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We report the case of a 28-month-old boy who displayed symptoms of Henoch-Schonlein purpura (HSP), a type of small-vessel vasculitis that affects multiple systems in childhood and is caused by IgA. The symptoms include dermatological, abdominal, articular, and renal manifestations. HSP can occur due to several factors, such as upper respiratory tract infections, medications, vaccinations, and malignancies. The patient had positive COVID-19 serology but no other trigger factor for HSP, indicating a possible correlation between the two. The boy received oral prednisolone, leading to a swift clinical improvement. Our findings align with other research that suggests a link between the SARS-CoV-2 coronavirus and infantile HSP.

Kawasaki disease (KD) is a common pediatric vasculitis with a risk of coronary artery aneurysm. In this report, we review some particularities of KD disease, especially coronary involvement, and highlight its aspects during the COVID-19 epidemic which saw the emergence of a syndrome named multisystem inflammatory syndrome in children (MIS-C). Because of its many similarities with KD, MIS-C is often referred to as Kawasaki-like disease (KLD) or pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS).We report on a retrospective study on the different epidemiological, clinical, and evolutionary aspects of KD and the coronary involvement resulting from this disease before and after the pandemic. The study is based on the echocardiography records of the P4 Department at Rabat Children’s Hospital, from January 2002 to December 2021. A total of 379 patients were diagnosed with KD during that period. This includes 47 cases that were reported during the first year of the COVID-19 epidemic in Morocco (March 2020). Echocardiography results for our series show that cardiac complications wererelatively more frequent among KD patients during the COVID-19 period, perhaps because they were relatively older (67 months on average) than classic KD patients (37 months on average). However, all patients had a favorable outcome after treatment with a combination of intravenous immunoglobulin (IVIG) and aspirin. The few patients who did not respond to standard treatment received corticosteroids, and no mortality occurred. We conclude that as far as cardiac complications,KD, KLD, and MIS-C are the same core disease that is triggered under different conditions for different age groups.The emergence of the Sars-Cov-2 virus changed the epidemiologic profile of KD but not its treatment. Insights from this study would help in the decision to initiate targeted immunotherapy quickly and reduce the risk factors associated with KD.

Sinus histiocytosis, also known as Rosaï Dorfman Syndrome (SRD), is a noncancerous condition that causes the growth of large masses of histiocytes in lymph nodes, primarily in the cervical area. Visceral damage is common, and diagnosis is made through histological examination. The cause of SRD is unknown and can occur at any age, even in children. The condition can sometimes improve spontaneously, but large tumor masses can cause compression and damage, particularly if they involve the retro-orbital or epidural areas. In most cases, it is best to avoid treatment, but therapeutic interventions may be necessary for forms of the disease that pose a direct threat or are progressing. Treatment is not standardized and may involve surgery, corticosteroids, immunosuppressants, and/or alpha interferon, depending on the individual case. We present a case study of a 4-year-old child who had multiple bilateral adenopathies. The diagnosis was verified through a biopsy of the lymph nodes.

PAN is an inflammatory and necrotizing vasculitis affecting small and medium caliber arteries of the body, rarely described in children. Its pathophysiology is complex and remains poorly elucidated, involving the deposition of circulating immune complexes in the vascular wall, neutrophil anti-cytoplasmic antibodies, the role of cytotoxic lymphocytes, cytokines, environmental factors (infections), as well as genetic susceptibility (mutations in ADA 2 and the MEFV gene). There are two main forms: a classic systemic form with visceral involvement (60% of cases) and a cutaneous form with lesions limited to the skin and muscles (30%), which usually evolve less severely. Positive diagnosis is based on the Eular/Printo/Pres criteria. The treatment depends on the form of PAN, and relies essentially on NSAIDs, colchicine, corticotherapy and immunosuppressants: azathioprine and cyclophosphamide. Our work is a retrospective study of 5 cases of PAN, collected at the IV pediatric department and the pediatric rheumatology consultation of the children's hospital of Rabat between 2009 and 2014: The diagnosis was retained on the criteria of Eular/Printo/Pres. The clinical picture was dominated by skin and joint involvement. One of our patients presented an atypical picture of PAN associated with infective endocarditis and large vessel involvement. All of our patients received corticosteroid therapy, and one of our patients benefited́ in addition to colchicine.

Sarcopenia appears to be a negative prognostic factor for poor survival outcomes and worse treatment tolerance in patients with head-and-neck squamous cell carcinoma (HNSCC). We evaluated sarcopenia's impact on overall survival (OS), disease-free survival (DFS) and chemo-radiation tolerance in patients with head-and-neck cancer (HNC) treated with chemoradiotherapy (CRT) from a monocentric observational study.We identified patients with HNC treated by CRT between 2009 and 2018 with pretreatment imaging using positron emission tomography-computed tomography scans (PET/CT). Sarcopenia was measured using the pretreatment PET/CT at the L3 vertebral body using previously published methods. Clinical variables were retrospectively retrieved.Of 216 patients identified, 54 patients (25.47%) met the criteria for sarcopenia. These patients had a lower mean body mass index before treatment (21.92 vs. 25.65 cm/mSarcopenia in HNSCC patients is an independent adverse prognostic factor for DFS after definitive chemoradiotherapy.

