Rheumatic Diseases in Children: 2nd Edition

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Allergy and Immunology".

Deadline for manuscript submissions: closed (1 October 2024) | Viewed by 3919

Special Issue Editor


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Guest Editor
Pediatric and Neonatology Unit, Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Polo Pontino, Latina, Italy
Interests: pediatric rheumatic diseases; autoimmune diseases; autoinflammatory diseases; translational research
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Special Issue Information

Dear Colleagues,

Pediatric rheumatology is a developing field, with important links to other clinical specialties. The importance of this linkage was also seen during the pandemic period with the study of the role of inflammation in COVID-19 disease and the emerging role of anti-rheumatic drugs for its treatment.

This update on rheumatic diseases in children embraces both conditions that are unique to children and others that are also found in adults but that require a different, age-related approach. They are represented by several disorders, including autoimmune diseases, non-inflammatory pain syndromes, inflammatory disorders, as well as disorders of the innate immune system such as autoinflammatory diseases. Early recognition and treatment of these conditions are fundamental for the management of these patients.

Moreover, recent advances in healthcare, evidence-based medicine, translational approaches, as well as greater focus on childrens’ needs, have all significantly improved the prognosis and quality of life for children and their families.

The purpose of this Special Issue of Children is to collect contributions related to autoimmune and rheumatic disorders practice and research in children.

We welcome reviews and research considering novel approaches and identifying gaps in knowledge. Description of interesting case reports will also be appreciated. The volume is intended to encourage and promote multidisciplinary collaboration among laboratory and clinical researchers.

I forward to receiving your contributions.

Dr. Emanuela Del Giudice
Guest Editor

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Keywords

  • pediatric rheumatic diseases
  • autoimmune diseases
  • autoinflammatory diseases
  • non-inflammatory pain syndromes
  • inflammation
  • multidisciplinary

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Published Papers (3 papers)

