Orlanski-Meyer Esther, Yogev Dotan, Auerbach Adi, Megged Orli, Glikman Daniel, Hashkes Philip J, Bar-Meir Maskit
Institute of Pediatric Gastroenterology and Nutrition, Shaare Zedek Medical Center, Jerusalem, Israel.
Hadassah Hebrew University Medical School, Jerusalem, Israel.
J Pediatric Infect Dis Soc. 2020 Dec 31;9(6):781-784. doi: 10.1093/jpids/piaa137.
We describe an 8-week-old infant with severe gastrointestinal symptoms, significant hypoalbuminemia, and mild carditis following asymptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The infant's symptoms, including their temporal appearance, were consistent with multisystem inflammatory syndrome in children (MIS-C). A unique finding on colonic histology which may shed light on the pathogenesis of MIS-C was identified. The patient improved significantly following several anti-inflammatory treatments. The lag between the presentation of MIS-C and initial SARS-CoV-2 exposure, which may often be asymptomatic, together with the young age of our patient, makes this a challenging diagnosis. Clinicians should be aware of this entity, even in the neonatal and infantile age groups, to facilitate timely identification and treatment.
我们描述了一名8周大的婴儿,在无症状感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)后出现严重胃肠道症状、显著低白蛋白血症和轻度心肌炎。该婴儿的症状,包括出现的时间,与儿童多系统炎症综合征(MIS-C)一致。在结肠组织学上发现了一个独特的发现,这可能有助于阐明MIS-C的发病机制。经过几种抗炎治疗后,患者病情显著改善。MIS-C的出现与最初SARS-CoV-2暴露之间的时间间隔(最初暴露通常可能无症状),再加上我们患者的年龄较小,使得这成为一个具有挑战性的诊断。临床医生即使在新生儿和婴儿年龄组中也应了解这种疾病,以便及时识别和治疗。