World journal of clinical pediatrics最新文献

{"title":"Genetic and environmental factors contributing to anophthalmia and microphthalmia: Current understanding and future directions.","authors":"Shiwali Goyal, Shailja Tibrewal, Ria Ratna, Vanita Vanita","doi":"10.5409/wjcp.v14.i2.101982","DOIUrl":"10.5409/wjcp.v14.i2.101982","url":null,"abstract":"<p><p>Anophthalmia is defined as a complete absence of one eye or both the eyes, while microphthalmia represents the presence of a small eye within the orbit. The estimated birth prevalence for anophthalmia is approximately 3 per 100000 live births, and for microphthalmia, it is around 14 per 100000 live births. However, combined evidence suggests that the prevalence of these malformations could be as high as 30 per 100000 individuals. Microphthalmia is reported to occur in 3.2% to 11.2% of blind children. Anophthalmia and microphthalmia (A/M) are part of a phenotypic spectrum alongside ocular coloboma, hypothesized to share a common genetic basis. Both A/M can occur in isolation or as part of a syndrome. Their complex etiology involves chromosomal aberrations, monogenic inheritance pattern, and the contribution of environmental factors such as gestational-acquired infections, maternal vitamin A deficiency (VAD), exposure to X-rays, solvent misuse, and thalidomide exposure. A/M exhibit significant clinical and genetic heterogeneity with over 90 genes identified so far. Familial cases of A/M have a complex genetic basis, including all Mendelian modes of inheritance, <i>i.e.</i>, autosomal dominant, recessive, and X-linked. Most cases arise sporadically due to <i>de novo</i> mutations. Examining gene expression during eye development and the effects of various environmental variables will help us better understand the phenotypic heterogeneity found in A/M, leading to more effective diagnosis and management strategies. The present review focuses on key genetic factors, developmental abnormalities, and environmental modifiers linked with A/M. It also emphasizes at potential research areas including multiomic methods and disease modeling with induced pluripotent stem cell technologies, which aim to create innovative treatment options.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"101982"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding antituberculosis drug-induced hepatotoxicity: Risk factors and effective management strategies in the pediatric population.","authors":"Pooja Semwal, Manjit Kaur Saini, Moinak Sen Sarma","doi":"10.5409/wjcp.v14.i2.101875","DOIUrl":"10.5409/wjcp.v14.i2.101875","url":null,"abstract":"<p><p>Antituberculosis drug-induced hepatotoxicity (ATDIH) is a significant concern while managing pediatric tuberculosis. There is limited data on pediatric ATDIH, and much of the management practices are extrapolated from adult experiences. This article provides a comprehensive overview of the incidence, risk factors, clinical presentation, and management strategies for ATDIH in children. Pyrazinamide, isoniazid, and rifampicin are the most hepatotoxic first-line antituberculosis therapy (ATT). Though pyrazinamide has the highest potential for ATDIH, isoniazid is most frequently implicated. Hepatotoxicity typically manifests within the first 2-8 weeks of treatment, particularly during the intensive phase. Risk factors include younger age, female gender, malnutrition, hypoalbuminemia, and baseline liver dysfunction. Extra-pulmonary TB, particularly tuberculous meningitis, and concomitant hepatotoxic medications such as antiretro viral therapy or antiepileptic drugs further increase susceptibility. Genetic predisposition, including N-acetyltransferase 2 and cytochrome P4502E1 polymorphisms and specific HLA alleles also contribute to the increased risk. Clinically, ATDIH ranges from asymptomatic transaminase elevation to severe acute liver failure (ALF), necessitating prompt recognition and intervention. Diagnosis relies on the temporal association of liver injury with ATT initiation, supported by liver function tests, improvement upon ATT cessation, and recurrence upon reintroduction. Management involves discontinuing hepatotoxic drugs, initiating non-hepatotoxic regimens, and sequential reintroduction of ATT under close monitoring. For children with ALF, care in a tertiary center with liver transplantation expertise is essential. While pediatric ATDIH generally has favorable outcomes with timely intervention, delays can result in significant morbidity and mortality. Improved understanding of risk factors, vigilant monitoring protocols, and standardized pediatric management strategies are critical for optimizing outcomes in pediatric ATDIH.