巴西亚马逊地区一名与冠状病毒病19相关的儿童多系统炎症综合征：一名婴儿的致命结局
MULTISYSTEM INFLAMMATORY SYNDROME IN A CHILD ASSOCIATED WITH CORONAVIRUS DISEASE 19 IN THE BRAZILIAN AMAZON: FATAL OUTCOME IN AN INFANT.
作者信息
Farias Emmerson Carlos Franco de, Justino Maria Cleonice Aguiar, Mello Mary Lucy Ferraz Maia Fiuza de
机构信息
Hospital Fundação Santa Casa de Misericórdia do Pará, Belém, PA, Brazil.
Instituto Evandro Chagas, Ananindeua, PA, Brazil.
出版信息
Rev Paul Pediatr. 2020;38:e2020165. doi: 10.1590/1984-0462/2020/38/2020165. Epub 2020 Aug 26.
OBJECTIVE
Recently, there have been reports of children with severe inflammatory syndrome and multiorgan dysfunction associated with elevated inflammatory markers. These cases are reported as presenting the Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19. In this study, we describe with parental permission a case of MIS-C in an infant with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
CASE DESCRIPTION
A seven-month-old infant, with SARS-CoV-2 infection and a history of extreme preterm birth and very low weight at birth, with an initial course of mild respiratory symptoms and abrupt progression to vasoplegic shock, myocarditis and hyperinflammation syndrome, shown by high levels of troponin I, ferritin, CRP, D-dimer and hypoalbuminemia. Despite the intensive care provided, the child developed multiple organ dysfunction and died.
COMMENTS
Patients with a history of extreme prematurity may present with MIS-C in the presence of COVID-19 and are a group of special concern.
目的
最近，有报道称儿童出现严重炎症综合征和多器官功能障碍，伴有炎症标志物升高。这些病例被报告为与2019冠状病毒病（COVID-19）相关的儿童多系统炎症综合征（MIS-C）。在本研究中，我们在获得家长许可的情况下，描述了1例感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的婴儿患MIS-C的病例。
病例描述
一名7个月大的婴儿，感染SARS-CoV-2，有极早产和出生时体重极低的病史，最初有轻度呼吸道症状，随后突然进展为血管麻痹性休克、心肌炎和高炎症综合征，肌钙蛋白I、铁蛋白、CRP、D-二聚体水平升高及低白蛋白血症表明了这一点。尽管给予了重症监护，该患儿仍出现多器官功能障碍并死亡。
评论
有极早产病史的患者在感染COVID-19时可能会出现MIS-C，是一组特别值得关注的人群。
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