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哪些发现使儿童多系统炎症综合征有别于大流行前的川崎病?

Which Findings Make multisystem Inflammatory Syndrome in Children Different from the Pre-Pandemic Kawasaki Disease?

机构信息

Department of Paediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Children's Hospital, İzmir, Turkey.

Department of Paediatrics, University of Health Sciences Dr. Behçet Uz Children's Hospital, İzmir, Turkey.

出版信息

Pediatr Cardiol. 2023 Feb;44(2):424-432. doi: 10.1007/s00246-022-02961-6. Epub 2022 Jul 8.

Abstract

Multisystem Inflammatory Syndrome in Children associated with COVID-19 infection attracted attention because some features overlapped with Kawasaki disease. And due to these overlapping features with Kawasaki disease, it has become difficult to diagnose both disorders. Therefore, this study focused on the differences between the patients diagnosed with MIS-C after COVID-19 and Kawasaki patients analyzed, particularly during the pre-pandemic period. In this way, it is aimed to reduce the dilemmas experienced in Diagnosis. In this descriptive study, 98 patients diagnosed with MIS-C throughout the pandemic were compared to 37 patients diagnosed with Kawasaki Disease during the pre-pandemic period.The patients in the MIS-C group were older children and clinically suffered from more headaches, vomiting, diarrhea, abdominal pain, and chest pain than Kawasaki patients. Signs of shock such as hypotension and tachycardia were more remarkable. Also, myocarditis and mitral regurgitation were detected at a higher rate in the MIS-C group. Besides, in the laboratory, lymphopenia, hypoalbuminemia, and creatinine elevation were more apparent.In conclusion, our present study findings support that although the MIS-C and Kawasaki share common features, they present with different clinical and laboratory features. And these differences are thought to be supportive in treatment and patient management.

摘要

儿童多系统炎症综合征与 COVID-19 感染相关,因其某些特征与川崎病重叠而引起关注。由于与川崎病存在这些重叠特征,因此两种疾病的诊断变得更加困难。因此,本研究侧重于分析 COVID-19 后诊断为 MIS-C 的患者与川崎病患者之间的差异,特别是在大流行前时期。这样,旨在减少诊断中遇到的困境。在这项描述性研究中,将整个大流行期间诊断为 MIS-C 的 98 例患者与大流行前时期诊断为川崎病的 37 例患者进行了比较。MIS-C 组的患者为年龄较大的儿童,临床症状较川崎病患者更常出现头痛、呕吐、腹泻、腹痛和胸痛。休克体征如低血压和心动过速更为明显。此外,MIS-C 组更易发生心肌炎和二尖瓣反流。此外,在实验室检查中,淋巴细胞减少、低白蛋白血症和肌酐升高更为明显。总之,本研究结果支持虽然 MIS-C 和川崎病有共同的特征,但它们表现出不同的临床和实验室特征。这些差异被认为对治疗和患者管理有帮助。

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