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"101875"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex relationship between childhood obesity and the gut microbiota.","authors":"Trung Nguyen Tran, Thang Viet Luong, Nam Van Duc Nguyen, Hai Nguyen Ngoc Dang","doi":"10.5409/wjcp.v14.i2.100975","DOIUrl":"10.5409/wjcp.v14.i2.100975","url":null,"abstract":"<p><p>Recently, the gut microbiota has been identified as a significant risk factor associated with metabolic disorders related to obesity. Advances in high-throughput sequencing technology have clarified the relationship between childhood obesity and changes in the gut microbiota. This commentary focuses on analyzing the study by Li <i>et al</i>, which utilized 16S rRNA molecular markers to compare differences in gut microbiota between obese and normal-weight children. Additionally, the review by Pan <i>et al</i> is referenced to supplement perspectives and evaluate the findings of this study. We also analyze the strengths and limitations of the original study and suggest potential research directions to elucidate the complex relationship between gut microbiota and childhood obesity, thereby providing a scientific basis for developing effective prevention and treatment strategies.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"100975"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human milk oligosaccharide secretion dynamics during breastfeeding and its antimicrobial role: A systematic review.","authors":"Mohammed Al-Beltagi","doi":"10.5409/wjcp.v14.i2.104797","DOIUrl":"10.5409/wjcp.v14.i2.104797","url":null,"abstract":"<p><strong>Background: </strong>Human milk oligosaccharides (HMOs) are bioactive components of breast milk with diverse health benefits, including shaping the gut microbiota, modulating the immune system, and protecting against infections. HMOs exhibit dynamic secretion patterns during lactation, influenced by maternal genetics and environmental factors. Their direct and indirect antimicrobial properties have garnered significant research interest. However, a comprehensive understanding of the secretion dynamics of HMOs and their correlation with antimicrobial efficacy remains underexplored.</p><p><strong>Aim: </strong>To synthesize current evidence on the secretion dynamics of HMOs during lactation and evaluate their antimicrobial roles against bacterial, viral, and protozoal pathogens.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, Web of Science, and Cochrane Library focused on studies investigating natural and synthetic HMOs, their secretion dynamics, and antimicrobial properties. Studies involving human, animal, and <i>in vitro</i> models were included. Data on HMO composition, temporal secretion patterns, and mechanisms of antimicrobial action were extracted. Quality assessment was performed using validated tools appropriate for study design.</p><p><strong>Results: </strong>A total of 44 studies were included, encompassing human, animal, and <i>in vitro</i> research. HMOs exhibited dynamic secretion patterns, with 2'-fucosyllactose (2'-FL) and lacto-N-tetraose peaking in early lactation and declining over time, while 3-fucosyllactose (3-FL) increased during later stages. HMOs demonstrated significant antimicrobial properties through pathogen adhesion inhibition, biofilm disruption, and enzymatic activity impairment. Synthetic HMOs, including bioengineered 2'-FL and 3-FL, were structurally and functionally comparable to natural HMOs, effectively inhibiting pathogens such as <i>Pseudomonas aeruginosa</i>, <i>Escherichia coli</i>, and <i>Campylobacter jejuni</i>. Additionally, HMOs exhibited synergistic effects with antibiotics, enhancing their efficacy against resistant pathogens.</p><p><strong>Conclusion: </strong>HMOs are vital in antimicrobial defense, supporting infant health by targeting various pathogens. Both natural and synthetic HMOs hold significant potential for therapeutic applications, particularly in infant nutrition and as adjuncts to antibiotics. Further research, including clinical trials, is essential to address gaps in knowledge, validate findings, and explore the broader applicability of HMOs in improving maternal and neonatal health.