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Weng RH, Zhao WY, He TY, Li XL, Li XQ, Zhao DM, Han YK, Zeng P, Tang XM, Wu XC, Liu L, Yang J. [Clinical research of multisystem inflammatory syndrome in children]. Zhonghua Er Ke Za Zhi 2023; 61:1086-1091. [PMID: 38018045 DOI: 10.3760/cma.j.cn112140-20230805-00081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Objective: To analyze the clinical characteristics of children with multisystem inflammatory syndrome (MIS-C) associated with SARS-CoV-2 in China, and to improve the understanding of MIS-C among pediatricians. Methods: Case series study.Collect the clinical characteristics, auxiliary examinations, treatment decisions, and prognosis of 64 patients with MIS-C from 9 hospitals in China from December 2022 to June 2023. Results: Among the 64 MIS-C patients, 36 were boys and 28 were girls, with an onset age being 2.8 (0.3, 14.0) years. All patients suffered from fever, elevated inflammatory indicators, and multiple system involvement. Forty-three patients (67%) were involved in more than 3 systems simultaneously, including skin mucosa 60 cases (94%), blood system 52 cases (89%), circulatory system 54 cases (84%), digestive system 48 cases (75%), and nervous system 24 cases (37%). Common mucocutaneous lesions included rash 54 cases (84%) and conjunctival congestion and (or) lip flushing 45 cases (70%). Hematological abnormalities consisted of coagulation dysfunction 48 cases (75%), thrombocytopenia 9 cases (14%), and lymphopenia 8 cases (13%). Cardiovascular lesions mainly affected cardiac function, of which 11 patients (17%) were accompanied by hypotension or shock, and 7 patients (12%) had coronary artery dilatation.Thirty-six patients (56%) had gastrointestinal symptoms, 23 patients (36%) had neurological symptoms. Forty-five patients (70%) received the initial treatment of intravenous immunoglobulin in combination with glucocorticoids, 5 patients (8%) received the methylprednisolone pulse therapy and 2 patients (3%) treated with biological agents, 7 patients with coronary artery dilation all returned to normal within 6 months. Conclusions: MIS-C patients are mainly characterized by fever, high inflammatory response, and multiple organ damage. The preferred initial treatment is intravenous immunoglobulin combined with glucocorticoids. All patients have a good prognosis.
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Affiliation(s)
- R H Weng
- Department of Rheumatology and Immunology, Shenzhen Children's Hospital, Shenzhen 518038, China
| | - W Y Zhao
- Department of Internal Medicine, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin 300074, China
| | - T Y He
- Department of Rheumatology and Immunology, Shenzhen Children's Hospital, Shenzhen 518038, China
| | - X L Li
- Department of Pediatrics, Boai Hospital of Zhongshan, Zhongshan 528400, China
| | - X Q Li
- Department of Rheumatology and Immunology, Xi'an Children's Hospital, Xi'an 710003, China
| | - D M Zhao
- Department of Rheumatology and Immunology, Urumqi Children's Hospital, Urumqi 830002, China
| | - Y K Han
- Department of Rheumatology and Immunology, Children's Hospital of Changchun, Changchun 130061, China
| | - P Zeng
- Department of Rheumatology and Immunology, Guangzhou Women and Children Medical Center, Guangzhou 510120, China
| | - X M Tang
- Department of Rheumatology and Immunology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - X C Wu
- the Children's Medical Center, the Second Xiangya Hospital, Central South University, Changhai 410011, China
| | - L Liu
- Department of Internal Medicine, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin 300074, China
| | - J Yang
- Department of Rheumatology and Immunology, Shenzhen Children's Hospital, Shenzhen 518038, China
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