, Immunology, and Rheumatology Division, Queen Rania Children's Hospital, Jordanian Royal Medical Service, Amman, Jordan
| | - Hamazh Nsour
- Pediatric Allergy, Immunology, and Rheumatology Division, Queen Rania Children's Hospital, Jordanian Royal Medical Service, Amman, Jordan
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Arab Y, Harahsheh AS, Dahdah N, El-Kholy N, Abed MY, Abu Al-Saoud SY, Agha HM, Alahmadi F, Alamer SR, Awadhi ZA, Ali S, Ali MT, Alrabte H, Al-Saloos H, Al-Senaidi KS, Alzyoud R, Awidat N, Bouayed K, Bouaziz A, Boukari R, El Ganzoury MM, Elmarsafawy HM, Elrugige N, Fitouri Z, Kotby A, Ladj MS, Bekkar M, Mouawad P, Salih AF, Suleiman M, Choueiter NF. Kawarabi: Administrative Structuring of a Multicenter Research Collaborative to Study Kawasaki Disease in the Arab Countries. World J Pediatr Congenit Heart Surg 2024; 15:177-183. [PMID: 37981829 DOI: 10.1177/21501351231205570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Kawasaki disease (KD), the leading cause of acquired heart disease in children in developed countries, merits conducting detailed studies in Arab countries. We introduce Kawarabi, as a multicenter research collaborative effort dedicated to improving diagnosis, care, and outcome of children and adults with KD in the Arab world. During the COVID-19 pandemic, there emerged a new multisystem inflammatory syndrome in children; a disease similar to KD. This highlighted the challenges that Arab physicians face in diagnosing and managing children with KD and KD-like illnesses. Kawarabi brings together experts in North America and Arab nations to study this family of diseases in a not-for-profit, voluntary scientific collaborative setting. Bylaws addressing the vision, objectives, structure, and governance of Kawarabi were established, and vetted by the 45 organizing members in 2021. An initial scientific publication showed evidence of a decreased level of awareness of the disease in the general population, as well as the lack of access to resources available for physicians caring for children with KD in Arab countries. Kawarabi has since held several educational webinars and an inaugural yearly meeting. The groundwork for future initiatives targeted at increasing awareness and understanding of the management and the long-term outcomes of children with KD in the region was established. Data on KD in the Arab world are lacking. Kawarabi is a multicenter research collaborative organization that has the unique resources, diversified ethnic makeup, and energy, to accomplish significant advances in our understanding and management of KD and its variants.
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Affiliation(s)
- Yousra Arab
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Ashraf S Harahsheh
- Division of Cardiology, Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Nagib Dahdah
- Division of Pediatric Cardiology, CHU Ste-Justine, Montreal, Canada
- Professor of Pediatrics - Université de Montréal, Montreal, Canada
| | | | - Maysam Y Abed
- Al-Ramadi Maternity and Child Teaching Hospital, Al-Ramadi, Iraq
| | - Sima Y Abu Al-Saoud
- Department of Pediatrics, Faculty of Medicine, Makassed Hospital, Al-Quds University, East- Jerusalem, Palestine
| | - Hala M Agha
- Pediatric Cardiology Division, Cairo University, Cairo, Egypt
| | - Fahad Alahmadi
- King Faisal Specialist Hospital and Research Center, Taibah University, Madinah, Saudi Arabia
| | - Suad R Alamer
- Mohammed Bin Khalifa Bin Salman Al Khalifa Cardiac Centre, Awali, Bahrain
| | - Zainab Al Awadhi
- Al Jalila Children's Speciality Hospital, Dubai, United Arab Emirates
| | - Sulafa Ali
- Sudan Heart Center, University of Kharthoum, Kharthoum, Sudan
| | | | - Hanifa Alrabte
- Pediatric Cardiology Department, Tripoli Children Hospital, Tripoli, Libya
| | - Hesham Al-Saloos
- Division of Cardiology, Sidra Medicine, Doha, Qatar
- Clinical Pediatrics, Weill Cornell Medicine, Doha, Qatar
| | - Khalfan S Al-Senaidi
- Division of Pediatric Cardiology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Raed Alzyoud
- Pediatric Immunology, Allergy, and Rheumatology Division, Queen Rania Children's Hospital, Amman, Jordan
| | | | - Kenza Bouayed
- Abderrahim Harouchi Mother-Child Hospital, CHU Ibn Rochd, Casablanca, Morocco
| | - Asma Bouaziz
- Children and Neonatal Department, Hôpital Régional, Ben Arous, Tunisia
| | - Rachida Boukari
- Department of Pediatrics, University Hospital Mustapha Bacha, Algiers University, Alger, Algeria
| | - Mona M El Ganzoury
- Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hala M Elmarsafawy
- Division of Pediatric Cardiology, Children's Hospital, Mansoura University, Mansoura, Egypt
| | - Najat Elrugige
- Pediatric Cardiology Department, Benghazi Children Hospital, Benghazi University, Benghazi, Libya
| | - Zohra Fitouri
- Division of Rheumatology, Pediatric Hospital of Béchir Hamza of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Alyaa Kotby
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed S Ladj
- Department of Pediatrics, Djillali Belkhenchir University Hospital, Algiers, Algeria
- Faculty of Medicine, Algiers University, Alger, Algeria
| | - Mokhtar Bekkar
- Division of Pediatric Cardiology, Department of Pediatrics, CHU Oran, Oran, Algeria
| | - Pierre Mouawad
- Department of Pediatrics, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Aso F Salih
- Pediatric Cardiology Department, Children's Heart Hospital-Sulaimani College of Medicine, Sulaimani University, Al-Sulaimaniyah, Iraq
| | | | - Nadine F Choueiter
- Division of Pediatric Cardiology, Department of Pediatrics, Icahn School of Medicine, Mount Sinai Kravis Children's Hospital, New York, NY, USA
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Alzyoud R, El-Kholy N, Arab Y, Choueiter N, Harahsheh AS, Aselan AS, Kotby A, Bouaziz A, Salih AF, Abushhaiwia A, Alahmadi F, Agha HM, Elmarsafawy HM, Alrabte H, Al-Saloos H, Boudiaf H, Hijazi I, Bouayed K, Al Senaidi KS, Boughammoura L, Jalal M, Ladj MS, Abu-Shukair ME, ElGanzoury MM, Hammadouche N, Elsamman N, Mouawad P, Boukari R, Benalikhoudja N, Jdour S, Abu Al-Saoud SY, Touri SN, Kammoun T, Fitouri Z, Dahdah N. Access to Care and Therapy for Kawasaki Disease in the Arab Countries: A Kawasaki Disease Arab Initiative (Kawarabi) Multicenter Survey. Pediatr Cardiol 2023:10.1007/s00246-023-03166-1. [PMID: 37126143 DOI: 10.1007/s00246-023-03166-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 04/16/2023] [Indexed: 05/02/2023]
Abstract
Kawasaki Disease (KD) is still the most common acquired heart disease in children below the age of five years; it has been well described in the developed world; however, data from the Arab world are limited to case reports or single-center case series. In an effort of optimizing KD research in the Arab world, a group of physicians and researchers established the KD Arab Initiative (Kawarabi) in 2021, and published the first survey, which showed disparities in the availability of intravenous immunoglobulin (IVIG); this had prompted Kawarabi to assess the access to care and therapy of KD patients in Arab countries. A 32 structured questions survey was conducted in thirteen Arab countries and addressed KD patients' access to healthcare in urban and rural settings. The survey results showed that access to care was uniform across large, mid-size cities and rural areas in 7/13 (54%) countries, while in 6/13 (46%) countries, it was in favor of large and mid-size cities over rural areas. The quality of medical services received by children with KD in large cities was rated as excellent in 6/13 or good in 7/13 countries compared to fair in 4/13 or poor in 4/13 countries in rural areas. Availability of IVIG was limited (23%) in mid-size cities and almost impossible (23%) in rural areas. The KD patients in mid-size cities and rural areas have limited access to standard healthcare in the Arab world. This survey laid the foundation for future Kawarabi endeavors to improve the care of children with KD.
