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子供における多系統炎症症症候群における心臓の関与のレビュー
Tarek Alsaied1, Adriana H Tremoulet2, Jane C Burns2
1The Heart Institute, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, OH(T.A., S.M.L.).
Circulation
|November 9, 2020
まとめ
子供における多系統炎症症候群 (MIS-C) は,COVID-19感染後に発生する希少だが深刻な疾患である. 深刻な炎症を引き起こし,特に心臓に影響し,迅速な治療が必要になります.
科学分野:
- 小児感染症
- 小児心臓科
- 免疫学
背景:
- SARS-CoV-2によって引き起こされるCOVID-19は,MIS-Cと呼ばれる重度の炎症状態を引き起こす可能性があります.
- MIS-Cは毒性ショック症候群とカワサキ病の特徴を共有し,600以上の症例が報告されています.
- この症候群は アメリカで黒人とヒスパニック系の子どもの割合に 大きく影響しています
研究 の 目的:
- MIS-Cに関する公表されたデータを検討し,特に心臓合併症に焦点を当てます.
- MIS- Cの子供の心臓の評価とフォローアップのための臨床的ガイドラインを提供すること.
主な方法:
- MIS-Cに関する公表されたデータの文献レビュー.
- 心血管症状に焦点を当てた臨床表現の分析
- 現在の治療戦略と結果の要約
主要な成果:
- MIS-Cは通常,SARS-CoV-2感染から数週間後に発現し,しばしば発熱と胃腸症状が伴う.
- 常見の心臓疾患には,心室機能不全,冠動脈拡張/動脈乱れ,心律不全があります.
- 重篤なケースでは 電気ショックが起こり 機械呼吸器やECMOなどの 集中的なサポートが必要になります
結論:
- MIS-Cは,小児における重要なCOVID-19後の合併症であり,全身の炎症と頻繁な心臓関わりによって特徴付けられます.
- 免疫調節治療は標準的なもので,ほとんどの子どもは回復しますが,長期的な続変は不明です.
- MIS- C患者の管理には,注意深く心臓のモニタリングとフォローアップが不可欠です.
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