bluuebunny/crossref_metadata_2025_split huggingface dataset:
P038 Let’s look at coxitis features in enthesitis-related arthritis population
Authors: Yasmine Makhlouf , Ferjani Hanene , Maatallah Kaouther , Triki Wafa , Ben Nessib Dorra , Kaffel Dhia , Hamdi Wafa 
Published: November 2021

Abstract

Background
Enthesitis-related arthritis (ERA) is a defined juvenile idiopathic arthritis subtypes, which presents with enthesitis, arthritis and axial skeleton involvement. ∼20–50% of JIA patients have hip involvement within 1–6 years of diagnosis onset [1]. The frequency of coxitis in ERA category is not recognized. The aim of this study was to assess coxitis features and its management in ERA population.

Methods
A retrospective study including children with ERA according to the International League of Associations for Rheumatology (ILAR). Data recorded included sociodemographic features, disease characteristics (disease duration, extra-articular manifestations, and presence of HLAB27) as well as treatment modalities. Regarding coxitis, we collected radiographs, ultrasound (US) and magnetic resonance imaging (MRI) of the hip when performed. Coxitis was defined by clinical (limited range of motion) and/or radiographic findings (destruction, synovitis, bone marrow oedema).

Results
The study included 51 patients with ERA. There was a male predominance (78.4%). The mean age of onset of the disease was 12.2 years [6–16]. The mean current age was 24.3 years old [9–59]. A family history of spondyloarthritis was found in 26.8% of cases. A positive HLAB27 was reported in 85.7% of cases. The distribution of extra-articular manifestations (37.5%) was as follows: ocular (n = 8), cardiovascular (n = 2), gastrointestinal (n = 1), pulmonary (n = 4). A peripheral onset was found in 39% and a peripheral and axial onset was reported in 42% of patients. Hip involvement was found in 78.4% of the patients and revealed the disease in 43% of cases. The mean delay between disease onset and coxitis was 4.5 years [0–34]. Coxitis was bilateral and destructive in 82.5% and 51% of cases respectively. The most limited range of motion was the internal rotation (68%), followed by hip flexion (48%) and the external rotation (43.2%). In patients with normal hip radiography (n = 8), US or MRI depicted early changes in 75% of cases. Hip replacement was noted in ten patients and was bilateral in 70% of cases. Regarding treatment modalities, NSAIDs and csDMARD (MTX n = 14, SLZ n = 8, biologics n = 2) were prescribed in 76.4% and 52% respectively. Most of the patients had physical therapy (88%) and 23.5% of them had intra-articular corticoid injection. Twenty-six percent of the patients had hip replacement.

Conclusion
Our study showed a high prevalence of coxitis among ERA patients. There is a need to further optimize therapeutic strategies for such patients.
P039 Evolutionary course of Juvenile Idiopathic Arthritis
Authors: Mechid F , Bahaz N , Remilaoui A , Zehraoui F H , Benaziez R , Dahou-Makhloufi C 
Published: November 2021

Abstract

Background
Juvenile idiopathic arthritis (JIA) is a heterogeneous group of rare conditions that begin before the age of 16. Seven categories have been defined by the International League of Associations for Rheumatology (ILAR) classification. The aim of our work is to describe the demographic, clinical, and radiological characteristics and therapeutic of patients with JIA.

Materials and methods
A retrospective, descriptive study of patients followed for AIJ in the rheumatology department of Mohamed LamineDebaghine during a period of 15 years (2005–2020). Patients were included if satisfied ILAR criteria.

Results
Ten patients with JIA were included, 5 of whom were females. The mean age of onset was 9.20 ± 3.15 (range: 5–14 years). The subtypes were as follows: 4 patients had RF-negative polyarthritis, one case had RF-positive polyarthritis, one with systemic arthritis form, 2 cases of oligoarthritis, 1 case of psoriatic arthritis, and enthesitis-related arthritis. Three children have coxitis. ACPA was positive in one case and antinuclear antibodies were negative. Eight patients have developed osteoarticular destruction. Pulmonary involvement was noted in a patient who had RF-positive polyarthritis.
Corticosteroid therapy was prescribed in 9 patients, 5 of whom developed complications related to steroids, including growth retardation, which was observed in 3 cases. Nine JIA patients received methotrexate. The use of etanercept and IL-1 inhibitors were required in 7 and 1 cases, respectively. Corticosteroid infiltrations were performed in 9 patients. Total hip replacement was indicated in 3 patients.