Introduction: Digestive involvement is not uncommon during chronic inflammatory diseases in children, it may be just digestive manifestations other than other systemic signs or association of two different pathologies with a common immunological terrain. Objective: To recognize the different types of digestive involvement encountered during chronic inflammatory diseases in children and to discuss the frequency of association of digestive involvement with chronic inflammatory diseases in children . Materials and Methods: Retrospective study involving 10 children with chronic inflammatory diseases with digestive involvement collected at the department of pediatrics IV and the consultation of pediatric rheumatology of the children's hospital of Rabat over a period of 17 years (2001-2018). Results: Our series includes 7 female and 3 male children. The average age of our patients at the time of diagnosis of JIA or SLE is 10 years and the average age of the digestive involvement is 07 years. The types of digestive involvement found were diverse: Crohn's disease, ulcerative colitis and celiac disease. The frequency of digestive involvement in chronic inflammatory diseases in our series is 1.58%. The incidence of association of juvenile idiopathic arthritis with IBD is 1.08% and with celiac disease is 0.4%, while the frequency of association of systemic lupus with celiac disease is 2.8%. Conclusion: There is a very strong link between digestive involvement and chronic inflammatory diseases, The common etiopathogenic mechanisms that explain this link are not yet well defined, but genetic predisposition seems to play an important role in these associations, as well as environmental factors such as long exposure to gluten, for celiac disease.

Background Craniopharyngioma (CP) in adults is a rare benign tumor associated with many morbidities, with limited contemporary studies to define treatment, and follow-up guidelines. Methods A single-center retrospective study was conducted on patients aged ≥ 18 years from 2006–2018 with CP and who were treated with proton therapy (PT). Late toxicity was defined as a minimum of 18 months from diagnosis. Overall survival (OS), local recurrence-free survival (LRFS), and toxicity were characterized using Kaplan–Meier and Cox regression analyses. Results Ninety-one patients met the criteria, with a median age of 37 years (range 18–82 years). PT was conducted after tumor resection in 88 patients (97%), in 64 patients (70.3%) as an adjuvant strategy and in 27 (29.7%) after recurrent disease. Three patients received exclusive PT. A median MRI follow-up of 39 months revealed 35.2% complete response, 49.5% partial response, and 9.9% stable disease. Five patients developed local recurrence (LR). The pattern of failure study showed that these five LR were within the GTV volume. The 5-year LRFS was 92.0% [CI 95% 84.90–99.60]. All the patients were alive at the end of the follow-up. Patients requiring treatment adaptation during PT tend to have a higher risk of LR (P = .084). Endocrinopathy was the most frequent grade ≥ 2 late toxicity. Among patients who were symptom-free before the start of treatment, none developed hearing toxicity but four (9.8%) developed visual disorders and 10 (11.3%) symptomatic memory impairment. Patients with large tumors had a higher risk of developing symptomatic memory impairment (P = .029). Conclusion Adults with CP treated with PT have favorable survival outcomes, with acceptable late toxicity. Prospective quality-of-life and neurocognitive studies are needed to define late adverse effects better.

Deficiency rickets due to maternal hypovitaminosis D cause hypocalcaemia in infants, which may be complicated by dilated cardiomyopathy (DCM) with myocardial dysfunction. Calcium is central in myocardial contraction coupling, and hypocalcemia decreases myocardial contractility. However, dilated cardiomyopathy (DCM) due to hypocalcemia in infants has been rarely reported. Correction of hypocalcemia was associated with resolution of congestive heart failure and the left ventricular (LV) geometry and systolic function. We report the case of an infant who presented deficiency rickets due to maternal hypovitaminosis D, complicated by convulsion and dilated cardiomyopathy, with good improvement under treatment with calcium and vitamin D.

The Aicardi-Goutières syndrome is an encephalopathy characterized by an arrest of psychomotor development in the first months of life, spastic tetraplegia spastic tetraplegia, abnormal movements and acquired microcephaly. Neuroimaging reveals calcifications of the basal ganglia and cerebrospinal fluid (CSF) study shows lymphocytosis. Our patient is a 7 month old child, from a 1st degree consanguineous marriage. She presents a psychomotor delay with hypotonia, nystagmus and convulsive myoclonic seizures. Cerebral CT shows an active tri ventricular hydrocephalus with multiple parenchymal calcifications with multiple cerebral parenchymal calcifications and basal ganglia of infectious appearance. The intercritical sleep EEG was unremarkable. Ophthalmological examination, including an EPI, revealed a probable retinal dystrophy predominantly on the scopic system. Brain MRI shows a mesencephalic atrophy of the annular protuberance and increased volume of the volume of the cisterns of the posterior cerebral fossa. The dosage of interferon alpha in the CSF is increased to 113 pg /ml.

