Loomba Rohit S, Villarreal Enrique G, Flores Saul
Cardiology, Advocate Children's Hospital, Chicago, USA.
Pediatrics, Tecnologico De Monterrey, Escuela De Medicina Y Ciencias De La Salud, Monterrey, MEX.
Cureus. 2020 Aug 1;12(8):e9515. doi: 10.7759/cureus.9515.
A hyperinflammatory syndrome has been described in times of COVID-19 in children. In the setting of uncertainty due to a new virus, the so-called hyperinflammatory syndrome has been coined as a novel entity by some and is being referred to as pediatric inflammatory multisystem syndrome (PIMS). However, the characteristics of the syndrome resemble those of Kawasaki disease (KD), an inflammatory syndrome in children that can lead to coronary artery abnormalities due to a subsequent vasculitis. Furthermore, Kawasaki disease may occasionally trigger macrophage activation syndrome (MAS), a condition in which there is uncontrolled activation and proliferation of macrophages and other cell types, and could lead to multiorgan system dysfunction. This study provides a review of the data regarding COVID-19, Kawasaki disease, and macrophage activation syndrome to demonstrate the similarities and differences between the inflammatory syndrome seen with COVID-19 and KD. In addition, a framework for diagnosis and evaluation is provided that focuses on the pathway previously established for KD and MAS. The authors believe that based on current knowledge, KD treatment delays may carry deleterious effects in the near future for children with COVID-19-related Kawasaki disease.
在新冠疫情期间，儿童中出现了一种高炎症综合征。在面对一种新型病毒所带来的不确定性时，这种所谓的高炎症综合征被一些人视为一种新的病症，并被称为儿童炎症性多系统综合征（PIMS）。然而，该综合征的特征与川崎病（KD）相似，川崎病是一种儿童炎症综合征，由于后续的血管炎可导致冠状动脉异常。此外，川崎病偶尔可能引发巨噬细胞活化综合征（MAS），即巨噬细胞和其他细胞类型出现不受控制的活化和增殖的一种病症，并可能导致多器官系统功能障碍。本研究回顾了有关新冠病毒、川崎病和巨噬细胞活化综合征的数据，以阐明新冠病毒感染时出现的炎症综合征与川崎病之间的异同。此外，还提供了一个诊断和评估框架，该框架聚焦于先前为川崎病和巨噬细胞活化综合征所确立的途径。作者认为，基于目前的认知，对于患有新冠相关川崎病的儿童，延误川崎病的治疗在不久的将来可能会产生有害影响。