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Affiliation(s)
- Raed Alzyoud
- Chief of Pediatric Allergy, Immunology and Rheumatology Divsion, Queen Rania Children's Hospital, Amman, Jordan
| | | | - Yousra Arab
- Université de Sherbrooke, Sherbrooke, Canada
| | | | - Ashraf S Harahsheh
- Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine & HealthSciences Cardiology, Washington, DC, USA
| | - Adnan Salem Aselan
- Pediatric Cardiologist, Madinah Maternity and Children Hospital, King Salman Medical City, Al Madinah Al Munawwarah, Saudi Arabia
| | - Alyaa Kotby
- Pediatric Cardiology Division, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Asma Bouaziz
- Headmaster of Children and Neonatal Department, Hôpital Régional, Tunis, Tunisia
| | - Aso F Salih
- HD Cardiology, Pediatric Cardiology Department, Children's Heart Hospital, Sulaimani College of Medicine, Sulaimani University, Sulaimani, Iraq
| | - Awatif Abushhaiwia
- Pediatric Rheumatology Department, Tripoli Children's Hospital, Tripoli, Libya
| | - Fahad Alahmadi
- King Faisal Specialist Hospital and Research Center, Pediatric Cardiology, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| | - Hala M Agha
- Pediatric Cardiology Division, Cairo University, Cairo, Egypt
| | - Hala M Elmarsafawy
- Pediatric Cardiology Division, Children Hospital, Mansoura University, Mansoura, Egypt
| | - Hanifa Alrabte
- Pediatric Cardiology Department, Tripoli Children's Hospital, Tripoli, Libya
| | - Hesham Al-Saloos
- Division of Cardiology, Clinical Pediatrics, Sidra Medicine, Weill Cornell Medicine, Doha, Qatar
| | - Houda Boudiaf
- Onco-Pediatric Department, University Hospital Mustapha Bacha, Algiers University, Algiers, Algeria
| | - Issa Hijazi
- Cardiology Center, King Hussein Medical Center, Amman, Jordan
| | - Kenza Bouayed
- Harouchi, Mother and Child Hospital, CHU Ibn Rochd, Casablanca, Morocco
| | | | - Lamia Boughammoura
- Pediatric Department of Farhat Hached Hospital, Faculté de Médecine de Sousse, Sousse, Tunisia
| | - Maryam Jalal
- Harouchi, Mother and Child Hospital, CHU Ibn Rochd, Casablanca, Morocco
| | - Mohamed S Ladj
- Pediatric Department, Faculty of Medicine, Djillali Belkhenchir University Hospital, Algiers University, Algiers, Algeria
| | | | - Mona M ElGanzoury
- Pediatric Cardiology Division, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nacera Hammadouche
- Pediatric Department, Faculty of Medicine, Djillali Belkhenchir University Hospital, Algiers University, Algiers, Algeria
| | - Nora Elsamman
- Pediatric Cardiology, Pediatrics Department, Ain Shams University, Cairo, Egypt
| | - Pierre Mouawad
- Pediatric Department, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Rachida Boukari
- Pediatric Department University Hospital, Mustapha Bacha, Algiers, Algeria
| | | | - Salima Jdour
- Pediatric Cardiology Department, Tripoli Children's Hospital, Tripoli, Libya
| | - Sima Y Abu Al-Saoud
- Department of Pediatrics, Faculty of Medicine, Makassed Hospital, Al- Quds University, Jerusalem, Palestine
| | | | - Thouraya Kammoun
- Pediatric Department of Hedi Chakar Hospital, Faculté de Médecine de Sfax, Sfax, Tunisia
| | - Zohra Fitouri
- Unit of Rheumatology, Emergency and Outpatient Department, Pediatric Hospital of Béchir Hamza of Tunis. University Tunis El Manar, Tunis, Tunisia
| | - Nagib Dahdah
- Division of Pediatric Cardiology, CHU Ste-Justine, Université de Montréal, Montréal, Canada.
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Alsuwaiti M, Alzyoud R, Maaitah H, Aladaileh B, Alnsoor H, Nobani M. Clinical and Laboratory Features of Patients with Multisystem Inflammatory Syndrome in Children (MIS-C): An Experience From Queen Rania Children's Hospital, Jordan. Cureus 2023; 15:e37282. [PMID: 37038378 PMCID: PMC10082549 DOI: 10.7759/cureus.37282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2023] [Indexed: 04/12/2023] Open
Abstract
Background Multisystem inflammatory syndrome in children (MIS-C) is a new clinical observation that emerged during the coronavirus pandemic of 2019 (COVID-19) and has similar manifestations to Kawasaki disease and toxic shock syndrome. In this study, we aim to describe the characteristics of MIS-C patients in a single center in Jordan. Methods A retrospective analysis of electronic medical records of pediatric patients diagnosed with MIS-C at the pediatric rheumatology division of Queen Rania Children's Hospital, Amman, Jordan, between January 2021 and December 2022. Data collected included age, gender, clinical and laboratory data on presentation, and treatment options, which were compared in two different age groups. Results A total of 80 patients were included in this cohort (53 males and 27 females). The mean age at presentation was 84.4 months (ranging between nine months and 16 years). The most common presenting symptoms included fever (100%), abdominal pain (76.2%), skin rash (75%), conjunctivitis (72.5%), and mucosal changes (62.5%). Lymphopenia was present in 66.2% of patients. The majority of patients (98.7%) showed elevated C-reactive protein (CRP); 72 patients showed elevated erythrocyte sedimentation rate (ESR) (92.5%); ferritin was elevated in 70% of patients; the median fibrinogen level was 390 (interquartile range (IQR) 0.6-20) mg/dL; and the D-dimer level was 3.9 (IQR 0.6-20) mg/dL. Pericardial effusion was present in 23.8% of patients, and five patients (6.3%) had coronary artery dilatation. Conclusion To the best of our knowledge, this study is the first large case series of MIS-C in Jordan, with a wide spectrum of clinical presentation and evidence of hyperinflammation.
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Affiliation(s)
- Motasem Alsuwaiti
- Immunology, Allergy, and Rheumatology, Queen Rania Children's Hospital, Amman, JOR
| | - Raed Alzyoud
- Immunology, Allergy, and Rheumatology, Queen Rania Children's Hospital, Amman, JOR
| | - Hiba Maaitah
- Immunology, Allergy and Rheumatology, Queen Rania Children's Hospital, Amman, JOR
| | - Bushra Aladaileh
- Immunology, Allergy, and Rheumatology, Queen Rania Children's Hospital, Amman, JOR
| | - Hamzeh Alnsoor
- Immunology, Allergy, and Rheumatology, Queen Rania Children's Hospital, Amman, JOR
| | - Mohammed Nobani
- Immunology, Allergy, and Rheumatology, Queen Rania Children's Hospital, Amman, JOR
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Baris S, Abolhassani H, Massaad MJ, Al-Nesf M, Chavoshzadeh Z, Keles S, Reisli I, Tahiat A, Shendi HM, Elaziz DA, Belaid B, Al Dhaheri F, Haskologlu S, Dogu F, Ben-Mustapha I, Sobh A, Galal N, Meshaal S, Elhawary R, El-Marsafy A, Alroqi FJ, Al-Saud B, Al-Ahmad M, Al Farsi T, Al Sukaiti N, Al-Tamemi S, Mehawej C, Dbaibo G, ElGhazali G, Kilic SS, Genel F, Kiykim A, Musabak U, Artac H, Guner SN, Boukari R, Djidjik R, Kechout N, Cagdas D, El-Sayed ZA, Karakoc-Aydiner E, Alzyoud R, Barbouche MR, Adeli M, Wakim RH, Reda SM, Ikinciogullari A, Ozen A, Bousfiha A, Al-Mousa H, Rezaei N, Al-Herz W, Geha RS. The Middle East and North Africa Diagnosis and Management Guidelines for Inborn Errors of Immunity. J Allergy Clin Immunol Pract 2023; 11:158-180.e11. [PMID: 36265766 DOI: 10.1016/j.jaip.2022.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/07/2022] [Accepted: 10/03/2022] [Indexed: 11/09/2022]
Abstract
Human inborn errors of immunity (IEI) are a group of 485 distinct genetic disorders affecting children and adults. Signs and symptoms of IEI are heterogeneous, and accurate diagnosis can be challenging and depends on the available human expertise and laboratory resources. The Middle East and North Africa (MENA) region has an increased prevalence of IEI because of the high rate of consanguinity with a predominance of autosomal recessive disorders. This area also exhibits more severe disease phenotypes compared with other regions, probably due to the delay in diagnosis. The MENA-IEI registry network has designed protocols and guidelines for the diagnosis and treatment of IEI, taking into consideration the variable regional expertise and resources. These guidelines are primarily meant to improve the care of patients within the region, but can also be followed in other regions with similar patient populations.
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Affiliation(s)
- Safa Baris
- Faculty of Medicine, Division of Pediatric Allergy and Immunology, Marmara University, Istanbul, Turkey; The Isil Berat Barlan Center for Translational Medicine, Istanbul Jeffrey Modell Foundation Diagnostic Center for Primary Immune Deficiencies, Istanbul, Turkey.
| | - Hassan Abolhassani
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Division of Clinical Immunology, Department of Biosciences and Nutrition, Karolinska Institute, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Michel J Massaad
- Department of Experimental Pathology, Immunology, and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon; Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon
| | - Maryam Al-Nesf
- Allergy and Immunology Division, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Zahra Chavoshzadeh
- Allergy and Clinical Immunology Department, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sevgi Keles
- Division of Pediatric Allergy and Immunology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Ismail Reisli
- Division of Pediatric Allergy and Immunology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Azzeddine Tahiat
- Laboratory of Immunology, Department of Medical Biology, University of Algiers, Rouiba Hospital, Algiers, Algeria
| | - Hiba Mohammad Shendi
- Division of Pediatric Allergy and Immunology, Tawam Hospital, Abu Dhabi, United Arab Emirates
| | - Dalia Abd Elaziz
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Brahim Belaid
- Department of Medical Immunology, Beni Messous University Hospital Center, Faculty of Pharmacy, University of Algiers, Algiers, Algeria
| | - Fatima Al Dhaheri
- Department of Pediatrics, Pediatric Infectious Diseases, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Sule Haskologlu
- Department of Pediatric Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
| | - Figen Dogu
- Department of Pediatric Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
| | - Imen Ben-Mustapha
- Department of Immunology, Institut Pasteur de Tunis and University Tunis El Manar, Tunis, Tunisia
| | - Ali Sobh
- Department of Pediatrics, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Nermeen Galal
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Safa Meshaal
- Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rabab Elhawary
- Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Aisha El-Marsafy
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Fayhan J Alroqi
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Bandar Al-Saud
- Department of Pediatrics, Division of Allergy and Immunology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Mona Al-Ahmad
- Department of Microbiology, College of Medicine, Kuwait University, Kuwait
| | - Tariq Al Farsi
- Department of Pediatric Allergy and Clinical Immunology, The Royal Hospital, Muscat, Oman
| | - Nashat Al Sukaiti
- Department of Pediatric Allergy and Clinical Immunology, The Royal Hospital, Muscat, Oman
| | - Salem Al-Tamemi
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Cybel Mehawej
- Department of Human Genetics, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Ghassan Dbaibo
- Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon; Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon
| | - Gehad ElGhazali
- Department of Immunology, Sheikh Khalifa Medical City-Union 71-Purehealth, Abu Dhabi, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Sara Sebnem Kilic
- Department of Pediatric Immunology and Rheumatology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Ferah Genel
- Department of Pediatric Immunology and Allergy, University of Health Sciences Dr. Behcet Uz Children's Hospital, İzmir, Turkey
| | - Ayca Kiykim
- Division of Pediatric Allergy and Immunology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ugur Musabak
- Department of Internal Medicine, Division of Immunology and Allergy, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Hasibe Artac
- Division of Immunology and Allergy, Department of Pediatrics, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Sukru Nail Guner
- Division of Pediatric Allergy and Immunology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Rachida Boukari
- Department of Pediatrics, Mustapha Pacha Faculty of Medicine, Algiers University, Algeria
| | - Reda Djidjik
- Department of Medical Immunology, Beni Messous University Hospital Center, Faculty of Pharmacy, University of Algiers, Algiers, Algeria
| | - Nadia Kechout
- Department of Immunology, Pasteur Institute of Algeria, Faculty of Medicine, Algiers, Algeria
| | - Deniz Cagdas
- Department of Pediatrics, Section of Pediatric Immunology, Ihsan Dogramaci Children's Hospital, Institute of Child Health, Hacettepe University Medical School, Ankara, Turkey
| | - Zeinab Awad El-Sayed
- Pediatric Allergy, Immunology and Rheumatology Unit, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Elif Karakoc-Aydiner
- Faculty of Medicine, Division of Pediatric Allergy and Immunology, Marmara University, Istanbul, Turkey; The Isil Berat Barlan Center for Translational Medicine, Istanbul Jeffrey Modell Foundation Diagnostic Center for Primary Immune Deficiencies, Istanbul, Turkey
| | - Raed Alzyoud
- Section of Immunology, Allergy and Rheumatology, Queen Rania Children Hospital, Amman, Jordan
| | - Mohamed Ridha Barbouche
- Department of Immunology, Institut Pasteur de Tunis and University Tunis El Manar, Tunis, Tunisia
| | - Mehdi Adeli
- Department of Immunology, Sidra Medicine, Ar-Rayyan, Qatar
| | - Rima Hanna Wakim
- Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon; Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon
| | - Shereen M Reda
- Pediatric Allergy, Immunology and Rheumatology Unit, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Aydan Ikinciogullari
- Department of Pediatric Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
| | - Ahmet Ozen
- Faculty of Medicine, Division of Pediatric Allergy and Immunology, Marmara University, Istanbul, Turkey; The Isil Berat Barlan Center for Translational Medicine, Istanbul Jeffrey Modell Foundation Diagnostic Center for Primary Immune Deficiencies, Istanbul, Turkey
| | - Aziz Bousfiha
- Laboratory of Clinical Immunology, Inflammation and Allergy, Faculty of Medicine and Pharmacy of Casablanca, Department of pediatric infectious and immunological diseases, Ibn Rushd Children Hospital, King Hassan II University, Casablanca, Morocco
| | - Hamoud Al-Mousa
- Department of Pediatrics, Division of Allergy and Immunology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Waleed Al-Herz
- Department of Pediatrics, Faculty of Medicine, Kuwait University, Safat, Kuwait City, Kuwait; Allergy and Clinical Immunology Unit, Pediatric Department, Al-Sabah Hospital, Kuwait City, Kuwait
| | - Raif S Geha
- Division of Immunology, Boston Children's Hospital and Harvard Medical School, Boston, Mass
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Arab Y, Choueiter N, Dahdah N, El-Kholy N, Abu Al-Saoud SY, Abu-Shukair ME, Agha HM, Al-Saloos H, Al Senaidi KS, Alzyoud R, Bouaziz A, Boukari R, El Ganzoury MM, Elmarsafawy HM, ELrugige N, Fitouri Z, Ladj MS, Mouawad P, Salih AF, Rojas RG, Harahsheh AS. Kawasaki Disease Arab Initiative [Kawarabi]: Establishment and Results of a Multicenter Survey. Pediatr Cardiol 2022; 43:1239-1246. [PMID: 35624313 PMCID: PMC9140321 DOI: 10.1007/s00246-022-02844-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022]
Abstract
Studies on Kawasaki disease (KD) in Arab countries are scarce, often providing incomplete data. This along with the benefits of multicenter research collaboratives led to the creation of the KD Arab Initiative [Kawarabi] consortium. An anonymous survey was completed among potential collaborative Arab medical institutions to assess burden of KD in those countries and resources available to physicians. An online 32-item survey was distributed to participating institutions after conducting face validity. One survey per institution was collected. Nineteen physicians from 12 countries completed the survey representing 19 out of 20 institutions (response rate of 95%). Fifteen (79%) institutions referred to the 2017 American Heart Association guidelines when managing a patient with KD. Intravenous immunoglobulin (IVIG) is not readily available at 2 institutions (11%) yet available in the country. In one center (5%), IVIG is imported on-demand. The knowledge and awareness among countries' general population was graded (0 to 10) at median/interquartiles (IQR) 3 (2-5) and at median/IQR 7 (6-8) in the medical community outside their institution. Practice variations in KD management and treatment across Arab countries require solid proactive collaboration. The low awareness and knowledge estimates about KD among the general population contrasted with a high level among the medical community. The Kawarabi collaborative will offer a platform to assess disease burden of KD, among Arab population, decrease practice variation and foster population-based knowledge.
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Affiliation(s)
- Yousra Arab
- University of Sherbrooke, Sherbrooke, QC Canada
| | - Nadine Choueiter
- Department of Pediatrics, Albert Einstein College of Medicine, Children’s Hospital at Montefiore, 3415 Bainbridge Ave, Bronx, NY 10467 USA
| | - Nagib Dahdah
- Division of Pediatric Cardiology, CHU Ste-Justine, Université de Montréal, 3175 Côte Sainte-Catherine, Montreal, QC H3T 1C5 Canada
| | - Nermeen El-Kholy
- Pediatric Cardiology Department, AlJalila Children’s Specialty Hospital, Dubai, United Arab Emirates
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Sima Y. Abu Al-Saoud
- Department of Pediatrics, Makassed Hospital, Faculty of Medicine, Al- Quds University, East-Jerusalem, Palestine
| | | | - Hala M. Agha
- Pediatric Cardiology Division, Cairo University, Cairo, Egypt
| | - Hesham Al-Saloos
- Division of Cardiology, Sidra Medicine, Doha, Qatar
- Clinical Pediatrics, Weill Cornell Medicine, Doha, Qatar
| | | | - Raed Alzyoud
- Pediatric Immunology, Allergy, and Rheumatology Division, Queen Rania Children’s Hospital, Amman, Jordan
| | - Asma Bouaziz
- Headmaster of Children and Neonatal Department, Hôpital Régional, Ben Arous, Tunisia
| | - Rachida Boukari
- Pediatric Department, University Hospital Mustapha Bacha, Algiers University, Algiers, Algeria
| | - Mona M. El Ganzoury
- Pediatric Cardiology Division, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hala M. Elmarsafawy
- Pediatric Cardiology Division, Children Hospital, Mansoura University, Mansoura, Egypt
| | - Najat ELrugige
- Pediatric Cardiology Department, Benghazi Children Hospital, Faculty of Medicine, Benghazi University, Benghazi, Libya
| | - Zohra Fitouri
- Unit of Rheumatology, Emergency and Outpatient Department, Pediatric Hospital of Béchir Hamza of Tunis, University Tunis El Manar, 1007 Djebel Lakhedher Bab Saadoun, Tunis, Tunisia
| | - Mohamed S. Ladj
- Pediatric Department, Djillali Belkhenchir University Hospital, Algiers, Algeria
- Faculty of Medicine, Algiers University, Algiers, Algeria
| | - Pierre Mouawad
- Pediatric Department, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Aso F. Salih
- Pediatric Cardiology Department/Children’s Heart Hospital- Sulaimani College of Medicine- Sulaimani University, Al-Sulaimaniyah, Iraq
| | - Rocio G. Rojas
- Clinical Research Program, Division of Pediatric Cardiology, CHU Sainte-Justine, Montreal, QC H3T 1C5 Canada
| | - Ashraf S. Harahsheh
- Division of Cardiology, Department of Pediatrics, Children’s National Hospital, George Washington University School of Medicine & Health Sciences, 111 Michigan Ave, NW, Washington, DC 20010 USA
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Alzyoud R, Alsuwaiti M, Maittah H, Aladaileh B, Nobani M, Farhan A, Alqurieny H, Khatatbeh A, Habahbeh Z. Pediatric Noninfectious Uveitis in a Tertiary Referral Center in Jordan: Clinical Spectrum and Immunomodulatory Treatment. Cureus 2022; 14:e25841. [PMID: 35720782 PMCID: PMC9191259 DOI: 10.7759/cureus.25841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives This study aims to describe the clinical, etiological, and treatment features of noninfectious uveitis in Jordanian children in a single center. Methods A retrospective, observational analysis of medical records of pediatric patients who were diagnosed with noninfectious uveitis from 2015 to 2020 at pediatric rheumatology and ophthalmology clinics at Queen Rania Children’s Hospital, Amman, Jordan, was conducted. All patients were below 14 years of age at diagnosis. The collected data included age at diagnosis, anatomical location of uveitis, laterality, associated systemic disease, and used medications. Results Overall, 96 patients were included in this cohort (41 males and 55 females), with a mean age at diagnosis of 8.4±2.4 years. Anterior uveitis (44.8%) was the commonest anatomical location. Based on laterality, bilateral uveitis was reported in 59.3% of all patients. Idiopathic uveitis (46.9%) and juvenile idiopathic arthritis-associated uveitis (JIAU) (35.5%) were the most common diagnoses. Of the children with idiopathic uveitis, 47% had panuveitis, while 61.7% of the children with JIAU had chronic anterior uveitis. Posterior synechiae were the most common complication (12.5%). Patients with refractory uveitis received infliximab (29.1%) and adalimumab (4.1%). Conclusion To the best of our knowledge, this is the first report on noninfectious uveitis in Jordanian children. Compared with other regional and international published reports, JIAU and idiopathic uveitis were the most common diagnoses. To obtain more details on noninfectious uveitis characteristics, a population-based rather than a single-center study is needed in Jordan.
