Autoimmune hemolytic anemia (AIHA) is a common disease entity among adults; however, it is rare among the pediatric age group. Evidence is scarce regarding pediatric AIHA in the literature. The objective of this study is to assess the frequency of AIHA and describe the clinical and laboratory characteristics and treatment outcomes of a cohort of children with AIHA in Egypt. A retrospective study was conducted on 50 children with AIHA who were registered and followed up at the New Children’s Hospital in Cairo, Egypt, between January 2010 and January 2021. The study group comprised 60% females and 40% males. Their median age was 8.25 years. All patients showed low hemoglobin levels with a mean of 5.40 ± 1.34 g/dl and a median reticulocyte count of 10 (IQR: 8–15). Twelve (24%) patients were diagnosed with Evans syndrome, and a positive Coombs test was detected in 46 patients (92%). The frequency of primary AIHA was 40%, whereas it was 60% for secondary AIHA. The first line of therapy for acute attacks was high-dose IV steroids which responded well in 38 (76%) patients. Secondary AIHA was more common among our children (60%). AIHA is more prevalent in females (60%). The clinical and laboratory characteristics matched previous reports.

No abstract

Background Thyroid disease is more frequent in patients with systemic lupus erythematosus (SLE) than in the general population. The main purpose of this study is to evaluate the occurrence of immunological thyroid dysfunctions in Egyptian children with SLE in a single center and its relation to the disease activity and duration. Methods This is a cross-sectional observational study. The study included 50 children and adolescents with SLE. All patients were subjected to complete history taking, thorough physical examination. Thyroid profile, anti-thyroglobulin and anti-thyroid peroxidase antibodies were assayed using an enzyme-linked immunosorbent assay (ELISA) technique. Results Out of 50 patients, six were males (12%), and 44 were females (88%), with female to male ratio (F: M = 7: 1). Their ages ranged from 5–17 years, with a median of 12 years. Thirty-two of patients (64%) had thyroid dysfunctions, 19 (38%) were diagnosed with euthyroid sick syndrome, ten (20%) had overt hypothyroidism, three (6%) had subclinical hypothyroidism, and none of the patients had hyperthyroidism. Antithyroglobulin antibodies (Anti-TG) was normal in all patients of the studied group, and antithyroid peroxidase (anti-TPO) was elevated in one (2%) out of 50 patients. There was a significant negative correlation between free thyroxine (FT4) and disease duration with a p-value of 0.007. Moreover, by comparing the duration of the disease and thyroid antibodies (anti-TG, and anti-TPO), there was a significant negative correlation with p-values of 0.015 and 0.028. Conclusions Intermittent biochemical screening of thyroid function and anti-thyroid antibodies is recommended as part of the clinical profile in SLE patients, to identify clinical/subclinical thyroid disease. To intervene with the most convenient therapy whenever indicated.

Background: Frequency of congenital heart disease (CHD) association with Coronavirus disease 2019 (COVID-19) is lacking. Aim of work: to study difference of frequency and pattern of congenital heart diseases among neonates conceived during the pre-COVID-19 era, and those conceived during the COVID-19 era who were admitted to the Neonatal Intensive Care Unit (NICU), Faculty of Medicine Pediatric Hospitals, Cairo University. Material and Methods: This was a retrospective descriptive study in which we revised the files of all neonates admitted to NICU in a period of 6 months from September 2019 till February 2020 (group 1) and from September 2021 till February 2022 (group 2) who were conceived before and during the COVID era respectively. Results: 162 newborns with CHD were enrolled in this study from a total of 1488 admitted in NICU during the 12 months of the study. 74 CHD patients were conceived in the pre COVID era (group 1) whereas 88 patients were conceived during COVID era (group 2). In group 1: 43 cases were males (58.1%) and 31 were females (41.9%), compared to group 2: where 53 were males (60.2%) and 35 were females (39.8%) (p = 0.785). There was no difference in frequency or type of CHD among the 2 groups. The most common CHD was patent ductus arteriosus (PDA) with and without pulmonary hypertension in 34 cases (45.9%), followed by atrial septal defect (ASD) in 19 (25.7%), then ventricular septal defect (VSD) in 7 (9.5%), which was not different than in group 2, the most common CHD was PDA with and without pulmonary hypertension in 52 cases (59.1%) then VSD in 8 (9.1%), VSD and ASD in 8 (9.1%) (p= 0.555). Conclusion:The frequency and type of CHD among neonates admitted to our NICU was not different in the era before and the COVID-19 era. PDA with and without pulmonary hypertension was the commonest CHD in both eras.

Background: Juvenile idiopathic arthritis (JIA) represents a heterogeneous group of autoimmune diseases that arises before the age of 16 years and lasts more than 6 months. During acute inflammation of the disease, serum copper concentration increases and zinc decreases, that could point to the possible pharmacological properties of these trace elements. Aim: To measure the serum level of zinc and copper in patients with juvenile idiopathic arthritis (JIA) with different subtypes and correlate the levels of zinc and copper with the disease activity. Methods: This cross-sectional study was done on 40 patients already diagnosed clinically with JIA; patients were followed-up at the Rheumatology Outpatient Clinic, Children's Hospital, Cairo University. Results: Out of forty patients, 16 were males (40%) and 24 were females (60%) with a male to female ratio (M: F) of 1:1.5. Out of the forty patients 17 were in activity and 23 were without activity. Thirty age and sex matched controls were included for comparison. Serum copper level was significantly higher in patients with JIA than those of the controls (P= 0.017) while there were no significant difference in serum level of zinc between JIA patients and that of the controls. Conclusion: Alteration of serum copper and zinc probably is a defense response against JIA; increased copper may be due to inflammation associated, these elements could serve as biomarkers for the disease activity.