Conclusion
Through our study, we note a predominance of the polyarticular form. Osteoarticular destruction seems to be frequent, particularly in the hip. The use of biotherapy and the total hip prosthesis proved the severity of juvenile idiopathic arthritis in our patients.
P051 Juvenile Behcet's disease
Authors: Cherfi R , Mahieddine N , Mammeri K , Touri S , Sadaoui F , Kirouani B , Kedji L 
Published: November 2021

Abstract

Background
Behçet's disease is a rare systemic vasculitis in children. The most frequent manifestations are orogenitalaphthosis and uveitis. Neurological, digestive, vascular, joint, and skin involvement are possible. We aimed to describe the clinical, diagnostic criteria, and therapeutic features of pediatric-onset Behcet's disease

Methods
Study carried out based on files collected over 12 years (2007–2018) concerning patients under the age of 15 hospitalized in the pediatric department of CHU de Blida for Behcet disease

Results
For 12 years (2007–2018), we hospitalized five children for various reasons and whose diagnosis of Behcet's disease was retained. These are 03 boys (2 of the theme are brothers) and 02 girls. The average age at admission was 13.5 years (12–15 years), and the average duration of follow-up is 4.2 years (15 months-8 years).
The mean age of onset of first symptoms was 11 years, and the meantime to diagnosis was 2 years (12 months-3 years)
The main diagnostic criteria were: mouth ulcers in five patients (100%), genital ulcers in three patients (60%), ophthalmic manifestations in two patients (40%): one had bilateral uveitis, and the other had papillitis, the pathergy test was positive in 3 patients (60%).
The other manifestations were as follows: polyarthralgia in 3 patients (60%), family history in one patient (20%). Neurological manifestations were present in 3 patients (60%): one child presented two episodes of aseptic meningitis and thrombosis deep cerebral venous; one child with diffuse cerebral demyelination lesions, and the third with HIC syndrome and massive lateral sinus thrombosis.
Three children have a vascular involvement (60%): pulmonary embolism with thrombosis of the superior vena cava (20%), bilateral thrombosis of the jugular veins (20%), and thrombosis of the right ventricle complicated by pulmonary embolism (20%)
Initial symptoms included recurrent aphthous stomatitis (100%), arthralgia (60%), prolonged fever (20%), behavioral disturbances and dysarthria (20%), weight loss (40%), and headache (60 %).
The histocompatibility antigen (HLAB 51) was found in 2 children (40%). The treatment included corticosteroids for all patients (3 boluses of 1 g/m2/day of methylprednisolone then relayed by prednisone 1 mg/kg/day), azathioprine 2.5 mg/kg/day in 5 children (100%), and colchicine for 2 patients only one patient had received anticoagulant therapy (LMWH followed by VKA) Relapses were observed in a single patient (20%) and mortality in one patient (20%.)

Conclusion
Behcet's disease is a rare disease whose diagnosis remains difficult in children. However, early diagnosis and aggressive treatment are mandatory to avoid complications and functional sequelae.
P064 Henoch-Schonlein Purpura: experience of a general pediatric center
Authors: Belamri D J , Boustil I , Zoubir S , Chériet Bensoltane H , Bouchair N 
Published: November 2021

Abstract

Background
Henoch-Schonlein purpura (HSP) is the most classic dysimmune vasculitis in children, related to an abnormal response of an immature immune system following an external antigen attack. Digestive involvement in HSP conditions the immediate vital prognosis and severe renal failure conditions the long-term functional prognosis. The Objective is to identify the epidemiological, clinical, disease course and therapeutic particularities of patients with HSP with a review of the literature.

Material and method
The authors reported the results of a retrospective study of cases of patients with HSP hospitalized and treated in the 02 pediatric departments of the wilaya of Annaba in Algeria (Clinique Sainte Thérèse, Annaba hospital university center and EHS El Bouni) over a period of 02 years. Information was obtained from hospital records.

Results
24 cases of HSP were identified with a sex ratio of 1.4 (14 boys and 10 girls) and a hospital incidence of 1.66%. The average age was 6.6 years. Half of patients was hospitalized during the autumn-winter period, 67% of whom had an ENT infection before their hospitalizations. 17% of cases have personal history of HSP (the oldest was 5 years ago and the most recent 10 days before hospitalization). 7 patients underwent surgeries prior to hospitalization. Skin lesions were found in all patients. Joint, digestive and renal involvement were recorded in 50%, 80% and 25% respectively. Gastrointestinal bleeding has been observed in one patient. Only 1 patient with renal impairment progressed to chronic renal failure and only 1 patient had confirmed hypertension. A rare association with viral hepatitis A has been noted in one patient.

