Pathogenesis, immunology, and immune-targeted management of the multisystem inflammatory syndrome in children (MIS-C) or pediatric inflammatory multisystem syndrome (PIMS): EAACI Position Paper.

Autor: Feleszko W; Department of Pediatric Pneumology and Allergy, The Medical University of Warsaw, Warsaw, Poland., Okarska-Napierała M; Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Warsaw, Poland., Buddingh EP; Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands., Bloomfield M; Department of Immunology, 2nd Faculty of Medicine, Motol University Hospital, Charles University, Prague, Czech Republic.; Department of Pediatrics, 1st Faculty of Medicine, Thomayer University Hospital, Charles University, Prague, Czech Republic., Sediva A; Department of Immunology, 2nd Faculty of Medicine, Motol University Hospital, Charles University, Prague, Czech Republic., Bautista-Rodriguez C; Pediatric Cardiology Services, Royal Brompton Hospital, London, UK.; National Heart and Lung Institute, Imperial College London, London, UK., Brough HA; Paediatric Allergy Group, Department of Women and Children's Health, School of Life Course Sciences, St. Thomas' Hospital, King's College London, London, UK.; Children's Allergy Service, Evelina Children's Hospital, Guy's and St.Thomas' Hospital NHS Foundation Trust, London, UK.; Paediatric Allergy Group, Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Guys' Hospital, King's College London, London, UK., Eigenmann PA; Department of Women-Children-Teenagers, University Hospital of Geneva, Geneva, Switzerland., Eiwegger T; Karl Landsteiner University of Health Sciences, Krems, Austria.; Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.; Department of Immunology, University of Toronto, Toronto, Ontario, Canada.; Department of Pediatric and Adolescent Medicine, University Hospital St. Pölten, St. Pölten, Austria., Eljaszewicz A; Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Bialystok, Poland., Eyerich S; Center for Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany., Gomez-Casado C; Department of Dermatology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany., Fraisse A; Pediatric Cardiology Services, Royal Brompton Hospital, London, UK.; National Heart and Lung Institute, Imperial College London, London, UK., Janda J; Faculty of Science, Charles University, Prague, Czech Republic., Jiménez-Saiz R; Department of Immunology, Instituto de Investigación Sanitaria Hospital Universitario de La Princesa (IIS-Princesa), Madrid, Spain.; Department of Immunology and Oncology, Centro Nacional de Biotecnología (CNB-CSIC), Madrid, Spain.; Faculty of Experimental Sciences, Universidad Francisco de Vitoria (UFV), Madrid, Spain.; Department of Medicine, McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada., Kallinich T; Pediatric Pneumology, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin and Deutsches Rheuma-Forschungszentrum (DRFZ), an Institute of the Leibniz Association, Berlin, Germany., Krohn IK; SKIN Research Group, Vrije Univeristeit Brussel (VUB), Brussels, Belgium.; Department of Dermatology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium., Mortz CG; Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark., Riggioni C; Allergy, Immunology and Rheumatology Division, Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Sastre J; Fundacion Jimenez Diaz and CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain., Sokolowska M; Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.; Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland., Strzelczyk Z; Department of Pediatric Pneumology and Allergy, The Medical University of Warsaw, Warsaw, Poland., Untersmayr E; Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria., Tramper-Stranders G; Department of Paediatric Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands.; Department of Neonatology, Erasmus MC-Sophia, Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology [Pediatr Allergy Immunol] 2023 Jan; Vol. 34 (1), pp. e13900.
DOI: 10.1111/pai.13900
Abstrakt: Multisystem inflammatory syndrome in children (MIS-C) is a rare, but severe complication of coronavirus disease 2019 (COVID-19). It develops approximately 4 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and involves hyperinflammation with multisystem injury, commonly progressing to shock. The exact pathomechanism of MIS-C is not known, but immunological dysregulation leading to cytokine storm plays a central role. In response to the emergence of MIS-C, the European Academy of Allergy and Clinical Immunology (EAACI) established a task force (TF) within the Immunology Section in May 2021. With the use of an online Delphi process, TF formulated clinical statements regarding immunological background of MIS-C, diagnosis, treatment, follow-up, and the role of COVID-19 vaccinations. MIS-C case definition is broad, and diagnosis is made based on clinical presentation. The immunological mechanism leading to MIS-C is unclear and depends on activating multiple pathways leading to hyperinflammation. Current management of MIS-C relies on supportive care in combination with immunosuppressive and/or immunomodulatory agents. The most frequently used agents are systemic steroids and intravenous immunoglobulin. Despite good overall short-term outcome, MIS-C patients should be followed-up at regular intervals after discharge, focusing on cardiac disease, organ damage, and inflammatory activity. COVID-19 vaccination is a safe and effective measure to prevent MIS-C. In anticipation of further research, we propose a convenient and clinically practical algorithm for managing MIS-C developed by the Immunology Section of the EAACI.
(© 2023 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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