RESUMO
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.
RESUMO
BACKGROUND: Juvenile idiopathic arthritis (JIA) is a heterogeneous group of disorders, including all forms of arthritis, which develops in children who are less than 16 years old. This study aimed to evaluate the clinical and laboratory features of JIA in a single center in Jordan. METHODS: A retrospective analysis of the electronic medical records of Pediatric patients diagnosed with JIA based on the International League of Associations for Rheumatology (ILAR) criteria during the period from 2015 to 2019 at the Pediatric Rheumatology Clinic in the Queen Rania Children's Hospital. All patients were below the age of 14 years at the time of diagnosis and followed for at least 6 months. Collected data consisted of age, gender, age at initial presentation and diagnosis, JIA subtype, laboratory data, treatment options, and outcome. RESULTS: A total of 210 patients were included in this cohort (94 males and 116 females) with the mean age at diagnosis and mean age at onset of 5.33 ± 3.40 years and 5.08 ± 3.40 years (range: 7 months - 14 years), respectively. Oligoarticular JIA was the commonest subtype (54.7%), followed by systemic arthritis (17.1%) and polyarticular arthritis (12.3%). ANA was positive in 70 patients (33.6%). Uveitis occurred in 30 (14.2%) patients. CONCLUSION: To the best of our knowledge, this study on this cohort is the first report on JIA in Jordan, in comparison with other regionally and internationally published reports. Oligoarticular JIA was found to be the most common subtype. For detailed knowledge on JIA characteristics and patterns, a population-based, rather than a single center study, should be conducted in Jordan.
