Department of Pediatric Rheumatology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
Department of Pediatric Rheumatology, Faculty of Medicine, Ankara University, Ankara, Turkey.
Clin Rheumatol. 2022 Dec;41(12):3807-3816. doi: 10.1007/s10067-022-06350-5. Epub 2022 Aug 26.
In this study, it was aimed to evaluate the demographic, clinical and laboratory characteristics of MIS-C patients in our hospital, to share our treatment approach, and to assess the outcomes of short- and long-term follow-up.
MIS-C patients who were admitted and treated in our hospital between July 2020 and July 2021 were evaluated. Demographic, clinical, laboratory, and follow-up data were collected from patient records retrospectively.
A total of 123 patients with MIS-C (median age, 9.6 years) were included the study. Nineteen (15.4%) were mild, 56 (45.6%) were moderate, and 48 (39%) were severe MIS-C. High CRP, ferritin, pro-BNP, troponin, IL-6, and D-dimer values were found in proportion to the severity of the disease (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p = 0.005, p < 0.001), respectively. Two (1.6%) patients died. The mean follow-up period was 7.8 months. Valve failure, left ventricular dysfunction/hypertrophy, coronary involvement, and pericardial effusion were the most common cardiac pathologies in the short- and long-term follow-up of the patients. In the long-term follow-up, the most common reasons for admission to the hospital were recurrent abdominal pain (14.2%), cardiac findings (14.2%), pulmonary symptoms (8%), fever (7.1%), neuropsychiatric findings (6.2%) and hypertension (3.5%). Neuropsychiatric abnormalities were observed significantly more common in severe MIS-C patients at follow-up (p = 0.016). In the follow-up, 6.2% of the patients required recurrent hospitalization.
MIS-C is a serious and life-threatening disease, according to short-term outcomes. In addition to the cardiac findings of patients with MIS-C, long-term outcomes such as neuropsychiatric findings, persistent gastrointestinal symptoms, fever and pulmonary symptoms should be monitored. Key Points • In MIS-C patients, attention should be paid not only to cardiac findings, but also to symptoms related to other systems. • Patients should be followed up in terms of neuropsychiatric findings, persistent gastrointestinal symptoms, fever and pulmonary symptoms that may occur during follow-up.
本研究旨在评估我院 MIS-C 患儿的人口统计学、临床和实验室特征，分享我们的治疗方法，并评估短期和长期随访的结果。
回顾性收集 2020 年 7 月至 2021 年 7 月在我院住院和治疗的 MIS-C 患儿的人口统计学、临床、实验室和随访数据。
本研究共纳入 123 例 MIS-C 患儿（中位年龄 9.6 岁）。19 例（15.4%）为轻度，56 例（45.6%）为中度，48 例（39%）为重度 MIS-C。疾病严重程度与 CRP、铁蛋白、pro-BNP、肌钙蛋白、IL-6 和 D-二聚体升高呈正相关（p<0.001、p<0.001、p<0.001、p<0.001、p=0.005、p<0.001）。2 例（1.6%）患儿死亡。平均随访时间为 7.8 个月。瓣膜功能障碍、左心室功能障碍/肥大、冠状动脉受累和心包积液是患儿短期和长期随访中最常见的心脏病变。在长期随访中，患儿再次住院的最常见原因是腹痛（14.2%）、心脏发现（14.2%）、肺部症状（8%）、发热（7.1%）、神经精神症状（6.2%）和高血压（3.5%）。在随访中，严重 MIS-C 患儿的神经精神异常明显更为常见（p=0.016）。在随访中，6.2%的患儿需要再次住院。
根据短期结果，MIS-C 是一种严重且危及生命的疾病。除了 MIS-C 患儿的心脏发现外，还应监测神经精神发现、持续性胃肠道症状、发热和肺部症状等长期结果。
在 MIS-C 患儿中，不仅要注意心脏表现，还要注意与其他系统相关的症状。
在随访中，应注意可能发生的神经精神发现、持续性胃肠道症状、发热和肺部症状。
