Septic osteomyelitis in children is sometimes challenging for physicians to diagnose. The diagnosis often is unclear at the initial evaluation. The initial presentation may be nonspeci c. Children older than 3 months of age with hematogenous osteomyelitis usually present acutely with fever, constitutional symptoms (eg, irritability, decreased appetite or activity). Close monitoring of the clinical course is essential to establishing the diagnosis.
Many common diseases known to us initially have unusual, non-specific clinical manifestations, making diagnosis difficult. We presented cases from our practice where the so-called "Overlap" clinical manifestation occurred. Specifically, a 10-year-old boy with recurrent fever and hemorrhagic rash, with history of epilepsy, and a 5-year-old boy with pleuropneumonia and thrombocytopenia.
We are presenting a rare case of overlap of Sjögren's syndrome (SS) and Celiac disease (CD). It is necessary to evaluate and diagnose timely the possible presence of other autoimmune diseases in the presence of any autoimmune disease, because they have about a 25% risk of developing several of them at the same time, which is called overlap syndrome. It is very important to do screening, follow up and regular GI care of Sjögren's syndrome patients to identify CD case and help them to avoid severe malnutrition, hyponatremia, anaemia and later intestinal malignancies.
A rare case of SCFN was diagnosed in a newborn, a rare disease in the neonatal period, emphasizes the importance of a histological findings for a definitive diagnosis. Subcutaneous fat necrosis of the newborn (SCFN) is an uncommon panniculitis of neonates. Although SCFN is a self-limited condition, recognition of this entity is important, as affected infants require monitoring for associated hypercalcemia or other complications. SCFN generally has a good outcome, with spontaneous resolution of skin lesions over weeks to months. However, death from hypercalcemia has been reported in a few infants with SCFN.
Herein we are presenting unusual case of severe neutropenia and JIA in a child. To our understanding, in this particular case, maternal Covid-19 caused an unusual presentation of neutropenia and JIA, with very high ANF. The role of neutrophils in pediatric rheumatology is an understudied field but is receiving increasing attention. Although clearly implicated in JIA, the specific contribution of neutrophils to pathogenesis and the use of neutrophil activity as biomarkers require further study.
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