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Alzyoud R. Off-label use of omalizumab in a 6-year-old child with severe atopic dermatitis. Qatar Med J 2022; 2022:21. [PMID: 35909406 PMCID: PMC9284595 DOI: 10.5339/qmj.2022.fqac.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background: Atopic dermatitis (AD) is a common chronic inflammatory skin disorder that affects up to 3% of adults and 15%-20% of children across the world. Although the mainstay of treatment is topical corticosteroids and/or calcineurin inhibitors, a majority of patients will not achieve a control of their condition and will need systemic treatment with steroids and immunosuppressants (1). Omalizumab is a humanized anti-IgE antibody licensed by the European Medical Agency for treatment of severe allergic asthma and spontaneous chronic urticaria in children older than 6 and 12 years, respectively; and a promising efficacy of omalizumab in the treatment of severe refractory AD has been shown by the ADAPT randomized clinical trial (2). Case report: A 6-year-old male patient being treated and followed at a pediatric dermatology clinic for a diagnosis of AD since the age of 3 years, showed unresponsive disease to different topical treatment options and non-pharmacological measures. The patient was referred to our clinic for systemic treatment when his SCORAD index was 70/103. At our immunology clinic, we did an extensive workup to unveil a comorbid or underlying disease. His labs showed high IgE levels at 2500 IU/mL, hypereosinophilia, and normal IgA, IgM, and lymphocyte subsets. We started him on different lines of immunosuppressants, including cyclosporine, prednisolone, tacrolimus, and intensive topical treatment; however, the patient did not show any noticeable response for 2 years. We then started him on omalizumab 300 mg twice weekly, and the SCORAD index dropped to 57 at 12 weeks and 55 at 18 weeks. The drug is still well tolerated, and we were able to stop systemic steroids at 15 weeks of treatment. Conclusion: Off-label use of omalizumab in a 6-year-old child with refractory severe AD was effective and safe in controlling the disease even though conventional systemic immunosuppressants proved ineffective.
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Affiliation(s)
- Raed Alzyoud
- Pediatric Immunology, Allergy, and Rheumatology Division, Queen Rania Children's Hospital, Amman-Jordan. E-mail:
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Alzyoud R, Alansari S, Maaitah H, AlDossari H, Monies D, Al-Mayouf SM. Familial Clustering of Juvenile Psoriatic Arthritis Associated with a Hemizygous FOXP3 Mutation. Curr Rheumatol Rep 2021; 23:64. [PMID: 34216291 DOI: 10.1007/s11926-021-01026-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW We describe the clinical and genetic findings in four patients from a single family who presented with refractory psoriatic arthritis and were hemizygous in the forkhead box protein 3 (FOXP3) gene (c.1222G>A). RECENT FINDINGS We report four siblings with hemizygous mutation in the FOXP3 gene (c.1222G>A) who presented with type 1 diabetes mellitus and psoriatic arthritis poorly responsive to treatment. Our findings expand the phenotype spectrum of FOXP3 mutations. Immune dysregulation, polyendocrinopathy, and enteropathy, X-linked (IPEX) syndrome is a rare disorder caused by mutations in FOXP3 gene, which lead to early onset of constellation of autoimmune manifestations. This report highlights the influence of immune dysregulation in juvenile arthritis.
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Affiliation(s)
- Raed Alzyoud
- Department of Pediatric Rheumatology, Immunology & Allergy, Queen Rania Children Hospital, Amman, Jordan
| | - Shahad Alansari
- Department of Pediatric Rheumatology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Heba Maaitah
- Department of Pediatric Rheumatology, Immunology & Allergy, Queen Rania Children Hospital, Amman, Jordan
| | - Haya AlDossari
- Department of Clinical Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Dorota Monies
- Department of Clinical Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Sulaiman M Al-Mayouf
- Department of Pediatric Rheumatology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. .,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
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Alkwai HM, Mirza A, Abdwani R, Asiri A, Bakry R, Alenazi A, Khawaja K, Lotfy H, Almutairi M, Muzaffer M, Al-Suwairi W, Alzyoud R, Al-Mayouf SM. Consensus clinical approach for a newly diagnosed systemic juvenile idiopathic arthritis among members of the pediatric rheumatology Arab group. Int J Pediatr Adolesc Med 2021; 8:129-133. [PMID: 34350323 PMCID: PMC8319680 DOI: 10.1016/j.ijpam.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/02/2021] [Accepted: 05/30/2021] [Indexed: 12/02/2022]
Abstract
Background Systemic juvenile idiopathic arthritis (sJIA) is a diagnosis of exclusion. The complex nature and clinical variety of the disease, as well as the vast clinical variation of disease presentation, may lead to difficulties in disease detection and subsequent delays in treatment. Aim To provide a consensus guidance on the management of newly diagnosed sJIA patients among pediatric rheumatologists in Arab countries. Methods This work was conducted in two phases. The first phase utilized an electronic survey sent through an email invitation to all pediatric rheumatologists in Arab countries. In the second phase, a Task Force of ten expert pediatric rheumatologists from Arab countries met through a series of virtual meetings. Results obtained in phase one were prioritized using a nominal group and Delphi-like techniques in phase two. Results Seven overarching principles and a set of recommendations were approved by the Task Force to form the final consensus. Conclusion This is the first consensus on a clinical approach for pediatric rheumatic diseases among Arab pediatric rheumatologists. It is presented as a guidance on the clinical approach to sJIA that requires further evidence, and future updates are anticipated.
