Haslak Fatih, Gunalp Aybuke, Kasapcopur Ozgur
Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey.
Curr Opin Rheumatol. 2023 Jan 1;35(1):6-16. doi: 10.1097/BOR.0000000000000910. Epub 2022 Sep 12.
We aimed to summarize a novel disease called multisystem inflammatory syndrome in children (MIS-C), which develops several weeks after a severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) illness.
Given the rarity of the disease, the question of why a minority of children develop MIS-C is not known. Certain intrinsic susceptibility factors in the host have been described. In addition to hyperinflammation induced by the innate and acquired immune cells, evidence of molecular mimicry was presented for the disease pathogenesis. As there is an increasing number of infected individuals and mass vaccination schedules, concerns regarding the usefulness of the existing diagnostic criteria sets raised.
Although children are likely to have a milder COVID-19 course compared with adults, MIS-C as a postinfectious and life-threatening complication was reported in the pediatric age. After 2 years of the disease definition, optimal treatment regimes, effective preventive measures, and long-term outcomes are still debated.
我们旨在总结一种名为儿童多系统炎症综合征(MIS-C)的新型疾病,该疾病在严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染数周后出现。
鉴于该疾病的罕见性,少数儿童为何会患上MIS-C尚不清楚。已描述了宿主中的某些内在易感性因素。除了先天性和获得性免疫细胞诱导的过度炎症外,还提出了分子模拟作为该疾病发病机制的证据。随着感染人数的增加和大规模疫苗接种计划的实施,人们对现有诊断标准集的实用性产生了担忧。
尽管与成人相比,儿童感染新冠病毒(COVID-19)的病程可能较轻,但MIS-C作为一种感染后危及生命的并发症在儿童期已有报道。在该疾病定义两年后,最佳治疗方案、有效的预防措施和长期预后仍存在争议。