儿童多系统炎症综合征最新研究进展

Latest research progress on multisystem inflammatory syndrome in children

  • 摘要: 儿童多系统炎症综合征(MIS-C)于2020年4月由英国儿科医师首次报道,是一种与严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染相关、可引起多系统损害的疾病,其表现与其他儿童炎症综合征的临床特征有重叠,包括川崎病、中毒性休克综合征和巨噬细胞激活综合征等。MIS-C的发展与SARS-CoV-2感染密切相关,在大多数情况下,可以认为是继发于病毒感染后的异常免疫反应,类似于成人感染SARS-CoV-2数日后出现的症状。目前用于诊断MIS-C的标准很可能过于宽泛,这意味着或会纳入患有不同疾病的患儿。该病好发于较大年龄儿童,这与川崎病多见于5岁以下儿童有明显的不同。MIS-C主要表现为持续高热、明显的消化道症状、血流动力学不稳定、心肌炎及炎症指标升高等。由于MIS-C的发病机制尚未清楚,目前采用不同的治疗手段,虽尚无特异性的治疗方法,但整体预后良好。目前仍需要进行大量的研究来提高临床医师对MIS-C的认识水平,明确其对儿童健康的真正影响,并阐明最佳的诊断和治疗方法以及真正的预后。

     

    Abstract: Multisystem inflammatory syndrome in children (MIS-C), first reported by British pediatricians in April, 2020, is a disease associated with severe acute respiratory syndrome coronavirus-2(SARS-CoV-2) infection and can cause multiple system damage, and its manifestations overlap with the clinical features of other childhood inflammatory syndromes, including Kawasaki disease, toxic shock syndrome and macrophage activation syndrome, etc. The development of MIS-C is closely related to SARS-CoV-2 infection. In most cases, it can be considered as abnormal immune response following viral infection, similar to the symptoms of adults infected with SARS-CoV-2 a few days later. Current diagnostic criteria for MIS-C might be too broad so that children with different diseases can be included. MIS-C often occurs in older children, which is obviously different from Kawasaki disease in children under 5 years old. The main clinical manifestations of MIS-C were continuous high fever, obvious digestive tract symptoms, hemodynamic instability, myocarditis and increased inflammatory indicators, etc. As the pathogenesis of MIS-C is not clear, there is no specific treatment. However, the overall prognosis is excellent. At present, a large quantity of studies are required to deepen the understanding of MIS-C, assess the exact effect on children’s health, explore the optimal diagnosis and treatment and accurately evaluate clinical prognosis.

     

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