Conclusion
HSP remains a benign condition, easy to recognize clinically. Its immediate prognosis depends on the digestive complications and its long-term on nephropathy which may expose to the risk of chronic renal failure.
P067 Bone manifestations of Haematological Malignancies
Authors: Mzabi Anis , Fakhfakh Rym , Ben Hassine Imen , Anoun Jihed , Karmani Monia , Ben Fredj Fatma , Laouani Chadia 
Published: November 2021

Abstract

Background
Bone manifestations complicate many haematological malignancies and usually reflect a progression of the disease, affecting the prognosis (1). Because of the diversity of imaging appearances and clinical behavior of this spectrum of disease, diagnosis can be challenging. The Objectives is to describe the characteristics of bone manifestations in hematologic malignancies.

Methods
A retrospective descriptive study reviewing the medical records of all patients with hematologic malignancies, hospitalized in an internal medicine department.

Results
Among 70 patients, 39 men and 31 women were enrolled. The mean age was 55 years (15–83 years). Bone manifestations were related to multiple myeloma (28 cases), Hodgkin's disease (16 cases), non-Hodgkin's lymphoma (13 cases), chronic leukaemia (6 cases), acute leukaemia (5 cases) and Waldenström's disease (2 cases). The clinical presentation was dominated by: an alteration of the general condition (45 cases), peripheral lymphadenopathy (28 cases), hepato-splenomegaly (22 cases), diffuse bone pain (21 cases), back pain (16 cases) and night sweats (13 cases). The complete blood count found cytopenia in 47 cases. Patients presented a biologic inflammatory syndrome (58 cases), kidney failure (23 cases) and hypercalcemia (13 cases). Osteolytic lesions were objectified in 13 cases and vertebral collapse in 4 cases. A myelogram was performed in 40 cases, a lymph node biopsy in 25 cases, a bone marrow biopsy (6 cases) and a bone biopsy in 4 patients. The treatment was based on chemotherapy +/- radiotherapy. Therapeutic abstention was indicated in some patients.

Conclusion
Multiple myeloma and Hodgkin’s disease have shown the most bone manifestations. Knowledge of the different characteristics of hematological malignancies is essential to enable early diagnosis and appropriate treatment.
P069 Assessment of diagnostic delay for hip disorders in the pediatric population
Authors: Ines Cherif , Triki Wafa , Hassen Affes , Ferjani Hanene , Maatallah Kaouther , Ben Nessib Dorra , Kaffel Dhia , Wafa Hamdi 
Published: November 2021

Abstract

Background
Hip disorders are highly common among pediatric patients. The diagnosis is based primarily on the clinical findings, the context and the personal and family history of the child. It is in most cases steered by the biological and imaging findings. The latter are usually derived from radiographs, ultrasound imaging and, in some cases, MRI. The main purpose of this study is to evaluate assess the diagnostic delay for hip disorders in the pediatric population.

Methods
We conducted a retrospective study including pediatric patients from the rheumatology and the orthopedics department, who consulted or were referred to orthopeadics for a suspected hip disorder.
For all patients, we collected the following data: age, clinical findings, imaging findings, the number of consultations in general medicine or emergency medicine and the number of consultations in orthopedics department before the diagnosis is made, the final retained diagnosis and, ultimately, the diagnostic delay since onset of symptoms and first consultation.

Results
We included 81 children (48 boys and 33 girls) with a mean age of 9.9 years old [1.5–16]. Sixty-two patients were symptomatic at admission. The pain was located in the hip in 55.5% of patients (n = 45), in the groin in 7.4% of patients (n = 6) and in the knee in 12.34% of patients (n = 10). One child reported unilateral buttock pain. The other reasons for consultation were limping in 3.7% of cases (n = 3), deformity of the lower limb in 1.23% of cases (n = 1), a crying baby in 1.23% of cases (n = 1) and swelling of the knee in 1.23% of cases (n = 1). On clinical examination, 58 patients had a limitation of the hip motion. Twenty-nine percent of the children had a biological inflammatory syndrome at admission. In total, over one hundred and seventy-one imaging examinations were performed in order to adjust the diagnosis; among them, 7 CT pelvic scan and 23 MRI.
The different retained diagnoses of hip involvement are summarized in Table 1.
The mean number of consultations in general medicine or emergency medicine before the diagnosis is made was 0,58 ranging from 0 to 2. The mean diagnostic delay since the onset of symptoms was 9,12 months ranging from 3 days to 13 years. The mean diagnostic delay since the first medical check -up was 3,5 months ranging from 0 to 10 years.

