Childhood Multisystem Inflammatory Syndrome: An Emerging Disease with Prominent Cardiovascular Involvement-A Scoping Review.
Childhood Multisystem Inflammatory Syndrome: An Emerging Disease with Prominent Cardiovascular Involvement-A Scoping Review.
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DOI：
10.1007/s42399-020-00650-0
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Mishra A
中科院分区：
文献类型：
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作者：
Malviya A;Mishra A
儿童多系统炎症综合征(MIS-C)或与SARS-CoV-2暂时性相关的儿科炎性多系统综合征(PIMS-TS)是严重急性呼吸综合征冠状病毒-2(SARS-CoV-2)感染儿童的一种新发疾病，被认为是SARS-CoV-2免疫介导的感染后并发症。这种疾病的表现与川崎病相似，但有某些不同的特征。确切的发病机制尚不清楚，但异常的免疫反应、抗体介导的血管损伤以及病毒介导的I型和III型干扰素-伽马反应异常被认为是原因。大多数以前健康的儿童在感染SARS-CoV-2 2-4周后出现短期发热性疾病，胃肠道、心脏和血液系统表现突出，进展为血管麻痹性休克，需要血管加压治疗。心血管受累以急性心肌损伤/心肌炎和冠状动脉动脉瘤的发展为显著特征。炎症的实验室标记物均匀升高。大多数儿童需要重症监护，很少需要有创呼吸机。治疗主要包括抗炎和免疫调节治疗，如静脉注射免疫球蛋白和类固醇。总体预后良好，报告死亡率为0-4%。
Multisystem inflammatory syndrome in children (MIS-C) or paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) is an emerging disease in children affected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and thought to be an immune-mediated post-infectious complication of SARS-CoV-2. The disease presentation is similar to Kawasaki disease but has certain distinguishing features. The exact pathogenesis is still not clear but an aberrant immune response, antibody-mediated vascular damage and virus-mediated abnormal type I and III interferon-gamma response are thought to be responsible. Most children who are previously healthy present after 2–4 weeks of SARS-CoV-2 infections with febrile illness of short duration with prominent gastrointestinal, cardiac and hematologic manifestations, progressing to vasoplegic shock, requiring vasopressor therapy. Cardiovascular involvement is prominently marked by acute myocardial injury/myocarditis and the development of coronary artery aneurysms. Laboratory markers of inflammation are elevated uniformly. Most children require intensive care, and few need invasive ventilation. The treatment mainly consists of anti-inflammatory and immunomodulatory therapy like intravenous immunoglobulins and steroids. The overall prognosis is good and reported mortality rates are 0–4%.