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儿童多系统炎症综合征的治疗。

Treatment of multisystem inflammatory syndrome in children.

机构信息

Department of Cardiology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, No. 3333 Binsheng Road, Hangzhou, 310052, China.

出版信息

World J Pediatr. 2024 Apr;20(4):325-339. doi: 10.1007/s12519-024-00798-y. Epub 2024 Mar 21.

Abstract

BACKGROUND

Multisystem inflammatory syndrome in children (MIS-C), a relatively uncommon but severe pediatric complication, is associated with coronavirus disease 2019 (COVID-19). A variety of treatment approaches, including intravenous immunoglobulins (IVIGs), glucocorticoids (GCs) and biologic agents, such as anakinra and infliximab, have been described for the management of COVID-19-related MIS-C. Anticoagulant therapy is also important. However, a well-developed treatment system has not been established, and many issues remain controversial. Several recently published articles related to the treatment of MIS-C have been released. Hence, in this review, we identified relevant articles published recently and summarized the treatment of MIS-C more comprehensively and systematically.

DATA SOURCES

We reviewed the literature on the treatment of MIS-C through 20 September 2023. The PubMed/Medline, Web of Science, EMBASE, and Cochrane Library databases were searched with the combination of the terms "multisystem inflammatory syndrome", "MIS-C", "PIMS-TS", "therapy", "treatment", "drug", "IVIG", "GCs", "intravenous immunoglobulin", "corticosteroids", "biological agent", and "aspirin".

RESULTS

The severity of MIS-C varies, and different treatment schemes should be used according to the specific condition. Ongoing research and data collection are vital to better understand the pathophysiology and optimal management of MIS-C.

CONCLUSIONS

MIS-C is a disease involving multiple systems and has great heterogeneity. With the accumulation of additional experience, we have garnered fresh insights into its treatment strategies. However, there remains a critical need for greater standardization in treatment protocols, alongside the pressing necessity for more robust and meticulously conducted studies to deepen our understanding of these protocols. Supplementary file1 (MP4 208044 kb).

摘要

背景

儿童多系统炎症综合征(MIS-C)是一种相对罕见但严重的儿科并发症,与 2019 年冠状病毒病(COVID-19)相关。已经描述了多种治疗方法,包括静脉注射免疫球蛋白(IVIG)、糖皮质激素(GCs)和生物制剂,如阿那白滞素和英夫利昔单抗,用于治疗 COVID-19 相关的 MIS-C。抗凝治疗也很重要。然而,尚未建立完善的治疗体系,许多问题仍存在争议。最近发表了几篇与 MIS-C 治疗相关的文章。因此,在本综述中,我们检索了最近发表的相关文章,并更全面、系统地总结了 MIS-C 的治疗方法。

数据来源

我们通过 2023 年 9 月 20 日检索了关于 MIS-C 治疗的文献。检索了 PubMed/Medline、Web of Science、EMBASE 和 Cochrane Library 数据库,使用了“多系统炎症综合征”、“MIS-C”、“PIMS-TS”、“治疗”、“治疗”、“药物”、“IVIG”、“GCs”、“静脉注射免疫球蛋白”、“皮质类固醇”、“生物制剂”和“阿司匹林”等术语的组合。

结果

MIS-C 的严重程度不同,应根据具体情况使用不同的治疗方案。正在进行的研究和数据收集对于更好地了解 MIS-C 的病理生理学和最佳管理至关重要。

结论

MIS-C 是一种涉及多个系统的疾病,具有很大的异质性。随着更多经验的积累,我们对其治疗策略有了新的认识。然而,在治疗方案方面仍迫切需要更大的标准化,同时也需要更有力和精心设计的研究来深化我们对这些方案的理解。补充文件 1(MP4 208044 kb)。

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