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"104797"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"African minors' health challenges are comparable to those in the rest of the world.","authors":"Earl B Ettienne, Klaus Rose","doi":"10.5409/wjcp.v14.i2.102922","DOIUrl":"10.5409/wjcp.v14.i2.102922","url":null,"abstract":"<p><p>Today's youth in rich and poor countries faces comparable health risks and challenges. There is the temptation to enjoy too much food that is advertised as delicious and to eat too little healthier food. An increasingly sedentary lifestyle makes physical activity voluntary, no longer based on the daily need for physical activity in rural production. This is a serious medical problem, as today's young people are threatened tomorrow (and sometimes, already today) by cardiovascular disease and type 2 diabetes mellitus, later by further challenges including arthritis, stroke, and more. But this is a challenge far beyond medicine. Young people need to be empowered to distinguish between good and bad lifestyles and be strengthened in their willingness to make an effort for future health. It may not seem very sexy to eat mostly fruits and high-fiber traditional foods instead of hamburgers, snacks, sweets, or to eat in posh restaurants. Everyone needs a certain resistance to advertising today, whether they grow up in Nigeria, Europe or anywhere else. Medical doctors, teachers, and many other professionals with responsibilities for young people have a key role in this endeavour.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"102922"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"They will be famous: Multipotent stem cells in breast milk.","authors":"Gavino Faa, Giuseppina Pichiri, Pierpaolo Coni, Angelica Dessì, Matteo Fraschini, Vassilios Fanos","doi":"10.5409/wjcp.v14.i2.101080","DOIUrl":"10.5409/wjcp.v14.i2.101080","url":null,"abstract":"<p><p>Breast milk represents the gold standard for neonatal nutrition, especially for preterm and term infants with a low birthweight. This awareness is based not only on the nutritional properties of human milk, which is specifically designed for the growth of humans but also on breast milk's non-nutritional properties, such as protection against infection. In fact, breast milk should be considered a heterogeneous ecosystem, including a wide range of cells in addition to those involved in immune function; growth factors, such as vascular endothelial growth factor; multiple noncoding microRNAs; immune cells; epithelial cells and multipotent mesenchymal stem cells. This recent identification of a pool of progenitor stem cells in human milk is the driving force behind the growing research aimed at identifying the nature of these stem/progenitor cells and their sources.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"101080"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors and outcomes leading to postoperative emergency department visits after ureteroneocystostomy.","authors":"Young Son, Mark Quiring, Scott Serpico, Edward Wu, Ethan Wood, Shelby Deynzer, Will Olive, Brittney Henderson, Hira Choudhry, Aws Ahmed, Usama Aljameey, Danielle Terrenzio, Gregory E Dean","doi":"10.5409/wjcp.v14.i2.99455","DOIUrl":"10.5409/wjcp.v14.i2.99455","url":null,"abstract":"<p><strong>Background: </strong>Ureteroneocystostomy (UNC) is considered the gold standard for pediatric vesicoureteral reflux (VUR) treatment. While UNC lowers the likelihood of needing additional VUR procedures within 12 months, patients also have high 30-day and 90-day readmission rates and emergency department (ED) visits. The most common causes of an ED visit following any urologic procedure are urinary tract infections (UTIs) and catheter/drain concerns. Prior studies are limited in identifying predisposing factors to help mitigate complications of UNC and improve patient outcomes.</p><p><strong>Aim: </strong>To identify modifiable characteristics at the time of discharge after UNC that predict subsequent unplanned ED visits.</p><p><strong>Methods: </strong>The 2020 American College of Surgeons National Surgical Quality Improvement Program Pediatric data was analyzed for patients undergoing UNC for VUR. A total of 1742 patients were evaluated, with 1495 meeting inclusion criteria. Patients with an ED visit within 30 days following an anti-reflux procedure (<i>n</i> = 164) were compared to those who did not return to the ED (<i>n</i> = 1331). Basic statistics and logistic regression analysis were performed to find predictive factors associated with postoperative ED visits after UNC.