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Affiliation(s)
| | - Aisha Mirza
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | | | | - Wafaa Al-Suwairi
- King Abdullah Specialist Children Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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Al-Mayouf SM, Hashad S, Khawaja K, Alrasheedi A, Abdwani R, Abushhaiwia A, AlSuwaiti M, Alzyoud R, Al Abrawi S, Asiri A, Alshaikh M, Sharif E, Muzaffer M, Alsewairi W, Zlenti M, Kawaja E, Almutairi M, Majeed M, Lotfy H, AlMarri M, Almutairi N. Cumulative Damage in Juvenile Idiopathic Arthritis: A Multicenter Study From the Pediatric Rheumatology Arab Group. Arthritis Care Res (Hoboken) 2021; 73:586-592. [PMID: 32886859 DOI: 10.1002/acr.24436] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/27/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To report the cumulative articular and extraarticular damage in Arab children with juvenile idiopathic arthritis (JIA) and to identify variables that correlate with disease damage. METHODS We conducted a multicenter, cross-sectional study among 14 pediatric rheumatology centers from 7 Arab countries. JIA patients who met the International League of Associations for Rheumatology classification criteria and had a disease duration of >1 year were enrolled. Disease activity status was assessed using the Juvenile Arthritis Multidimensional Assessment Report. Disease damage was assessed by the Juvenile Arthritis Damage Index, articular (JADI-A) and extraarticular (JADI-E). RESULTS A total of 702 (471 female) JIA patients with a median age of 11.3 years (interquartile range [IQR] 8.0-14.0 years) were studied. Median age at disease onset was 5 years (IQR 2.0-9.0 years) and the median disease duration was 4 years (IQR 2.0-7.0 years). The most frequent JIA categories were oligoarticular JIA (34.9%), polyarticular JIA (29.5%), and systemic JIA (24.5%). Clinical remission was achieved in 73.9% of patients. At the last clinic visit, 193 patients experienced joint damage, with a mean ± SD JADI-A score of 1.7 ± 4.5, while 156 patients had extraarticular damage, with a mean ± SD JADI-E score of 0.5 ± 1.1. Patients with enthesitis-related arthritis had the highest JADI-A score. JADI-A correlated significantly with the presence of a family history of JIA. JADI-A and JADI-E had a significant correlation with long disease duration. CONCLUSION Cumulative damage was common in this Arab JIA cohort, and consanguinity and JIA in a sibling were frequent findings and were associated with a greater cumulative damage.
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Affiliation(s)
| | | | | | - Abeer Alrasheedi
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | - Manal Alshaikh
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | | - Hala Lotfy
- Medical School, Cairo University, Cairo, Egypt
| | - Munira AlMarri
- Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Al-Mayouf SM, Yateem M, Al-Dusery H, Monies D, Wakil S, AlShiakh M, AlEnazi A, Aladaileh B, Alzyoud R, Meyer B. New or vanishing frontiers: LACC1-associated juvenile arthritis. Int J Pediatr Adolesc Med 2021; 8:44-47. [PMID: 33718577 PMCID: PMC7922844 DOI: 10.1016/j.ijpam.2020.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/24/2020] [Accepted: 11/09/2020] [Indexed: 04/25/2023]
Abstract
BACKGROUND The classification and pathogenic basis of juvenile idiopathic arthritis (JIA) are a subject of some controversy. Essentially, JIA is an exclusion diagnosis that represents a phenotypically heterogeneous group of arthritis of unknown origin. Familial aggregation of JIA supports the concept of genetic influence in the pathogenesis of JIA. OBJECTIVE To present the spectrum of laccase domain-containing 1 (LACC1)-associated juvenile arthritis with clinical, biochemical, and molecular genetic data of a cohort of 43 patients, including 11 previously unpublished cases. METHODS We studied 11 patients with different categories of juvenile idiopathic arthritis from 5 consanguineous families, all from Saudi Arabia, except 2 patients who were of Jordanian ethnicity. Whole-exome sequencing was used to identify the disease-causing variant of LACC1. We also reviewed the clinical spectrum and molecular genetic data of previously published cases of LACC1-associated juvenile arthritis. RESULTS This study describes 43 (29 females, 14 males) patients from consanguineous multiplex families. Most of the included patients were of Arab origin with 86% having early onset disease. The most frequent categories were systemic (19 patients) and rheumatoid factor-negative polyarticular (19 patients). Thirty-seven (86%) had progressive erosive arthritis and 10 (23.3%) had persistent limb lymphedema. None of the patients had features of macrophage activation syndrome. Genetic analysis confirmed LACC1 variant in all patients; 22 patients had common founder mutation (LACC1: c.850T > C,p.C284R), while the others showed different LACC1 variants. All patients were treated aggressively with methotrexate and sequential biologic agents. Most of them showed a poor response to treatment. CONCLUSION This report expands the pathogenic variants of LACC1 and the clinical spectrum associated with this genetic subset of juvenile arthritis. The predominance of autosomal-recessive inheritance and strong genetic evidence allowed us to propose LACC1-associated juvenile arthritis as a distinct disorder.
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Affiliation(s)
- Sulaiman M. Al-Mayouf
- Department of Pediatric Rheumatology, Riyadh, Saudi Arabia
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- Corresponding author. Pediatric Rheumatology, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Alfaisal University, Po Box 3354, Riyadh, 11211, Saudi Arabia.
| | - Mada Yateem
- Department of Pediatric Rheumatology, Riyadh, Saudi Arabia
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Haya Al-Dusery
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Dorota Monies
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Salma Wakil
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Manal AlShiakh
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | | | | | | | - Brian Meyer
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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14
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Al-Mayouf SM, Almutairi A, Albrawi S, Fathalla BM, Alzyoud R, AlEnazi A, Abu-Shukair M, Alwahadneh A, Alsonbul A, Zlenti M, Khawaja E, Abushhaiwia A, Khawaja K, AlMosawi Z, Madan W, Almuatiri M, Almuatiri N. Pattern and diagnostic evaluation of systemic autoinflammatory diseases other than familial Mediterranean fever among Arab children: a multicenter study from the Pediatric Rheumatology Arab Group (PRAG). Rheumatol Int 2019; 40:49-56. [PMID: 31741047 DOI: 10.1007/s00296-019-04478-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 11/08/2019] [Indexed: 01/30/2023]
Abstract
To define the spectrum and phenotypic characteristics of systemic autoinflammatory diseases (SAIDs) other than familial Mediterranean fever (FMF) in Arab children and to delineate diagnostic evaluation. Data retrospectively collected on patients with clinical and/or genetically proven SAIDs other than FMF at 10 tertiary Arab pediatric rheumatology clinics from 1990 to 2018. The collected data comprised the clinical findings and diagnostic evaluation including genetic testing, the provided treatment and the accrual damage related to SAIDs. A total of 144 patients (93 female) with a median age at onset of 2.5 (range 0.1-12) years were enrolled. The initial diagnosis was inaccurate in 49.3%. Consanguinity rate among parents was 74.6%. The median time-to-diagnosis for all SAIDs was 2.5 (range 0.1-10) years. There were 104 patients (72.2%) with a confirmed diagnosis and 40 patients with suspected SAIDs. Seventy-two had monogenic and 66 patients with multifactorial SAIDs while six patients had undifferentiated SAIDs. The most frequent monogenic SAIDs were LACC1 mediated monogenic disorders (n = 23) followed by CAPS (12), TRAPS (12), HIDS (12), and Majeed's syndrome (6). The most frequent multifactorial SAIDs was CRMO (34), followed by PFAPA (18), and early onset sarcoidosis (EOS) (14). Genetic analysis was performed in 69 patients; 50 patients had genetically confirmed disease. Corticosteroid used for 93 patients while biologic agents for 96 patients. Overall, growth failure was the most frequent accrual damage (36%), followed by cognitive impairment (13%). There were three deaths because of infection. This study shows a heterogenous spectrum of SAIDs with a high number of genetically confirmed monogenic diseases; notably, LACC1 associated diseases. Hopefully, this work will be the first step for a prospective registry for SAIDs in Arab countries.
