Darshan Rajatadri

To the Editor: Pancytopenia in pediatric systemic lupus erythematosus (SLE) has a broad differential diagnosis. Distinguishing between disease flare, infection, macrophage activation syndrome (MAS), and drug-induced myelosuppression is often difficult because these conditions share overlapping clinical and laboratory features [1]. Variants in the thiopurine methyltransferase (TPMT) and nudix hydrolase 15 (NUDT15) genes are recognized predictors of azathioprine-related hematologic toxicity [2].

Dear Editors, We read with interest the recent article by Richard et al. describing pericardial effusion in pediatric Shiga toxin-producing E. coli hemolytic uremic syndrome (STEC-HUS) due to O26 strain [1]. We wish to highlight that pericardial effusion also complicates anti-factor-H antibody associated aHUS (anti-FH ab aHUS). Over the last 6 months, 4 children with anti-FH ab aHUS at our centre were detected with pericardial effusion.

Abstract Tuberculosis remains a global health challenge, with central nervous system tuberculosis (CNSTB) affecting 5–10% of extrapulmonary tuberculosis cases, leading to severe complications in children aged 2 to 4 years. Despite timely diagnosis and intervention, management of CNSTB is a challenge. Thalidomide, a TNF-α inhibitor, is a potential therapeutic option in cases resistant to adjuvant corticosteroid therapy.