</p><p><strong>Results: </strong>Among the 1495 patients, 11.0% visited the ED within the 30-day postoperative period. Patients who returned to the ED visit following UNC were more likely to have had a longer mean operative time, surgical site infection, postoperative UTI, postoperative sepsis, history of prior readmission, unplanned reoperation, blood transfusion, or unplanned urinary catheter placement. Multivariate analysis revealed postoperative UTI (<i>P</i> < 0.001), superficial surgical site infection (<i>P</i> = 0.022), unplanned procedure (<i>P</i> < 0.001), unplanned urinary catheter (<i>P</i> < 0.001), and prematurity (35-36 weeks gestation) (<i>P</i> = 0.004) as independent risk factors for postoperative ED visits.</p><p><strong>Conclusion: </strong>Utmost caution is needed prior to discharge after UNC to forestall a return to the ED. Postoperative infection remains a primary risk for ED visits in the acute postoperative period.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"99455"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uveitis associated with juvenile idiopathic arthritis and chronic idiopathic uveitis in children: A retrospective cohort study.","authors":"Alexandr Alexandrovich Yakovlev, Ekaterina Vladimirovna Gaidar, Lyubov Sergeevna Sorokina, Tatiana Nikolaevna Nikitina, Olga Valerievna Kalashnikova, Mikhail Mikhailovich Kostik","doi":"10.5409/wjcp.v14.i2.100336","DOIUrl":"10.5409/wjcp.v14.i2.100336","url":null,"abstract":"<p><strong>Background: </strong>Chronic idiopathic uveitis (CIU) and juvenile idiopathic arthritis-associated uveitis (U-JIA) are both vision-threatening conditions that share similar autoimmune mechanisms, but treatment approaches differ significantly. In managing U-JIA, various treatment options are employed, including biological and non-biological disease-modifying anti-rheumatic drugs. These drugs are effective in clinical trials. Given the lack of established diagnostic and treatment guidelines as well as the limited number of therapeutic options available, patients with CIU frequently do not receive optimal and timely immunosuppression. This study highlighted the necessity for additional research to develop novel diagnostic techniques, targeted therapies, and enhanced treatment outcomes for young individuals with CIU.</p><p><strong>Aim: </strong>To compare the characteristics and outcomes of U-JIA and CIU.</p><p><strong>Methods: </strong>A retrospective cohort study analyzed data from 110 pediatric patients (under 18 years old) with U-JIA and 40 pediatric patients with CIU. Data was collected between 2012 and 2023. The study focused on demographic, clinical, treatment, and outcome variables.</p><p><strong>Results: </strong>The median onset age of arthritis was 6.4 years (2.7 years; 9.3 years). In 28.2% of cases uveitis preceded the onset of arthritis. In 17.3% of cases it occurred simultaneously. In 53.6% of cases it followed arthritis. Both groups had similar onset ages, antinuclear antibodies/human leukocyte antigen positivity rates, and ESR levels, with a slight predominance of females (60.9% <i>vs</i> 42.5%, <i>P</i> = 0.062), and higher C-reactive protein levels in the U-JIA group. Anterior uveitis was more prevalent in patients with U-JIA (<i>P</i> = 0.023), although the frequency of symptomatic, unilateral, and complicated forms did not differ significantly. The use of methotrexate (83.8% <i>vs</i> 96.4%) and biologics (64.7% <i>vs</i> 82.1%) was comparable, as was the rate of remission on methotrexate treatment (70.9% <i>vs</i> 56.5%) and biological therapy (77.8% <i>vs</i> 95%), but a immunosuppressive treatment delay in CIU observed. Patients with CIU were less likely to receive methotrexate [hazard ratio (HR) = 0.48, <i>P</i> = 0.005] or biological treatment (HR = 0.42, <i>P</i> = 0.004), but they were more likely to achieve remission with methotrexate (HR = 3.70, <i>P</i> = 0.001).</p><p><strong>Conclusion: </strong>Treatment of uveitis is often limited to topical measures, which can delay systemic therapy and affect the outcome. Methotrexate and biological agents effectively manage eye inflammation. It is essential to develop standardized protocols for the diagnosis and management of uveitis, and collaboration between rheumatologists and ophthalmologists is needed to achieve optimal outcomes in the treatment of CIU.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"100336"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug prescribing pattern in upper respiratory tract infections among the pediatric population attending outpatient clinics in pediatric hospitals.","authors":"Amir F Kamal, Eman A Abdelaziz, Veronia F Fahim, Mohamed H Saad, Mai Badr","doi":"10.5409/wjcp.v14.i2.100614","DOIUrl":"10.5409/wjcp.v14.i2.100614","url":null,"abstract":"<p><strong>Background: </strong>Upper respiratory tract infections (URTIs) are one of the most frequent causes of childhood school leave and morbidity.