Conclusion
Our study showed that the patient lost an average of 9 months from symptom onset to retaining the final diagnosis. The hip being a prognosis joint, this delay could alter the child's future functional abilities.
P070 Evaluation of the perception of pediatric rheumatology by pediatric residents: results of a national survey
Authors: Hadef Djohra , Benaldjia Hanene , Saidani Feryal , Mechtaoui Nesrine 
Published: November 2021

Abstract

Background
Pediatric Rheumatology (PR) is a young specialty that has not yet gained momentum in Algeria. The aim of this study is the assessment of the perception of PR by pediatric residents in Algeria and the current practice of this young sub-specialty in our country.

Methods
Descriptive cross-sectional study evaluating the perception of PR by pediatric residents was created on Google forms and distributed via email and Facebook to be taken as a self-administered online survey.
The survey is composed of three parts: socio-demographic characteristics of the participant, current practice of PR and perspectives of PR training.

Results
Seventy-seven residents responded to the online questionnaire, with an average age of 30.40 ± 3.13 years and 65% of participants being female. Participation included different regions of Algeria (Batna, Annaba, Setif, Constantine, Algiers and Oran) and different levels of training (from the first year to the fifth year of residency)
Ninety-two percent (92%) of participants had managed PR consultations, with a frequency of once a week in 75.3% of cases and twice a week in 15.6% of cases. In 81% of cases, it was not the initial presentation. The patients were mainly referred by a general practitioner or a general pediatrician. The Management of these patients was provided by a general pediatrician in 69.4% of cases and only in 37.7% by a specialized pediatrician. In 71.4% of cases, there was no pediatric rheumatologist in the establishment where the resident was being trained.
The level of knowledge in PR was admitted to be poor by 59.7% of the respondents. Seventy-five percent of the residents wanted to have rotations dedicated to this sub-specialty during their training. Seventy percent thought that PR is equally as important to know as the other subspecialties in pediatrics (pediatric endocrinology, pediatric pneumology ...). Interest in further PR training was expressed by 80.5% of participants, given the chance.

Conclusion
This survey reinforces the perception that PR training needs to be improved in Algeria, especially as the number of PR consultations is on the rise.
The creation of specialized training in PR is becoming a necessity.
P075 Contribution of biothérapy in pediatric rheumatology: tolérance and efficacy
Authors: Messadi W , Salmi A , Cherif N 
Published: November 2021

Abstract

Background
Biotherapy result of spectacular advances in genetics and research in molecular and cellular biology, has considerably improved the management of rheumatic and autoinflammatory diseases in children. The Objective is to assess the efficacy and tolerance of biotherapy in pediatrics

Methods
A retro-prospective study was carried out in the Pediatric Department B at the pediatric rheumatology consultation, university hospital center. An operating sheet was drawn up including epidemiological, clinical, paraclinical and therapeutic data of the cases diagnosed as well as their evolution on biotherapy.

Results
26 children received treatment with biotherapy. 73% presented with JIA (54% systemic, 19% polyarticular with positive RF, 19% severe uveitis, and 4% familial Mediterranean fever. 4% behçet disease
The mean time to start biotherapy was 12 months [2–48]. There is a clear clinical and biological improvement for 93% of patients. Etanercept was effective in polyarticular-progressive JIA, Adalimumab in oligoarthritis with severe uveitis, Tocilizumab in systemic forms of JIA and Anakinra in familial Mediterranean fever resistant to colchicine and systemic arthritis.
The adverse reactions noted were: one case of tuberculosis, hepatic cytolysis in 4 cases, and one case of psoriasis.

