1.The SLC29A3 variant, neutrophilic dermatosis, and hyperferritinemia imitate systemic juvenile idiopathic arthritis in a Saudi child: a case report
Shahad ALANSARI ; Alhanouf ALSALEEM ; Tariq ALZAID ; Maad GALAL ; Noura ALYAHYA ; Sulaiman M AL-MAYOUF
Journal of Rheumatic Diseases 2023;30(2):133-137
Genetic defects of SLC29A3 result in a wide range of syndromic histiocytosis that encompasses H syndrome. Patients with SLC29A3 variants typically have hyperpigmentation, hypertrichosis, hepatosplenomegaly, sensorineural hearing loss, diabetes mellitus, and hypogonadism. Herein, we identify a novel phenotype in a girl presenting with clinical and laboratory findings similar to systemic juvenile arthritis and hyperferritinemia. Exome sequencing identified a homozygous variant in SLC29A3 (NM_018344.5: c.707C>T [p.T236M]). Our patient did not show the cardinal features of the broad spectrum of SLC29A3-related disorders. She demonstrated remarkable improvement in her clinical and laboratory manifestations after starting interleukin-1 blockade (Anakinra). Recent research suggests that SLC29A3-related disorders are accompanied with autoinflammation and autoimmunity due to an overactive inflammasome pathway, which is most likely induced by mitochondrial and lysosomal dysfunction. Hence, our findings may expand the phenotypic features of the SLC29A3 variant. Patients with the SLC29A3 variant and systemic inflammation may benefit from interleukin-1 blockade as a therapeutic option.
2.Clinical characteristics and prognostic value of autoantibody profile in children with monogenic lupus
Sulaiman M. AL-MAYOUF ; Alaa HAMAD ; Wassima KAIDALI ; Raghad ALHUTHIL ; Alhanouf ALSALEEM
Journal of Rheumatic Diseases 2024;31(3):143-150
Objective:
To report the frequency of selected autoantibodies and their associations with clinical features in Arab children with monogenic lupus.
Methods:
This study was retrospective single-center study of genetically confirmed monogenic lupus cases at childhood lupus clinic at King Faisal Specialist Hospital and Research Center, from June 1997 to July 2022. We excluded familial lupus without genetic testing and patients with insufficient data. Collected data comprised clinical and laboratory findings, including the autoantibody profile, which included the anti-double-stranded DNA (anti-dsDNA), anti-Smith, anti–Sjögren's-syndrome-related antigen A (anti-SSA), anti–Sjögren's-syndrome-related antigen B (anti-SSB), and antiphospholipid (APL) antibodies. Also, disease activity and accrual disease damage were collected at the last follow-up visit.
Results:
This study enrolled 27 Arab patients (14 males) with a median age of 11 years (interquartile range 8.0~16 years), with 63% having early-onset disease. The consanguinity rate and family history of lupus were high (74.1% and 55.6%, respectively).The most frequent clinical features were hematological (96.3%), fever (81.5%), mucocutaneous lesions (85.2%), and renal (66.7%).The frequency of the APL antibodies was 59.3%, anti-dsDNA was 55.6%, and anti-Smith and anti-SSA were 48.2% and 44.4%, respectively. Moreover, dsDNA antibodies were significantly associated with musculoskeletal complaints (p<0.05). Likewise, both anti-Smith and anti-SSA antibodies were linked to failure to thrive and recurrent infections in the univariate analysis (p<0.05).
Conclusion
Our study reveals autoantibody frequencies and their association with clinical and prognostic in a substantial monogenic lupus cohort. Distinct clinical manifestations and prognosis association with certain autoantibodies support the idea that monogenic lupus is a distinctive form of lupus. Larger studies needed to validate these findings.
3.Quality indicators for care in juvenile idiopathic arthritis
Hend ALKWAI ; Reem ALSHAMMARI ; Reem ABDWANI ; Muna ALMUTAIRI ; Raed ALZYOUD ; Thaschawee ARKACHAISRI ; Sumaira FARMAN ; Soad HASHAD ; Rebecca JAMES ; Khulood KHAWAJA ; Hala LOTFY ; Swee Ping TANG ; Soamarat VILAIYUK ; Sulaiman M AL-MAYOUF
Journal of Rheumatic Diseases 2024;31(4):223-229
Objective:
To develop a set of quality indicators (QIs) tailored to improve the care provided to children with juvenile idiopathic arthritis (JIA) in countries across the Asia-Pacific region.
Methods:
An adaptation of the Research and Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) was used. An initial set of 32 QIs was developed after a systematic search of the literature. These were presented to members of a Delphi panel composed of pediatric rheumatologists and other relevant stakeholders from the Asia Pacific League of Associations for Rheumatology Pediatric Special Interest Group (APLAR-Pediatric SIG). After each round, the mean scores for validity and reliability, level of disagreement, and median absolute deviation from the mean were calculated.
Results:
The panelists were presented with 32 QIs in two rounds of voting, resulting in the formulation of a final set of 22 QIs for JIA. These QIs are categorized within six domains of care, including access to care, clinical assessment, medications and medication monitoring, screening for comorbidities, counseling, and self-efficacy and satisfaction with care.