Factor XIII deficiency is a rare inherited disease, with a particularly high risk of intracerebral hemorrhage. We report the case of a newborn who was suspected to have a coagulation disorder at birth, due to an intracerebral hemorrhage. A quantitative dosage of factor XIII was requested but the usual coagulation tests (thromboplastin, thrombokinase, fibrinogen) were normal. Because of unavailability of specific treatment with factor XIII concentrate, the patient was treated with fresh frozen plasma. The initial dose was for normalizing factor XIII; subsequent monthly doses were designed for preventing the occurrence of serious bleeding.

"Background: Morality plays a fundamental role in the functioning of any human society by regulating social interactions and behaviors. Moral Foundations Theory (MFT) (Haidt & Joseph, 2004) led to a major change by proposing pluralist “moralities” with a common ground in all cultures composed of five main moral principles (Care, Fairness, Loyalty, Authority, Purity). These principles thought to be universal and rooted in the evolutionary past establish the moral system. Nevertheless, the prioritization of moral values stemming from these principles is different across cultures. We thus tested the moral endorsement of these principles in a cross-cultural dataset among a WEIRD society (France), and a non-WEIRD society (Morocco). Method: 150 French (mean age; 28.81±12.70 years) and 152 Moroccans (mean age; 29.94±13.90 years) were recruited online. They first completed the 14 ethnic identity questions of the Quebec version of the Ethnic Identity Measure (MIE). They also completed the Moral Foundations Questionnaire (MFQ). Results: The effect of culture on subjects' level of endorsement to moral principles is significant. Moroccans score higher on the moral principles of Loyalty, Authority, and Purity, while French score higher on the moral principles of Care and Fairness. The importance accorded to these principles influences the structure of the moral system of both societies. Discussion: The principles of Care and Fairness correspond to the individualizing foundation because these are all linked to individual rights and that the individual is at the center of moral values. France's moral system draws on more liberal social rules, founded upon individual rights, justice, and the principle of avoiding harm. The principles of Loyalty, Authority, and Purity correspond to the binding foundation. It restricts the liberty of individuals in favor of promoting the interests of the group. Morocco’s moral system supports the regulation of individuals’ egoism by encouraging them to adopt behaviors that facilitate cooperation."

Solitary mastocytoma is the most common form of mastocytosis in children. The main symptom is pruritus. The treatment is symptomatic and it’s based on Topical corticosteroids. The prognosis is good with possibility of spontaneous regression at adulthood. This case report is about a 7-month-old infant that presented with an erythromatous papular lesion on the left temple. The patient responded well to topical steroids and antihistamines.

Resume Les manifestations digestives dans le purpura rhumatoide n’ont aucune specificite. Elles peuvent etre banales a type de vomissements ou de douleurs abdominales ou mimer un syndrome chirurgical abdominal aigu, voire engager le pronostic vital a court terme. Leur frequence n’est pas negligeable et leur traitement est encore plus difficile a codifier. Nous avons realise une etude retrospective de cas de purpura rhumatoide colliges dans le service de pediatrie IV de l’hopital d’enfant de Rabat sur une periode de 10 ans (2008–2018) afin de degager les particularites epidemiologiques, cliniques, paracliniques et evolutives de son atteinte digestive. L’exploitation de nos resultats suggere l’efficacite des corticoides sur cette atteinte. Cependant, aucune etude randomisee n’a ete realisee dans ce domaine et le recours a la corticotherapie lors de manifestations digestives non chirurgicales reste controverse. Etablir des recommandations adaptees aux enfants a partir d’etudes prospectives seraient l’ideal.

Management of a recurrent vertebral metastasis in a situation of previously irradiated spinal cord is a challenging clinical dilemma. We report a first case of second retreatment of a spinal metastasis initially irradiated with standard radiotherapy and stereotactic body radiation therapy (SBRT), who subsequently progressed with imaging-confirmed local tumor progression at the same level. After a third course of irradiation with SBRT, a complete response was achieved. After 8 months of follow-up, the patients remain free of local recurrence. A third course of vertebral irradiation for a recurrent vertebral metastasis failing to two previous irradiations, in this particular case, have shown the feasibility and efficacy of the technique as a salvage treatment option. This approach could be used in a selected group of patient if an adequate dose is delivered to the target while observing critical tissue tolerance limits.

Many theories have shaped the concept of morality and its development by anchoring it in the realm of the social systems and values of each culture. This review discusses the current formulation of moral theories that attempt to explain cultural factors affecting moral judgment and reasoning. It aims to survey key criticisms that emerged in the past decades. In both cases, we highlight examples of cultural differences in morality, to show that there are cultural patterns of moral cognition in Westerners’ individualistic culture and Easterners’ collectivist culture. It suggests a paradigmatic change in this field by proposing pluralist “moralities” thought to be universal and rooted in the human evolutionary past. Notwithstanding, cultures vary substantially in their promotion and transmission of a multitude of moral reasonings and judgments. Depending on history, religious beliefs, social ecology, and institutional regulations (e.g., kinship structure and economic markets), each society develops a moral system emphasizing several moral orientations. This variability raises questions for normative theories of morality from a cross-cultural perspective. Consequently, we shed light on future descriptive work on morality to identify the cultural characteristics likely to impact the expression or development of reasoning, justification, argumentation, and moral judgment in Westerners’ individualistic culture and Easterners’ collectivist culture.