Plouffe Brett, Van Hooren Tamara, Barton Michelle, Nashid Nancy, Demirkaya Erkan, Norozi Kambiz, Rachinsky Irina, Delport Johan, Knauer Michael, Tole Soumitra, Filler Guido
Department of Pediatrics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
Children's Health Research Institute, Lawson Health Research Institute, University of Western Ontario, London, ON, Canada.
Front Pediatr. 2021 May 14;9:669453. doi: 10.3389/fped.2021.669453. eCollection 2021.
Renal infarction is a rare finding in children. Associations between SARS-CoV-2 infections and thromboembolic events including renal infarcts have been described in adults. Although a similar association in children has not yet been described with this pandemic, the pediatric literature is still evolving with the recognition of new manifestations including the post-infectious Multisystem Inflammatory Syndrome in Children (MIS-C). We report the rare event of multiple renal infarcts in a 6-year-old boy manifesting several features of MIS-C 9 weeks following a self-limiting febrile illness characteristic of COVID-19. An underlying Factor V Leiden mutation was identified in this child but felt to be insufficient on its own to explain his clinical presentation. As SARS-CoV-2 testing was delayed, the failure to identify viral RNA or antibodies may not exclude the virus' potential role in precipitating the infarct in this host. Given that renal infarcts have been described in adult patients with COVID-19, reporting this perplexing case where SARS-CoV-2 may have played a role, may help identify this potential complication.
肾梗死在儿童中较为罕见。在成人中，已描述了严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染与包括肾梗死在内的血栓栓塞事件之间的关联。尽管在本次大流行中尚未描述儿童中的类似关联，但随着对包括儿童感染后多系统炎症综合征（MIS-C）在内的新表现的认识，儿科文献仍在不断发展。我们报告了一名6岁男孩发生多发性肾梗死的罕见事件，该事件发生在一次具有COVID-19特征的自限性发热性疾病9周后，表现出MIS-C的若干特征。在该患儿中发现了潜在的凝血因子V莱顿突变，但认为其本身不足以解释他的临床表现。由于SARS-CoV-2检测延迟，未能检测到病毒RNA或抗体可能无法排除病毒在该宿主中引发梗死的潜在作用。鉴于在患有COVID-19的成年患者中已描述了肾梗死，报告这一SARS-CoV-2可能起作用的复杂病例，可能有助于识别这种潜在并发症。