Conclusion
These QIs have been developed to evaluate and improve the quality of care provided to children with JIA, aiming to enhance health outcomes and ensure that healthcare services are tailored to the unique needs of this patient population.
4.Quality indicators for care in juvenile idiopathic arthritis
Hend ALKWAI ; Reem ALSHAMMARI ; Reem ABDWANI ; Muna ALMUTAIRI ; Raed ALZYOUD ; Thaschawee ARKACHAISRI ; Sumaira FARMAN ; Soad HASHAD ; Rebecca JAMES ; Khulood KHAWAJA ; Hala LOTFY ; Swee Ping TANG ; Soamarat VILAIYUK ; Sulaiman M AL-MAYOUF
Journal of Rheumatic Diseases 2024;31(4):223-229
Objective:
To develop a set of quality indicators (QIs) tailored to improve the care provided to children with juvenile idiopathic arthritis (JIA) in countries across the Asia-Pacific region.
Methods:
An adaptation of the Research and Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) was used. An initial set of 32 QIs was developed after a systematic search of the literature. These were presented to members of a Delphi panel composed of pediatric rheumatologists and other relevant stakeholders from the Asia Pacific League of Associations for Rheumatology Pediatric Special Interest Group (APLAR-Pediatric SIG). After each round, the mean scores for validity and reliability, level of disagreement, and median absolute deviation from the mean were calculated.
Results:
The panelists were presented with 32 QIs in two rounds of voting, resulting in the formulation of a final set of 22 QIs for JIA. These QIs are categorized within six domains of care, including access to care, clinical assessment, medications and medication monitoring, screening for comorbidities, counseling, and self-efficacy and satisfaction with care.
Conclusion
These QIs have been developed to evaluate and improve the quality of care provided to children with JIA, aiming to enhance health outcomes and ensure that healthcare services are tailored to the unique needs of this patient population.
5.Quality indicators for care in juvenile idiopathic arthritis
Hend ALKWAI ; Reem ALSHAMMARI ; Reem ABDWANI ; Muna ALMUTAIRI ; Raed ALZYOUD ; Thaschawee ARKACHAISRI ; Sumaira FARMAN ; Soad HASHAD ; Rebecca JAMES ; Khulood KHAWAJA ; Hala LOTFY ; Swee Ping TANG ; Soamarat VILAIYUK ; Sulaiman M AL-MAYOUF
Journal of Rheumatic Diseases 2024;31(4):223-229
Objective:
To develop a set of quality indicators (QIs) tailored to improve the care provided to children with juvenile idiopathic arthritis (JIA) in countries across the Asia-Pacific region.
Methods:
An adaptation of the Research and Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) was used. An initial set of 32 QIs was developed after a systematic search of the literature. These were presented to members of a Delphi panel composed of pediatric rheumatologists and other relevant stakeholders from the Asia Pacific League of Associations for Rheumatology Pediatric Special Interest Group (APLAR-Pediatric SIG). After each round, the mean scores for validity and reliability, level of disagreement, and median absolute deviation from the mean were calculated.
Results:
The panelists were presented with 32 QIs in two rounds of voting, resulting in the formulation of a final set of 22 QIs for JIA. These QIs are categorized within six domains of care, including access to care, clinical assessment, medications and medication monitoring, screening for comorbidities, counseling, and self-efficacy and satisfaction with care.
Conclusion
These QIs have been developed to evaluate and improve the quality of care provided to children with JIA, aiming to enhance health outcomes and ensure that healthcare services are tailored to the unique needs of this patient population.
6.Quality indicators for care in juvenile idiopathic arthritis
Hend ALKWAI ; Reem ALSHAMMARI ; Reem ABDWANI ; Muna ALMUTAIRI ; Raed ALZYOUD ; Thaschawee ARKACHAISRI ; Sumaira FARMAN ; Soad HASHAD ; Rebecca JAMES ; Khulood KHAWAJA ; Hala LOTFY ; Swee Ping TANG ; Soamarat VILAIYUK ; Sulaiman M AL-MAYOUF
Journal of Rheumatic Diseases 2024;31(4):223-229
Objective:
To develop a set of quality indicators (QIs) tailored to improve the care provided to children with juvenile idiopathic arthritis (JIA) in countries across the Asia-Pacific region.
Methods:
An adaptation of the Research and Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) was used. An initial set of 32 QIs was developed after a systematic search of the literature. These were presented to members of a Delphi panel composed of pediatric rheumatologists and other relevant stakeholders from the Asia Pacific League of Associations for Rheumatology Pediatric Special Interest Group (APLAR-Pediatric SIG). After each round, the mean scores for validity and reliability, level of disagreement, and median absolute deviation from the mean were calculated.
Results:
The panelists were presented with 32 QIs in two rounds of voting, resulting in the formulation of a final set of 22 QIs for JIA. These QIs are categorized within six domains of care, including access to care, clinical assessment, medications and medication monitoring, screening for comorbidities, counseling, and self-efficacy and satisfaction with care.
Conclusion
These QIs have been developed to evaluate and improve the quality of care provided to children with JIA, aiming to enhance health outcomes and ensure that healthcare services are tailored to the unique needs of this patient population.