Reversible Cerebral Vasoconstriction Syndrome and Multisystem Inflammatory Syndrome in Children With COVID-19.

Autor: Sadeghizadeh A; Department of Pediatric Intensive Care, Isfahan University of Medical Sciences, Isfahan, Iran., Pourmoghaddas Z; Department of Pediatric Infectious, Isfahan University of Medical Sciences, Isfahan, Iran., Zandifar A; Division of Neuroradiology, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Tara SZ; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Rahimi H; Department of Pediatric Infectious, Isfahan University of Medical Sciences, Isfahan, Iran., Saleh R; Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran., Ramezani S; Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran., Ghazavi M; Department of Pediatric Neurology, Isfahan University of Medical Sciences, Isfahan, Iran., Yaghini O; Department of Pediatric Neurology, Isfahan University of Medical Sciences, Isfahan, Iran., Hosseini N; Department of Pediatric Neurology, Isfahan University of Medical Sciences, Isfahan, Iran., Aslani N; Department of Pediatric Rheumatology, Isfahan University of Medical Sciences, Isfahan, Iran., Saadatnia M; Department of Neurology, Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: mosaadatnia@yahoo.com., Vossough A; Division of Neuroradiology, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Jazyk: angličtina
Zdroj: Pediatric neurology [Pediatr Neurol] 2022 Apr; Vol. 129, pp. 1-6. Date of Electronic Publication: 2022 Jan 05.
DOI: 10.1016/j.pediatrneurol.2021.12.013
Abstrakt: Background: Multisystem inflammatory syndrome in children (MIS-C) involves multiple organs and shows increased inflammatory markers. Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, several studies have reported the association between severe COVID-19 and MIS-C. Reversible cerebral vasoconstriction syndrome (RCVS) presents with thunderclap headaches and multifocal reversible vasoconstriction on imaging. RCVS is very rare in children. This article reports two cases of pediatric COVID-19 with severe MIS-C and clinical and imaging features indicative of RCVS.
Methods: Clinical, laboratory, and imaging data of the patients were reviewed. The diagnosis of RCVS was confirmed based on clinical symptomatology and brain magnetic resonance imaging findings.
Results: Two pediatric patients with clinical findings compatible with severe MIS-C and hemodynamic compromise presented to the hospital. During their hospitalization course, they developed thunderclap headaches and neurological deficits. Both were receiving vasoactive agents, intravenous immunoglobulin, and immunosuppressants. Imaging studies showed marked multifocal cerebral vasoconstriction in both cases and infarcts in one. The course and management of the patients will be presented. After controlling inflammation and elimination of triggers, both patients were ultimately symptom free upon discharge. Cerebral vasoconstriction had completely resolved on follow-up imaging.
Conclusions: Although a variety of symptoms including headaches may be seen in pediatric COVID-19 patients with MIS-C, RCVS should be considered as a differential diagnosis in cases of thunderclap headache accompanied by neurological signs in these patients. Imaging findings and follow-up are also key in establishing the diagnosis.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: