Background. Psoriasis is a polygenic multifactorial immune-mediated disease. Its course can be aggravated by associated obesity. Recently, there is negative trend that is characterized by the increase in the number of moderate to severe psoriasis cases among children, and majority of them have obesity. Identification of factors that that are relevant in these two conditions will allow us to improve and optimize the genetically engineered biological therapy for this category of patients.

Objective. The aim of the study is to evaluate epicardial adipose tissue thickness, serum leptin levels, eating behavior via the data from Children’s Eating Behaviour Questionnaire (CEBQ) for patients with psoriasis and obesity, and compare the results with control group – patients with psoriasis and no associated obesity.

Results. We have studied 12 patients with established diagnosis of psoriasis, 5 of them had diagnosis of obesity. Epicardial fat thickening was revealed in 20% of cases in the study group (patients with psoriasis and obesity), and no epicardial fat thickening was revealed in the control group. The increase in serum leptin was revealed in 100% of cases in obese patients with psoriasis, and only in 14% of cases in the control group. The mean leptin level in obese patients was 16.65 ng/ml, in the group with normal body weight – 7.08 ng/ml. Obese patients have shown higher values in “food approach” scales group in comparison to normal weight patients.

Conclusion. Patients with obesity and psoriasis has shown elevated leptin levels, higher incidence of epicardial fat thickening, and tendency to develop abnormal eating behavior.

The steady increase in the number of people infected with SARS-CoV-2 virus causing COVID-19 all over the world necessitates further study of fundamental features of pandemic spreading and clinical signs of disease, especially in children population. This article presents the experience of managing patients with pericardial effusion that has developed after new coronavirus infection COVID-19. The role of timely diagnosis of pericardial effusion, principles of its diagnostics, management, and follow-up observation on outpatient level within the pandemic are presented.

Background. Enzyme replacement therapy (ERT) with iduronate-2-sulfatase recombinant forms (idursulfase and idursulfase beta) is effective for the management of mucopolysaccharidosis type II (MPS II). Patients with Hunter syndrome require lifelong ERT that can negate endogenous enzyme deficiency. However, hypersensitivity reactions may occur during ERT, and they significantly complicate the implementation of vital therapy.

Clinical case description. This article describes clinical case of a child with hypersensitivity reaction to ERT. The patient with confirmed diagnosis of MPS II was administrated with idursulfase. Then, the drug was replaced with idursulfase beta due to the allergic reaction. Thus, even after the drug change, side effects maintained without sustained improvement with underlying glucocorticosteroids (GCS), antihistamines and with decreased infusion rate. Concerning the vital need to continue ERT, this patient with drug allergy to this pharmacotherapeutic group was further administered with combined therapy of cyclosporine and omalizumab. Personalised protocol for the administration of idursulfase beta with desensitization was developed. Such experience was firstly described In Russian patient.

Conclusion. The presented personalised combination therapy made it possible to prevent hypersensitivity reactions during ERT in the patient with MPS II.

Background. Mastocytosis refers to the group of rare diseases with pathological mast cells accumulation in tissues. Although diagnosis of cutaneous mastocytosis is not usually difficult for experienced physicians, misdiagnosis is possible.

Clinical cases description. The authors describe two clinical cases of patients with mastocytosis cutaneous form, observed due to the skin rashes and without any correctly established diagnosis.

Conclusion. Patients with mastocytosis require specific living conditions and regular dynamic monitoring to prevent disease progression and complications development.