Clinical presentation and management of multisystem inflammatory syndrome in children associated with covid-19: a retrospective observational descriptive study in a pediatric hospital in Syria.

OBJECTIVE: Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 is a rare and serious medical condition. This study aims to review the clinical presentation, laboratory parameters, outcomes, and management of MIS-C cases in a pediatric hospital in Syria. METHODS: This retrospective observational study aimed to investigate MIS-C between May 2020 and October 2021. Data collection involved extracting information from medical records, and patients were identified based on the case definition established by the World Health Organization (WHO). Various laboratory investigations, diagnostic evaluations, clinical presentations, and treatments were performed to assess patients. Descriptive statistical analysis was conducted using Microsoft Excel. RESULTS: A total of 232 COVID-19 cases were reported with COVID-19 Infection. Among these cases, 25 (10.77%) were identified as MIS-C. The median age of the patients was 5.5 years, with the majority being male patients (72%). Patients experienced fever (100%), bilateral conjunctivitis (88%), rash (84%), gastrointestinal symptoms (76%), and cardiac dysfunction (72%). Other notable findings included oral cavity changes (64%), edema (36%), cervical lymphadenopathy (36%), and neurological manifestations (28%). Respiratory symptoms were uncommon (16%). All patients recovered, with no recorded deaths. CONCLUSION: The predominant presence of positive SARS-CoV-2 IgG in the majority of patients in this study supports the post-infectious nature of MIS-C. Respiratory symptoms were less prevalent in both pediatric COVID-19 and MIS-C patients. Early supportive care is crucial in management, although additional research is needed to establish definitive guidelines. Larger studies are necessary to overcome the limitations of this study and to enhance our understanding of MIS-C in pediatric COVID-19 patients.

Familial Mediterranean fever and scleroderma: a rare case report from Syria.

Familial Mediterranean fever (FMF) is an inherited autoinflammatory disease that affects the skin, joints, serous membranes and other various organs. Presentation of FMF can be solely but it can coexist with other conditions. It has been shown that it can be accompanied by various different disorders. Scleroderma is an autoimmune dermatologic condition that can present with systemic manifestations. No previous cases about the coexistence of FMF and scleroderma were previously documented, therefore we report the first case in Syria of a 10-year-old female that presented with clinically clear signs of both conditions (periodic fever and serous chest pain in addition to skin hyperpigmentation). The patient's symptoms required full genetic testing along with the proper antibody detection and The diagnosis of FMF and scleroderma was confirmed by genetic testing and treatment was started.

First case of childhood Takayasu arteritis from Syria: a case report.

BACKGROUND: Takayasu arteritis is a systemic granulomatous inflammation affecting the large- and medium-sized vessels such as aorta, its main branches, and pulmonary and renal arteries. Childhood Takayasu arteritis is a subtype of Takayasu arteritis that affects the age group ranging from young infants to late adolescents. CASE PRESENTATION: We report the first childhood Takayasu arteritis case from Syria, a 12-year-old Syrian girl presenting with nonspecific symptoms and signs plus ischemic clinical features in her left arm. She relapsed twice with different additional symptoms each time. CONCLUSIONS: There is scarcity of reviews and studies on childhood Takayasu arteritis in Arabs. We aim to share our experience to keep childhood Takayasu arteritis in mind as a differential diagnosis in any child presenting with hypertension, absent or reduced peripheral arterial pulse, or blood pressure differences between extremities.

Macrophage Activation Syndrome: A Report of Two Cases and a Literature Review.

Macrophage activation syndrome (MAS) is a severe, potentially fatal condition that may complicate autoimmune diseases, and it belongs to hemophagocytic lymphohistiocytosis (HLH) disorders. MAS occurs in adults and children. However, it is rare in juvenile systemic lupus erythematosus (jSLE), and it is extremely rare to be the initial presentation of jSLE. Here, we report two patients with juvenile SLE who initially presented with MAS. One of the two patients is 4 years old. This is the youngest reported patient to our knowledge.