Conclusion
The introduction of biotherapy in pediatric has considerably improved the management of inflammatory rheumatic diseases and transformed the prognosis of these chronic diseases. The maintenance of the good response to treatment and the good tolerance of biotherapy must be evaluated prospectively over the long term.
P076 SARS-COV-2 infection in two patients with juvenile lupus
Authors: Hanane Toumi , Tiaaza Faid , Asmaa Sakhi , Kenza Bouayed 
Published: November 2021

Abstract

Background
The new SARS-COV-2 pandemic affects both children and adults, with a low pediatric percentage of &lt; 1%. The severity and death rate of this disease are lower in this age range. The pediatric populations who are most likely to develop severe COVID 19 are those with particularly immunosuppressive comorbidities. Juvenile systemic lupus erythematosus “jSLE” which represents the prototype of autoimmune diseases, constitutes a predisposing ground for severe viral infections, related to immune dysfunction; linked on one hand to the disease, and on the other hand to the numerous immunosuppressive treatments prescribed. In this context, a great risk was incurred by patients with jSLE. The aim of this work is to assess the severity of COVID 19 infection in our patients with jSLE

Methods and results
Among 20 cases of jSLE hospitalized during the year 2020, we report 2 medical cases report of patients aged 9 and 8, respectively, followed-up in our tertiary care unit for jLES based on the criteria of the Systemic Lupus International Collaborating Clinics “SLICC 2012” and the American College of Rheumatology “ACR 2019”, and who developed a cough, progressing dyspnea and feverish. The Covid 19 was confirmed by a positive PCR for SARS-COV-2. The chest X-ray showed a systematized right cavity in 1 case. Thoracic CT showed foci of alveolar condensation systematized with air bronchogram sign extended to &gt; 25%, associated with bilateral subpleural ground glass areas centrally and peripherally compatible with moderate pneumonia type COVID 19 in one case. The patients were in flare of their lupus disease, proven by the consumption of the C3 and C4 fractions of the complement.
They were treated according to the national COVID 19 infection management plan comprising azithromycin at a dose of 20 mg/kg/day on D1 then 10 mg/kg/day for 6 days, increasing the doses of hydroxychloroquine, associated with vitamin therapy (vitamin C, Zinc, vitamin D), the evolution was favorable after 7 days of treatment.

Conclusion
Reassuringly, several studies have shown that the clinical course of covid 19 in SLE does not appear to be more severe than in the general population. The hydroxychloroquine prescribed routinely in patients with SLE does not protect against covid 19, but may prevent the occurrence of severe forms.
P080 Acroosteolysis: a rare complication or a co-occurrence with Juvenile Idiopathic Arthritis?
Authors: Yasmine Makhlouf , Saoussen Miladi , Alia Fazaa , Mariem Sellami , Leila Souabni , Kmar Ouenniche , Selma Kassab , Selma Chekili , Ben Abdelghani Kawther , Ahmed Laatar 
Published: November 2021

Abstract

Background
Acroosteolysis refers to a destructive process involving the distal phalanges of the fingers and toes that may extend to metacarpals or metatarsals. Rarely idiopathic, the diagnosis of primary acroosteolysis requires ruling out other causes. Juvenile idiopathic arthritis is an exceptional aetiology of acroosteolysis occurring mainly in psoriatic arthritis. Here by a case of juvenile idiopathic arthritis associated with acroosteolysis of the toes.

Methods
A 13-year-old girl with no past medical history, presented to our department of rheumatology with oligoarthritis affecting both wrists and knees. She had no familiar history of psoriasis nor rheumatic diseases. She described a dull ache and recurring swelling of knees evolving for &gt;6 years associated with a macular rash of the chest without fever. On examination, the knees were swollen with a limited range of motion of &lt; 90°. Examination of the spine and sacroiliac joints was unremarkable. There was no deformity, no dysmorphic syndrome nor ligamentous hyper laxity. The mucocutaneous examination was normal. Similarly, there was no hepatosplenomegaly or swollen lymph nodes. Laboratory investigations showed high acute phase reactants and normal blood count. Rheumatoid factor, anti-cyclic citrullinated peptide antibodies and antinuclear antibodies were also negative. Besides, she was negative for HLAB-27. Ophthalmic examination did not show any sequelae of uveitis.

Results
Plain radiograph of the feet revealed bone resorption of the second and fifth distal phalanges without signs of reconstruction. Other secondary causes of acroosteolysis were ruled out. The diagnosis of oligoarticular juvenile idiopathic arthritis was made. In view of the involvement of the distal phalanges, the phenotype of psoriatic arthritis was probable. The patient was initially treated with non-steroidal anti-inflammatory drugs as well as intraarticular injections of corticosteroids in knees. As the flares persisted, she was put on Methotrexate at a dosage of 15 mg per week with marked clinical improvement.

Conclusion
Our case illustrates a possible occurrence of acroosteolysis of the feet in the field of an active juvenile idiopathic arthritis. It is important to rule out other causes and make a rapid diagnosis in order to ensure appropriate management decisions.