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多系统炎症综合征(MIS-C)患儿的临床特征与实验室检查结果——罗马尼亚康斯坦察一家三级医疗中心的回顾性研究

Clinical Characteristics and Laboratory Findings in Children with Multisystem Inflammatory Syndrome (MIS-C)-A Retrospective Study of a Tertiary Care Center from Constanta, Romania.

作者信息

Mihai Cristina Maria, Chisnoiu Tatiana, Balasa Adriana Luminita, Frecus Corina Elena, Mihai Larisia, Pantazi Alexandru Cosmin, Stuparu Alina Zorina, Axelerad Any

机构信息

Department of Pediatrics, General Medicine Faculty, Ovidius University, 900470 Constanta, Romania.

Department of Pediatrics, County Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania.

出版信息

Healthcare (Basel). 2023 Feb 12;11(4):544. doi: 10.3390/healthcare11040544.


DOI:10.3390/healthcare11040544
PMID:36833078
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9957378/
Abstract

A new hyper-inflammatory syndrome in children was identified after SARS-CoV-2 infection as a post-infectious complication that is temporally associated with coronavirus disease (COVID-19). Fever, rash, conjunctival hyperemia, and gastrointestinal problems are all clinical manifestations of multisystem inflammatory syndrome in children. This condition, in some cases, causes multisystem involvement, affecting multiple organ systems and necessitating admission to a pediatric intensive care unit. Due to limited clinical studies, it is necessary to analyze the characteristics of the pathology in order to improve the management and long-term follow-up of high-risk patients. The objective of the study was to analyze the clinical and paraclinical characteristics of children diagnosed with MIS-C. The clinical study is a retrospective, observational, descriptive research work that includes patients diagnosed with MIS-C, temporally associated with coronavirus disease, and it contains clinical characteristics, laboratory data, and demographic information. The majority of patients had normal or slightly increased leukocyte counts, which were associated with neutrophilia, lymphocytopenia, and significantly elevated inflammatory markers, including high levels of C-reactive protein, fibrinogen, the erythrocyte sedimentation rate, serum ferritin, and IL 6 and elevated levels of the cardiac enzymes NT-proBNP and D-dimers, owing to the cardiovascular system involvement in the pro-inflammatory process. At the same time, renal system involvement led to raised creatinine and high proteinuria in association with hypoalbuminemia. This characteristic of the pro-inflammatory status as well as multisystem impairment are highly suggestive of the post-infection immunological reaction of the multisystem syndrome temporally associated with SARS-CoV-2 infection.

摘要

一种新型儿童超炎症综合征在SARS-CoV-2感染后被确认为一种感染后并发症,它与冠状病毒病(COVID-19)在时间上相关。发热、皮疹、结膜充血和胃肠道问题都是儿童多系统炎症综合征的临床表现。这种情况在某些病例中会导致多系统受累,影响多个器官系统,需要入住儿科重症监护病房。由于临床研究有限,有必要分析病理特征,以改善高危患者的管理和长期随访。该研究的目的是分析被诊断为儿童多系统炎症综合征(MIS-C)的患儿的临床和辅助检查特征。这项临床研究是一项回顾性、观察性、描述性研究工作,纳入了被诊断为MIS-C且与冠状病毒病在时间上相关的患者,包含临床特征、实验室数据和人口统计学信息。大多数患者白细胞计数正常或略有升高,伴有中性粒细胞增多、淋巴细胞减少,炎症标志物显著升高,包括高水平的C反应蛋白、纤维蛋白原、红细胞沉降率、血清铁蛋白和白细胞介素6,以及由于心血管系统参与促炎过程导致心脏酶N末端脑钠肽前体(NT-proBNP)和D-二聚体水平升高。同时,肾脏系统受累导致肌酐升高、蛋白尿增多,并伴有低白蛋白血症。这种促炎状态以及多系统损伤的特征高度提示了与SARS-CoV-2感染在时间上相关的多系统综合征的感染后免疫反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/773a/9957378/6a23c5572ea8/healthcare-11-00544-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/773a/9957378/5ddca96b2070/healthcare-11-00544-g001a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/773a/9957378/9163710fb30f/healthcare-11-00544-g002a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/773a/9957378/ee3db6230b2b/healthcare-11-00544-g003a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/773a/9957378/6a23c5572ea8/healthcare-11-00544-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/773a/9957378/5ddca96b2070/healthcare-11-00544-g001a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/773a/9957378/9163710fb30f/healthcare-11-00544-g002a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/773a/9957378/ee3db6230b2b/healthcare-11-00544-g003a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/773a/9957378/6a23c5572ea8/healthcare-11-00544-g004.jpg

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Clinical Characteristics and Laboratory Findings in Children with Multisystem Inflammatory Syndrome (MIS-C)-A Retrospective Study of a Tertiary Care Center from Constanta, Romania.

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引用本文的文献

[1]
Multisystem inflammatory syndrome in children and Kawasaki disease.

Front Immunol. 2025-4-15

[2]
Pediatric endocarditis - a stone left after the pandemic cascade.

Front Cell Infect Microbiol. 2024

[3]
Multisystem Inflammatory Syndrome in Children Following COVID-19 Vaccination: A Sex-Stratified Analysis of the VAERS Database Using Brighton Collaboration Criteria.

Pharmaceuticals (Basel). 2023-8-30

[4]
COVID-19 and Laboratory Markers from Romanian Patients-A Narrative Review.

Life (Basel). 2023-8-30

[5]
Immunomodulatory Effects of Vitamin D in Respiratory Tract Infections and COVID-19 in Children.

Nutrients. 2023-8-2

本文引用的文献

[1]
Thromboembolic complications in children with COVID-19 and MIS-C: A narrative review.

Front Pediatr. 2022-8-11

[2]
Advanced Echocardiographic Analysis in Medium-Term Follow-Up of Children with Previous Multisystem Inflammatory Syndrome.

Children (Basel). 2022-6-18

[3]
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Pediatr Crit Care Med. 2022-4-1

[4]
Gastrointestinal, hepatic and pancreatic manifestations of COVID-19 in children.

Clin Res Hepatol Gastroenterol. 2022-4

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J Appl Lab Med. 2022-1-5

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Myocarditis With COVID-19 mRNA Vaccines.

Circulation. 2021-8-10

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Front Pediatr. 2021-6-10

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N Engl J Med. 2021-7-1

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6-month multidisciplinary follow-up and outcomes of patients with paediatric inflammatory multisystem syndrome (PIMS-TS) at a UK tertiary paediatric hospital: a retrospective cohort study.

Lancet Child Adolesc Health. 2021-7

[10]
Multisystem inflammatory syndrome in children is driven by zonulin-dependent loss of gut mucosal barrier.

J Clin Invest. 2021-7-15

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