在儿童中区分不完整的川崎和非严重的多系统炎症综合征
Lucie K Fan1, Shasha Bai2, Chenxi Du2
1Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
Hospital pediatrics
|September 8, 2023
概括
儿童多系统炎症综合征 (MIS-C) 和川崎病共享重叠的症状. 血小板缺血,淋巴缺血和缺少炎症有助于区分MIS-C和不完整的川崎病 (iKD).
科学领域:
- 儿童传染病 儿童传染病
- 儿科风湿病学 儿科风湿病学
- 炎症综合征的流行病学
背景情况:
- 随着COVID-19大流行,儿童多系统炎症综合征 (MIS-C) 的出现,使其与川崎病区分开来具有挑战性.
- 川崎病是一种影响血管的炎症状况,可呈现不完整的形式 (iKD),使诊断复杂化.
- 了解MIS-C和iKD之间的重叠和差异对于准确和及时的患者管理至关重要.
研究的目的:
- 调查MIS-C和大流行前不完整的川崎病 (iKD) 之间的临床重叠.
- 评估MIS-C概率得分在区分不严重的MIS-C与iKD中的有效性.
- 确定区分这两种疾病的关键临床参数.
主要方法:
- 对非严重的MIS-C (2020年3月至2021年2月) 和iKD (2018年1月至2019年1月) 队列的住院病例记录的回顾性审查.
- 将MIS-C概率得分应用于两组患者.
- 人口和临床特征的比较,包括实验室发现.
主要成果:
- MIS-C队列 (n=68) 比iKD队列 (n=28,4年) 年长 (8年).
- 血小板缺血和淋巴缺血在MIS-C中更为普遍,而炎症在IKD中更为常见.
- 显著比例 (86%) 的iKD患者符合MIS-C标准,得分系统在诊断预测中达到71%-74%的准确性.
结论:
- 在不严重的MIS-C和iKD之间存在相当大的临床重叠.
- 血小板缺血,淋巴缺血和缺血是区分MIS-C和IKD的关键指标.
- 在MIS-C概率得分中,在区分这些条件方面表现适度.
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