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Research

14 pages, 744 KiB  
Article
Pre-Rheumatology Referral Consultation and Investigation Pattern in Children with Joint Complaints: Focus on Juvenile Idiopathic Arthritis
by Achille Marino, Paola Baldassarre, Cristina Ferrigno, Andrea Biuso, Martina Minutoli, Francesco Baldo, Stefania Costi, Maurizio Virgilio Gattinara, Roberto Felice Caporali and Cecilia Beatrice Chighizola
Children 2024, 11(5), 600; https://doi.org/10.3390/children11050600 - 16 May 2024
Cited by 1 | Viewed by 982
Abstract
The diagnosis of juvenile idiopathic arthritis (JIA) is often entrusted to the pediatric rheumatologist specialist. Timely referral to a specialized center is crucial. This study aims to assess the consultation and investigation patterns of patients with joint complaints before rheumatology referral. This longitudinal [...] Read more.
The diagnosis of juvenile idiopathic arthritis (JIA) is often entrusted to the pediatric rheumatologist specialist. Timely referral to a specialized center is crucial. This study aims to assess the consultation and investigation patterns of patients with joint complaints before rheumatology referral. This longitudinal cohort study included patients with joint complaints who were referred to the Pediatric Rheumatology Unit. The cohort included 301 patients (58% female), 50 of them (17%) diagnosed with JIA. Compared to patients with orthopedic conditions or functional diseases, JIA patients had seen more specialists (p < 0.01) and received a quicker diagnosis (p < 0.01). Patients with early JIA diagnosis (within 3 months from symptoms onset) were younger (8.46 vs. 11.5 years old; p = 0.04), more frequently female (78% vs. 47%, p = 0.03), and with higher erythrocyte sedimentation rate (ESR) values (37 vs. 9 mm/h; p = 0.02) than those diagnosed later. Patients with a late diagnosis of JIA had a significantly longer median time between the first healthcare visit and the PR referral (25 vs. 101 days; p < 0.01). The main contributor to diagnostic delay in JIA was the time required for PR referral after the first healthcare consult. Younger age, female sex, and higher ESR values were associated with earlier diagnosis of JIA. Full article
(This article belongs to the Special Issue Rheumatic Diseases in Children: 2nd Edition)
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10 pages, 494 KiB  
Article
Facing Pediatric Rheumatic Diseases: The Role of Disease Activity and Parental Emotion Regulation Strategy in Parents’ and Children’s Psychological Adjustment
by Emanuela Del Giudice, Riccardo Lubrano, Sonia Monique Bramanti, Alessandra Babore, Carmen Trumello, Sara Giovanna De Maria, Anna Dilillo, Alessia Marcellino, Vanessa Martucci, Mariateresa Sanseviero, Silvia Bloise, Flavia Ventriglia and Valerio Manippa
Children 2023, 10(12), 1863; https://doi.org/10.3390/children10121863 - 28 Nov 2023
Viewed by 1152
Abstract
Background: Pediatric rheumatic diseases (PRDs) are a group of chronic disorders that start in childhood and are characterized by periodic exacerbations and remissions of symptoms, with limitations in family, school, and social activities. The aim of this study was to detect differences in [...] Read more.
Background: Pediatric rheumatic diseases (PRDs) are a group of chronic disorders that start in childhood and are characterized by periodic exacerbations and remissions of symptoms, with limitations in family, school, and social activities. The aim of this study was to detect differences in parents’ psychological adjustment and emotion regulation strategies, and parent-reported children’s adjustments in families of children with active and inactive PRDs. Methods: Fifty-four parents (38 mothers and 16 fathers) of children with PRD were recruited from a pediatric unit. Disease activity was evaluated by their pediatric rheumatologist, while parents’ depressive and anxiety symptoms, emotion regulation strategies, and children’s emotional difficulties and hyperactivity–inattention symptoms were assessed through a web-based survey. Results: Parents of children with active PRDs reported higher levels of their child’s emotional difficulties and hyperactivity–inattention symptoms. Linear regression analysis demonstrated that having a child in the active phases of PRD and lower use of cognitive reappraisal lead to higher children’s emotional symptoms, while active disease, low use of cognitive reappraisal, and greater expressive suppression were associated with higher hyperactivity–inattention symptoms. Our study highlights that children with PRDs and their parents may be at increased risk for psychological problems, especially during the active disease phase, highlighting the importance of a multidisciplinary approach. Full article
(This article belongs to the Special Issue Rheumatic Diseases in Children: 2nd Edition)
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10 pages, 272 KiB  
Article
Renal Involvement in Multisystem Inflammatory Syndrome in Children: Not Only Acute Kidney Injury
by Alessandra Meneghel, Valentina Masenello, Fiorenza Alfier, Stefania Giampetruzzi, Camilla Sembenini, Giorgia Martini, Francesca Tirelli, Davide Meneghesso and Francesco Zulian
Children 2023, 10(10), 1661; https://doi.org/10.3390/children10101661 - 7 Oct 2023
Cited by 2 | Viewed by 1225
Abstract
Kidney involvement has been poorly investigated in SARS-CoV-2 Multisystem Inflammatory Syndrome in Children (MIS-C). To analyze the spectrum of renal involvement in MIS-C, we performed a single-center retrospective observational study including all MIS-C patients diagnosed at our Pediatric Department between April 2020 and [...] Read more.
Kidney involvement has been poorly investigated in SARS-CoV-2 Multisystem Inflammatory Syndrome in Children (MIS-C). To analyze the spectrum of renal involvement in MIS-C, we performed a single-center retrospective observational study including all MIS-C patients diagnosed at our Pediatric Department between April 2020 and May 2022. Demographic, clinical, pediatric intensive care unit (PICU) admission’s need and laboratory data were collected at onset and after 6 months. Among 55 MIS-C patients enrolled in the study, kidney involvement was present in 20 (36.4%): 13 with acute kidney injury (AKI) and 7 with isolated tubular dysfunction (TD). In eight patients, concomitant AKI and TD was present (AKI-TD). AKI patients needed higher levels of intensive care (PICU: 61.5%, p < 0.001; inotropes: 46.2%, p = 0.002; second-line immuno-therapy: 53.8%, p < 0.001) and showed lower levels of HCO3- (p = 0.012), higher inflammatory markers [neutrophils (p = 0.092), PCT (p = 0.04), IL-6 (p = 0.007)] as compared to no-AKI. TD markers showed that isolated TD presented higher levels of HCO3- and lower inflammatory markers than AKI-TD. Our results indicate a combination of both pre-renal and inflammatory damage in the pathogenesis of kidney injury in MIS-C syndrome. We highlight, for the first time, the presence of tubular involvement in MIS-C, providing new insights in the evaluation of kidney involvement and its management in this condition. Full article
(This article belongs to the Special Issue Rheumatic Diseases in Children: 2nd Edition)
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