Mesenteric Lymphadenitis Presenting as Acute Abdomen in a Child with Multisystem Inflammatory Syndrome

Vitamin D combined with compound glutamine for treatment of mesenteric lymphadenitis in preschool children: Efficacy and effect on cellular immune function

BACKGROUND

Mesenteric lymphadenitis (ML) is a major cause of acute diarrhoea in children and affects their health. The etiology of ML is not fully understood and is generally thought to be caused by respiratory viral or bacterial infections, which are closely related to immunocompromise. Vitamin D and compound glutamine have been shown to have immune-regulating effects. This study was conducted to investigate the effects of vitamin D combined with compound glutamine in children with ML.

AIM

To evaluate the efficacy of vitamin D combined with compound glutamine in the treatment of ML in preschool children and analyze its influence on cellular immune function.

METHODS

A total of 180 preschool children with ML treated at our hospital from December 2019 to December 2022 were included and randomly divided into either a control group or a study group. The control group (90 cases) was treated with compound glutamine alone, and the study group (90 cases) was treated with vitamin D combined with compound glutamine for 7 d. The therapeutic effects, adverse reactions, time to improvement of clinical symptoms, serum inflammatory factors [tumor necrosis factor-α (TNF-α), procalcitonin (PCT), and interleukin-8 (IL-8)], immune function indicators [immunoglobulin (Ig)A, IgG, CD3⁺ T cells, and CD4⁺/CD8⁺ ratio], and imaging indicators (lymph) were compared between the two groups. The patients were followed for 2 mo after treatment, and the recurrence rate of abdominal pain was statistically compared between the two groups.

RESULTS

The total effective rate of the study group was 92.22% (83/90) compared with 86.67% (78/90) of the control group (P > 0.05). Fever subsided, abdominal pain disappeared, nausea/vomiting disappeared, and lymph node enlargement disappeared in a shorter time in the study group than in the control group (P < 0.05). The levels of serum PCT, TNF-α, and IL-8 in the study group were significantly lower than those in the control group after 3 days of treatment (P < 0.05). The serum levels of IgA, IgG, CD3⁺ T cells and CD4⁺/CD8⁺ ratio in the study group were higher than those in the control group after 3 days of treatment (P < 0.05). After 3 days of treatment, the longitudinal and transverse diameters of lymph nodes in the study group were shorter than those in the control group (P < 0.05). The incidence of adverse reactions in the study group was 2.22% (2/90) compared with 3.33% (3/90) in the control group (P > 0.05), and the recurrence rate of abdominal pain in the study group was 5.56% (5/90), lower than that in the control group (14.44%, 13/90) (P < 0.05).

CONCLUSION

Vitamin D combined with compound glutamine in the treatment of preschool children with ML is safe and effective, can significantly inhibit the inflammatory response, improve immune function, promote the regression of symptoms, accelerate the recovery of disease, and reduce the recurrence rate.

A cursed goodbye kiss from severe acute respiratory syndrome-coronavirus-2 to its pediatric hosts: multisystem inflammatory syndrome in children

PURPOSE OF REVIEW

We aimed to summarize a novel disease called multisystem inflammatory syndrome in children (MIS-C), which develops several weeks after a severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) illness.

RECENT FINDINGS

Given the rarity of the disease, the question of why a minority of children develop MIS-C is not known. Certain intrinsic susceptibility factors in the host have been described. In addition to hyperinflammation induced by the innate and acquired immune cells, evidence of molecular mimicry was presented for the disease pathogenesis. As there is an increasing number of infected individuals and mass vaccination schedules, concerns regarding the usefulness of the existing diagnostic criteria sets raised.

SUMMARY

Although children are likely to have a milder COVID-19 course compared with adults, MIS-C as a postinfectious and life-threatening complication was reported in the pediatric age. After 2 years of the disease definition, optimal treatment regimes, effective preventive measures, and long-term outcomes are still debated.