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MESH Headings
- Acne Vulgaris/diagnosis
- Acne Vulgaris/drug therapy
- Acne Vulgaris/epidemiology
- Acne Vulgaris/physiopathology
- Adolescent
- Anemia, Dyserythropoietic, Congenital/diagnosis
- Anemia, Dyserythropoietic, Congenital/drug therapy
- Anemia, Dyserythropoietic, Congenital/epidemiology
- Anemia, Dyserythropoietic, Congenital/physiopathology
- Antirheumatic Agents/therapeutic use
- Arabs
- Arthritis/diagnosis
- Arthritis/drug therapy
- Arthritis/epidemiology
- Arthritis/physiopathology
- Arthritis, Infectious/diagnosis
- Arthritis, Infectious/drug therapy
- Arthritis, Infectious/epidemiology
- Arthritis, Infectious/physiopathology
- Arthritis, Juvenile/drug therapy
- Arthritis, Juvenile/epidemiology
- Arthritis, Juvenile/genetics
- Arthritis, Juvenile/physiopathology
- Bahrain/epidemiology
- Child
- Child, Preschool
- Consanguinity
- Crohn Disease/drug therapy
- Crohn Disease/epidemiology
- Crohn Disease/genetics
- Crohn Disease/physiopathology
- Cross-Sectional Studies
- Cryopyrin-Associated Periodic Syndromes/diagnosis
- Cryopyrin-Associated Periodic Syndromes/drug therapy
- Cryopyrin-Associated Periodic Syndromes/epidemiology
- Cryopyrin-Associated Periodic Syndromes/physiopathology
- Diagnostic Errors
- Female
- Fever/diagnosis
- Fever/drug therapy
- Fever/epidemiology
- Fever/physiopathology
- Hereditary Autoinflammatory Diseases/diagnosis
- Hereditary Autoinflammatory Diseases/drug therapy
- Hereditary Autoinflammatory Diseases/epidemiology
- Hereditary Autoinflammatory Diseases/physiopathology
- Humans
- Immunologic Deficiency Syndromes/diagnosis
- Immunologic Deficiency Syndromes/drug therapy
- Immunologic Deficiency Syndromes/epidemiology
- Immunologic Deficiency Syndromes/physiopathology
- Infant
- Intracellular Signaling Peptides and Proteins/genetics
- Jordan/epidemiology
- Kuwait/epidemiology
- Libya/epidemiology
- Male
- Mevalonate Kinase Deficiency/diagnosis
- Mevalonate Kinase Deficiency/drug therapy
- Mevalonate Kinase Deficiency/epidemiology
- Mevalonate Kinase Deficiency/physiopathology
- Oman/epidemiology
- Osteomyelitis/diagnosis
- Osteomyelitis/drug therapy
- Osteomyelitis/epidemiology
- Osteomyelitis/physiopathology
- Pyoderma Gangrenosum/diagnosis
- Pyoderma Gangrenosum/drug therapy
- Pyoderma Gangrenosum/epidemiology
- Pyoderma Gangrenosum/physiopathology
- Retrospective Studies
- Sarcoidosis/diagnosis
- Sarcoidosis/drug therapy
- Sarcoidosis/epidemiology
- Sarcoidosis/physiopathology
- Saudi Arabia/epidemiology
- Synovitis/diagnosis
- Synovitis/drug therapy
- Synovitis/epidemiology
- Synovitis/physiopathology
- United Arab Emirates/epidemiology
- Uveitis/diagnosis
- Uveitis/drug therapy
- Uveitis/epidemiology
- Uveitis/physiopathology
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Affiliation(s)
- Sulaiman M Al-Mayouf
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Alfaisal University, Po Box 3354, Riyadh, 11211, Saudi Arabia.
| | - Abdulaziz Almutairi
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Alfaisal University, Po Box 3354, Riyadh, 11211, Saudi Arabia
| | | | - Basil M Fathalla
- Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates
| | | | | | | | | | - Abdullah Alsonbul
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Alfaisal University, Po Box 3354, Riyadh, 11211, Saudi Arabia
| | | | | | | | | | | | - Wafa Madan
- Salmaniya Medical Complex, Manama, Bahrain
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15
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Volpi S, Cicalese MP, Tuijnenburg P, Tool ATJ, Cuadrado E, Abu-Halaweh M, Ahanchian H, Alzyoud R, Akdemir ZC, Barzaghi F, Blank A, Boisson B, Bottino C, Brigida I, Caorsi R, Casanova JL, Chiesa S, Chinn IK, Dückers G, Enders A, Erichsen HC, Forbes LR, Gambin T, Gattorno M, Karimiani EG, Giliani S, Gold MS, Jacobsen EM, Jansen MH, King JR, Laxer RM, Lupski JR, Mace E, Marcenaro S, Maroofian R, Meijer AB, Niehues T, Notarangelo LD, Orange J, Pannicke U, Pearson C, Picco P, Quinn PJ, Schulz A, Seeborg F, Stray-Pedersen A, Tawamie H, van Leeuwen EMM, Aiuti A, Yeung R, Schwarz K, Kuijpers TW. A combined immunodeficiency with severe infections, inflammation, and allergy caused by ARPC1B deficiency. J Allergy Clin Immunol 2019; 143:2296-2299. [PMID: 30771411 DOI: 10.1016/j.jaci.2019.02.003] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/31/2019] [Accepted: 02/05/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Stefano Volpi
- Clinica Pediatrica e Reumatologia, Centro per le malattie Autoinfiammatorie e Immunodeficienze, Istituto Giannina Gaslini, Genova, Italy; DINOGMI, Università degli Studi di Genova, Genova, Italy.
