Santos Mônica de Oliveira, Ribeiro Diuly Caroline, Rocha Jordanna Sousa, Maia Sibely Braga Santos, Moreira André Luís Elias, Silva Paulo Alex Neves, Ito Célia Regina Malveste, Carneiro Lilian Carla, Avelino Melissa Ameloti Gomes
Clinical Pathology and Medicine, Federal University of Goiás, Goiânia 74690-900, GO, Brazil.
Department of Pediatrics, Hospital das Clinicas, Federal University of Goiás, Goiânia 74690-900, GO, Brazil.
Children (Basel). 2022 Oct 29;9(11):1653. doi: 10.3390/children9111653.
During the COVID-19 pandemic, we followed with concern the evolution of several children diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C). The purpose of this study is to describe the evolution of MIS-C in a previously healthy 3-year-old girl.
We tracked the daily medical report of all children admitted with suspected MIS-C to the five largest regional hospitals.
Our screening identified a child who had several neurological complications associated with MIS-C. We report hematological alterations, transient cardiac dysfunction, and cerebral involvements such as laminar cortical necrosis caused by ischemic stroke. We present the course of treatment and clinical outcome, and other complications such as a severe subglottic stenosis occurring after extubation.
Subglottic stenosis is an expected complication after prolonged intubation, and the presence of dysphonia and/or stridor is an important predictive factor. MIS-C with severe neurological alteration may occur in a healthy child, and early diagnosis and treatment with a pulse of corticoid with immunoglobulin are essential for a favorable outcome.
在新冠疫情期间，我们密切关注了多名被诊断为儿童多系统炎症综合征（MIS-C）的儿童的病情发展。本研究旨在描述一名此前健康的3岁女童的MIS-C病情发展情况。
我们追踪了五家最大的地区医院收治的所有疑似MIS-C儿童的每日医疗报告。
我们的筛查发现了一名患有与MIS-C相关的多种神经并发症的儿童。我们报告了血液学改变、短暂性心脏功能障碍以及诸如缺血性中风导致的层状皮质坏死等脑部病变。我们介绍了治疗过程和临床结果，以及其他并发症，如拔管后出现的严重声门下狭窄。
声门下狭窄是长时间插管后的一种常见并发症，声音嘶哑和/或喘鸣的出现是一个重要的预测因素。健康儿童可能会发生伴有严重神经改变的MIS-C，早期诊断并使用皮质类固醇和免疫球蛋白进行脉冲治疗对于取得良好预后至关重要。
