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区分儿童多系统炎症综合征(MIS-C)及其类似疾病——来自热带地区单中心的经验。

Differentiating Multisystem Inflammatory Syndrome in Children (MIS-C) and Its Mimics - A Single-Center Experience From a Tropical Setting.

机构信息

Department of Paediatrics, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, Tamil Nadu, India.

Department of Paediatrics, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, Tamil Nadu, India. Correspondence to: Dr S Lakshan Raj, Department of Paediatrics, KanchiKamakoti CHILDS Trust Hospital, 12A Nageswara Road, Nungambakkam, Chennai, Tamil Nadu 600 034.

出版信息

Indian Pediatr. 2023 May 15;60(5):377-380. doi: 10.1007/s13312-023-2884-3. Epub 2023 Mar 10.

Abstract

OBJECTIVE

Identifying clinical and laboratory indicators that differentiate multisystem inflam-matory syndrome in children (MIS-C) apart from other febrile diseases in a tropical hospital setting.

METHODS

Review of hospital records done in a tertiary care exclusive children's hospital for children admitted from April, 2020 till June, 2021. Laboratory values, severe acute respiratory syndrome coronavirus (SARS-CoV-2) serological status, and clinical signs and symptoms of patients with MIS-C, and those with similar presentations were analyzed.

RESULTS

114 children fulfilled the inclusion criteria (age group of 1 mo-18 y) for whom a diagnosis of MIS-C was considered in the emergency room based on the clinical features. Among them, 64 children had the final diagnosis of MIS-C, and the remaining 50 children had confirmatory evidence of infections mimicking MIS-C such as enteric fever, scrub typhus, dengue and appendicitis.

CONCLUSION

Older age group, presence of muco-cutaneous symptoms, very high C-reactive protein, neutrophilic leukocytosis, abdominal pain and absence of hepatosplenomegaly favor a diagnosis of MIS-C.

摘要

目的

在一家热带医院环境中,确定将儿童多系统炎症综合征(MIS-C)与其他发热性疾病区分开来的临床和实验室指标。

方法

对 2020 年 4 月至 2021 年 6 月期间在一家三级保健专门儿童医院住院的患儿进行医院病历回顾。分析了 MIS-C 患儿以及具有类似表现的患儿的实验室值、严重急性呼吸综合征冠状病毒(SARS-CoV-2)血清学状态以及临床体征和症状。

结果

114 名儿童符合纳入标准(年龄在 1 个月至 18 岁之间),在急诊室根据临床特征考虑 MIS-C 的诊断。其中,64 名儿童的最终诊断为 MIS-C,其余 50 名儿童具有类似 MIS-C 的感染的确诊证据,如肠热病、斑疹伤寒、登革热和阑尾炎。

结论

年龄较大、存在黏膜皮肤症状、非常高的 C 反应蛋白、中性粒细胞增多、腹痛和无肝脾肿大有助于 MIS-C 的诊断。

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