</p><p><strong>Aim: </strong>To study the present trend of medications' prescribing pattern utilized in URTIs among the pediatric population attending outpatient clinics in pediatric hospitals.</p><p><strong>Methods: </strong>This analytical observational cross-sectional research was conducted in 200 children aged 1-10 years with URTIs attending the pediatric outpatient clinics in pediatric hospitals, one of which is an educational hospital, from July 2018 to August 2020.</p><p><strong>Results: </strong>Most of the prescriptions in our study included antibiotics (116/58%). The most commonly prescribed antibiotic family was ampicillin/sulbactam or amoxicillin/clavulanic acid (53/26.5%), followed by first-generation cephalosporin (25/12.5%) and third-generation cephalosporin (20/10%). Macrolides and second-generation cephalosporins were prescribed less frequently, in 16 (8%) and 2 (1%) patients, respectively. Most of our study population (155/77.5%) was satisfied with their prescriptions, whereas the rest of the study population (45/22.5%) was unsatisfied.</p><p><strong>Conclusion: </strong>Overprescription of antibiotics is a significant issue among clinicians in pediatric outpatient clinics. Stewardship of drugs, particularly antibiotics, is a must to prevent the development of drug resistance. Most cases of URTIs were treated in accordance with the existing national treatment guidelines.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"100614"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic heterogeneity of juvenile arthritis in the Republic of Sakha (Yakutia) related to a high human leukocyte antigen B27 frequency.","authors":"Sargylana Boeskorova, Marina Afonskaya, Vera Argunova, Polina Sleptsova, Liudmila Leonteva, Tatiana Burtseva, Mikhail Mikhailovich Kostik","doi":"10.5409/wjcp.v14.i2.101873","DOIUrl":"10.5409/wjcp.v14.i2.101873","url":null,"abstract":"<p><strong>Background: </strong>Prevalence of the main rheumatic diseases in the Republic of Sakha (Yakutia) [RS(Y)], one of the regions of the Russian Federation, differs from the other regions of the Russian Federation due to its ethnic and geographic features. Knowledge regarding the prevalence and structure of juvenile idiopathic arthritis (JIA) allows us to shape the work of the pediatric rheumatology service in the region correctly, and optimize the healthcare system and the need for medications.</p><p><strong>Aim: </strong>To describe the epidemiological, demographic, clinical, and laboratory characteristics of children with JIA in the RS(Y) and evaluate the main outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study assessed all the data from the medical histories of the patients (<i>n</i> = 225) diagnosed with JIA (2016-2023) in the Cardiorheumatology Department of the M.E. Nikolaev National Center of Medicine. Pearson's <i>χ</i>² test, Fisher's exact test, Mann-Whitney and Kruskal-Wallis tests were used for statistical analyses.</p><p><strong>Results: </strong>The ethnic prevalence of JIA is higher in Sakha than in Russian children at 110.1 per 100000 children and 69.4 per 100000 children, respectively. The prevalence of JIA among boys and girls in Sakha was similar, unlike in Russians, where the number of girls predominated. The JIA categories were as follows: (1) Systemic arthritis: 3.5%; (2) Oligoarthritis (persistent and extended): 33.8%; (3) Rheumatoid factor (RF) (+) polyarthritis: 0.9%; (4) RF (-) polyarthritis: 14.7%; (5) Enthesitis-related arthritis (ERA): 44%; and (6) Psoriatic arthritis: 3.1%. Prevalence of the ERA category was 4.4 times higher in Sakha children, but the prevalence of systemic arthritis was 2.9 times lower compared to Russians (<i>P</i> = 0.0005). The frequency of uveitis was 10.2%, and the frequency of human leukocyte antigen (HLA) B27 was 39.6% in JIA children. Biologic treatment was received by 40.4% of JIA children and 45.3% achieved remission.</p><p><strong>Conclusion: </strong>Higher JIA prevalence, male and ERA predominance, related to a higher frequency of HLA B27 are typical in RS(Y). These data might improve the pediatric rheumatology health service.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"101873"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}