Multisystem inflammatory syndrome in a neonate masquerading as surgical abdomen.
Multisystem inflammatory syndrome in a neonate masquerading as surgical abdomen.
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DOI：
10.1136/bcr-2021-246579
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发表时间：
2021-10-28
期刊：
影响因子：
0.9
通讯作者：
Sethi SK
中科院分区：
文献类型：
--
作者：
Agrawal G;Wazir S;Arora A;Sethi SK
在世界范围内，已经有数以千计的儿童多系统炎症综合征(MIS-C)病例在儿童中报道。关于新生儿MIS-C的证据是有限的。我们报告第一例新生儿在出生48小时内出现明显的腹部体征，类似于外科腹部。临床表现包括发热、多器官功能障碍(胃肠道、心肺、肝脏和皮肤)、炎症标志物阳性、高铁蛋白和高D-二聚体水平。心肌酶N末端-B型利钠肽原和D-二聚体水平升高。血、尿、粪便和脑脊液培养均为无菌。母亲和婴儿中的抗SARS-CoV-2抗体阳性，加上母亲接触新冠肺炎的流行病学证据，确定了MISC的诊断。应用免疫调节药物(静脉注射免疫球蛋白和全身类固醇)，取得了良好的临床疗效。危重新生儿的高可疑指数可改善预后。
Worldwide, thousands of cases of multisystem inflammatory syndrome in children (MIS-C) have already been reported in children. Evidence regarding neonatal MIS-C is limited. We present the first case report of a neonate presenting within 48 hours of life with predominant abdominal signs mimicking surgical abdomen. Clinical picture comprised fever, multiorgan dysfunction (gastrointestinal, cardiorespiratory, hepatic and dermatological), positive inflammatory markers, high ferritin and high D-dimer levels. Cardiac enzyme N-terminal-pro-B-type natriuretic peptide as well as D-dimer levels were elevated. Blood, urine, stool and cerebrospinal fluid cultures were sterile. Positive anti-SARS-CoV-2 IgG in both the mother and the infant, along with an epidemiological evidence of maternal contact with COVID-19, clinched the diagnosis of MIS-C. Immunomodulatory drugs (intravenous immunoglobulin and systemic steroids) were administered and showed good clinical response. A high index of suspicion of MIS-C in critically ill neonates can improve outcomes.