We provide an update on the state of play with regards a newly described inflammatory condition which has arisen during the current SARS‐CoV‐2 pandemic. The condition has been named paediatric inflammatory multisystem syndrome temporally associated with SARS‐CoV‐2 or multisystem inflammatory syndrome in children. This condition has shown significant similarities to Kawasaki disease and toxic shock syndrome.

Objective: To assess parental stress levels of mothers of children with juvenile idiopathic arthritis (JIA) aged between 2-12 years and compare with those reported for other chronic childhood illnesses.Methodology: Mothers of children aged between 2-12 years with JIA were recruited from hospital-based outpatient clinics. Maternal stress was measured by using the Parenting Stress Index Long Form (PSI). The physician assessing the child completed an active joint count, a physician's global assessment and recorded the C-reactive protein and/or erythrocyte sedimentation rate if one was clinically indicated.Results: The mothers recruited had children with a mean age of 6 years. The mean total stress score of mothers of children with JIA measured by the PSI was 235.4 (95% CI 218.5-252.3) was greater than the mean total stress scores for mothers of normal children at 222.8 (95% CI 221.4-224.2). It was also greater than children with other chronic disorders such as insulin-dependent diabetes mellitus (IDDM), 218.1 (95% CI 204.7-231.6) and profound deafness,. One third of mothers had total PSI scores that were in the clinical range (Total PSI > 260), indicating a need for intervention.Conclusion: JIA should be regarded as a significant illness in which maternal stress is at least equivalent to that associated with the care of children with other chronic diseases of childhood.

Juvenile idiopathic arthritis results in significant pain and disability in both children and adults. Advances in treatment resulting in improved long-term outcomes have occurred; however, an emphasis on early and aggressive diagnosis and management hopes to improve outcomes further. Juvenile idiopathic arthritis remains a clinical diagnosis of exclusion, but further research may delineate biological markers associated with the disease and its subtypes. Therapy for patients includes intra-articular steroid injections, disease modifying agents such as methotrexate and biological agents. Biological agents have provided exciting new therapeutic options in the last decade; however, long-term side effects of modulating the immune system are not yet fully understood. Systemic steroids may also be required but their long-term use is avoided. Uveitis needs to be screened for in all of those with the diagnosis. Multidisciplinary team care is required in managing these young people.

Maori and Pacific Island children were more likely to present with poor prognostic features at diagnosis although the incidence of JIA was demonstrated to be significantly higher among European children compared to all ethnic groups. This article is protected by copyright. All rights reserved.