| | - Maria Pia Cicalese
- Pediatric Immunohematology, San Raffaele Hospital and San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), Milan, Italy
| | - Paul Tuijnenburg
- Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Experimental Immunology, Amsterdam Infection & Immunity Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Anton T J Tool
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Eloy Cuadrado
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Marwan Abu-Halaweh
- Department of Biotechnology and Genetics Engineering in Philadelphia University, Amman, Jordan
| | - Hamid Ahanchian
- Department of Allergy and Immunology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Raed Alzyoud
- Queen Rania Children's Hospital, Immunology, Allergy and Rheumatology Section, Bone Marrow Transplantation for Primary Immunodeficiency Disorders, Amman, Jordan
| | - Zeynep Coban Akdemir
- Baylor-Hopkins Center for Mendelian Genomics of the Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Federica Barzaghi
- Pediatric Immunohematology, San Raffaele Hospital and San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), Milan, Italy
| | - Alexander Blank
- Department of Pediatrics, University Medical Center Ulm, Ulm, Germany
| | - Bertrand Boisson
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY; Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Paris, France; Imagine Institute, Paris Descartes University, Paris, France
| | - Cristina Bottino
- Department of Experimental Medicine (DIMES), University of Genoa, Genova, Italy; Istituto Giannina Gaslini, Genova, Italy
| | - Immacolata Brigida
- Pediatric Immunohematology, San Raffaele Hospital and San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), Milan, Italy
| | - Roberta Caorsi
- Clinica Pediatrica e Reumatologia, Centro per le malattie Autoinfiammatorie e Immunodeficienze, Istituto Giannina Gaslini, Genova, Italy
| | - Jean-Laurent Casanova
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY; Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Paris, France; Imagine Institute, Paris Descartes University, Paris, France; Pediatric Hematology-Immunology and Rheumatology Unit, Necker Hospital for Sick Children, APHP, Paris, France; Howard Hughes Medical Institute, New York, NY
| | - Sabrina Chiesa
- Clinica Pediatrica e Reumatologia, Centro per le malattie Autoinfiammatorie e Immunodeficienze, Istituto Giannina Gaslini, Genova, Italy
| | - Ivan Kingyue Chinn
- Department of Pediatrics, Section of Allergy, Immunology, and Rheumatology & Center for Human Immunobiology, Texas Children's Hospital, Houston, Texas
| | - Gregor Dückers
- Center for Child and Adolescent Medicine, Helios-Clinic, Krefeld, Germany
| | - Anselm Enders
- Department of Immunology and Infectious Disease, John Curtin School of Medical Research and Centre for Personalised Immunology, Australian National University, Canberra, ACT, Australia
| | - Hans Christian Erichsen
- Section of Paediatric Medicine and Transplantation, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Lisa R Forbes
- Department of Pediatrics, Section of Allergy, Immunology, and Rheumatology & Center for Human Immunobiology, Texas Children's Hospital, Houston, Texas
| | - Tomasz Gambin
- Baylor-Hopkins Center for Mendelian Genomics of the Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas; Institute of Computer Science, Warsaw University of Technology, Warsaw, Poland
| | - Marco Gattorno
- Clinica Pediatrica e Reumatologia, Centro per le malattie Autoinfiammatorie e Immunodeficienze, Istituto Giannina Gaslini, Genova, Italy
| | - Ehsan Ghayoor Karimiani
- Molecular and Clinical Sciences Institute, St George's, University of London, Cranmer Terrace, London, United Kingdom; Innovative Medical Research Center, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Silvia Giliani
- Medical Genetics Unit and "A. Nocivelli" Institute for Molecular Medicine, Spedali Civili Hospital, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Michael S Gold
- Discipline of Pediatrics, School of Medicine, University of Adelaide and Department of Allergy and Clinical Immunology, Women's and Children's Health Network, Adelaide, South Australia, Australia
| | | | - Machiel H Jansen
- Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Experimental Immunology, Amsterdam Infection & Immunity Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jovanka R King
- Discipline of Pediatrics, School of Medicine, University of Adelaide and Department of Allergy and Clinical Immunology, Women's and Children's Health Network, Adelaide, South Australia, Australia
| | - Ronald M Laxer
- Division of Rheumatology, Department of Paediatrics and Department of Medicine, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - James R Lupski
- Baylor-Hopkins Center for Mendelian Genomics of the Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas; Department of Pediatrics, Baylor College of Medicine, Houston, Texas; Texas Children's Hospital, Houston, Texas
| | - Emily Mace
- Department of Pediatrics, Section of Allergy, Immunology, and Rheumatology & Center for Human Immunobiology, Texas Children's Hospital, Houston, Texas
| | | | - Reza Maroofian
- Medical Research, RILD Welcome Wolfson Centre, Exeter Medical School, Royal Devon and Exeter NHS Foundation Trust, Exeter and Genetics and Molecular Cell Sciences Research Centre, St George's University of London, London, United Kingdom
| | - Alexander B Meijer
- Department of Plasma Proteins, Sanquin Research and Landsteiner Laboratory AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Tim Niehues
- Center for Child and Adolescent Medicine, Helios-Clinic, Krefeld, Germany
| | - Luigi D Notarangelo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Md
| | - Jordan Orange
- Department of Pediatrics, Section of Allergy, Immunology, and Rheumatology & Center for Human Immunobiology, Texas Children's Hospital, Houston, Texas
| | - Ulrich Pannicke
- Institute for Transfusion Medicine, University Ulm, Ulm, Germany
| | - Chris Pearson
- Department of General Medicine, Women's and Children's Health Network, Adelaide, South Australia, Australia
| | - Paolo Picco
- Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Genova, Italy
| | - Patrick J Quinn
- Discipline of Pediatrics, School of Medicine, University of Adelaide and Department of Allergy and Clinical Immunology, Women's and Children's Health Network, Adelaide, South Australia, Australia
| | - Ansgar Schulz
- Department of Pediatrics, University Medical Center Ulm, Ulm, Germany
| | - Filiz Seeborg
- Department of Pediatrics, Section of Allergy, Immunology, and Rheumatology & Center for Human Immunobiology, Texas Children's Hospital, Houston, Texas
| | - Asbjørg Stray-Pedersen
- Norwegian National Unit for Newborn Screening, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Hasan Tawamie
- Institute of Human Genetics of Leipzig, Leipzig, Germany
| | - Ester M M van Leeuwen
- Department of Experimental Immunology, Amsterdam Infection & Immunity Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Alessandro Aiuti
- Pediatric Immunohematology, San Raffaele Hospital and San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), Milan, Italy
| | - Rae Yeung
- Division of Rheumatology, Department of Paediatrics and Department of Medicine, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Paediatrics, Institute of Medical Science, University of Toronto, Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Immunology, Institute of Medical Science, University of Toronto, Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Klaus Schwarz
- Institute for Transfusion Medicine, University Ulm, Ulm, Germany; the Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Wuerttemberg - Hessen, Ulm, Germany
| | - Taco W Kuijpers
- Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory AMC, University of Amsterdam, Amsterdam, the Netherlands.
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16
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Alzyoud R, Alsweiti M, Maittah H, Zreqat E, Alwahadneh A, Abu-Shukair M, Habahbeh L, Mutereen M. Familial Mediterranean fever in Jordanian Children: single centre experience. Mediterr J Rheumatol 2018; 29:211-216. [PMID: 32185329 PMCID: PMC7045932 DOI: 10.31138/mjr.29.4.211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/14/2018] [Accepted: 11/15/2018] [Indexed: 11/04/2022] Open
Abstract
Background Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disorder caused by mutations in the Mediterranean Fever (MEFV) gene. The disease is especially common among Mediterranean ancestry, mostly Armenian, Turkish, Jewish and Arab populations. Our aim is to describe clinical phenotype, and genotype of FMF in the Jordanian children. Patients and Methods A retrospective analysis was conducted on paediatric patients who were below 14 years of age and diagnosed as FMF at Queen Rania Children's Hospital in Jordan between 2014 and 2017. Results A total of 196 paediatric patients diagnosed with FMF were included; 54% females and 46% males. The mean age of patients at time of study was 7.8 years, at disease onset was 4.9 years, and at time of diagnosis was 6.6 years. The most common presenting features were abdominal pain (91.8%), fever (73%), arthralgia (16.8 %), and myalgia (12.8%). MEFV gene mutations were homozygous in 47 (24%) patients, heterozygous in 87 (44.4%) patients, compound heterozygous in 55 (28.1%), and negative genotype in 7 (3.6%) patients. Five mutations were the most frequent; M694V, V726A, E148Q, M680I, M694I. All patients were colchicine responsive. We reported only one case of amyloidosis. Conclusion The five FMF founder mutations: M694V, V726A, E148Q, M680I, and M694I were the most common in Jordanian children, but had a different order from other ethnic groups.
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Affiliation(s)
- Raed Alzyoud
- Division of Paediatric Immunology, Allergy, and Rheumatology
| | | | - Hiba Maittah
- Division of Paediatric Immunology, Allergy, and Rheumatology
| | - Ehab Zreqat
- Division of Paediatric Gastroenterology, Queen Rania Children's Hospital
| | - Adel Alwahadneh
- Division of Paediatric Immunology, Allergy, and Rheumatology
| | | | - Lana Habahbeh
- Department of Pathology, King Hussein Medical Centre, Amman, Jordan
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