Department of Paediatrics, Fazaia Medical College, Pakistan Air Force Hospital, Islamabad, Pakistan.
J Coll Physicians Surg Pak. 2024 Jun;34(6):727-731. doi: 10.29271/jcpsp.2024.06.727.
Neonatal multisystem inflammatory syndrome (MIS-N) is a unique disease of neonates described in several case reports from all over the world with a myriad of presentations and the emergence of new cases.
Retrospective case series. Place and Duration of the Study: Department of Paediatrics, Fazaia Medical College, Pakistan Air Force Hospital, Islamabad, Pakistan, from December 2021 to November 2022.
The study was conducted on neonates who were managed as MIS-N in the neonatal ICU. Data were collected and analysed on SPSS version 24.
Patients in this study ranged from newborns to 13 days of age with a mean age of 3.27 ± 4.29 days and average gestational age of 35.18 ± 3.67 weeks. Among these neonates, 7 (63.6%) had bleeding diathesis, 11 (100%) had seizures, 8 (72.2%) presented with haemodynamic instability and shock, and 7 (63.3%) had signs of heart failure. All neonates (100%) had markedly raised SARS-CoV2 IgG antibodies, CRP, ferritin, D-dimers, interleukin 6, procalcitonin, 10 (90.9%) had hypoalbuminemia, and 7 (63.3%) had deranged coagulation profile. Cardiac involvement was seen in all neonates (100%) with raised proBNP and myocardial dysfunction on echocardiography. Pulmonary hypertension was present in 6 (54.4%) neonates. High mortality was observed at 6 (54.5%) among which 4 (66.6%) were premature neonates.
MIS-N is a new disease entity which is still under research. There is a high propensity for cardiovascular system involvement and higher mortality among preterm neonates.
Neonatal multisystem inflammatory syndrome (MIS-N), Multisystem inflammatory syndrome in children (MIS-C), SARS-CoV2 infection, SARS-CoV2 spike protein, SARS-CoV2 IgG antibodies.
新生儿多系统炎症综合征(MIS-N)是一种独特的新生儿疾病,在世界各地的多项病例报告中均有描述,其临床表现多种多样,且新病例不断出现。
回顾性病例系列研究。地点和研究时间:巴基斯坦空军医院法扎亚医学院儿科,巴基斯坦伊斯兰堡,2021 年 12 月至 2022 年 11 月。
本研究纳入在新生儿 ICU 接受 MIS-N 治疗的新生儿患者。数据在 SPSS 版本 24 上进行收集和分析。
本研究中的患者年龄从新生儿至 13 天不等,平均年龄为 3.27 ± 4.29 天,平均胎龄为 35.18 ± 3.67 周。这些新生儿中,有 7 例(63.6%)存在出血倾向,11 例(100%)有癫痫发作,8 例(72.2%)表现为血流动力学不稳定和休克,7 例(63.3%)有心力衰竭迹象。所有新生儿(100%)的 SARS-CoV2 IgG 抗体、CRP、铁蛋白、D-二聚体、白细胞介素 6、降钙素原显著升高,10 例(90.9%)有低白蛋白血症,7 例(63.3%)有凝血功能异常。所有新生儿(100%)均有心脏受累,超声心动图显示脑利钠肽前体升高和心肌功能障碍。6 例(54.4%)新生儿存在肺动脉高压。死亡率较高,为 6 例(54.5%),其中 4 例(66.6%)为早产儿。
MIS-N 是一种新的疾病实体,仍在研究中。早产儿心血管系统受累和死亡率较高。
新生儿多系统炎症综合征(MIS-N)、儿童多系统炎症综合征(MIS-C)、SARS-CoV2 感染、SARS-CoV2 刺突蛋白、SARS-CoV2 IgG 抗体。