| Autor: |
Avcu, Gulhadiye, Arslan, Asli, Arslan, Sema Y, Sahbudak Bal, Zumrut, Turan, Caner, Ersayoglu, Irem, Cebeci, Kubra, Kurugol, Zafer, Ozkinay, Ferda |
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| Zdroj: |
Journal of Paediatrics & Child Health; Apr2023, Vol. 59 Issue 4, p667-672, 6p |
| Abstrakt: |
Aims: As the COVID‐19 pandemic continues, multisystem inflammatory syndrome in children (MIS‐C) maintains its importance in the differential diagnosis of common febrile diseases. MIS‐C should be promptly diagnosed because corticosteroid and/or intravenous immunoglobulin treatment can prevent severe clinical outcomes. In this study, we aimed to evaluate clinical presentation, diagnostic parameters and management of MIS‐C and compare its clinical features to those of common febrile disease. Methods: This study was conducted at a tertiary‐level university hospital between December 2020 and October 2022. One hundred and six children who were initially considered to have MIS‐C disease were included in the study. During the follow‐up period in the hospital, when the clinical and laboratory findings were re‐evaluated, 38 out of 106 children were diagnosed differently. The clinical and laboratory findings of 68 children followed up with the diagnosis of MIS‐C and 38 children who were initially misdiagnosed as MIS‐C but with different final diagnoses were retrospectively compared. Results: We identified 68 patients with MIS‐C and 38 patients misdiagnosed as MIS‐C during the study period. Infectious causes (71%), predominantly bacterial origin, were the most frequently confused conditions with MIS‐C. Patients with MIS‐C were older and had a more severe clinical course with high rates of respiratory distress, shock, and paediatric intensive care unit admission. While rash and conjunctivitis were more common among patients with MIS‐C, cough, abdominal pain and diarrhoea were observed more frequently in patients misdiagnosed as MIS‐C. Lower absolute lymphocyte counts, platelet counts and higher C‐reactive protein and fibrinogen levels, pathological findings on echocardiography were the distinctive laboratory parameters for MIS‐C. Multivariate analysis showed that older age, presence of conjunctivitis, high level of serum CRP and lower platelets were the most discriminative predictors for the diagnosis of MIS‐C. Conclusion: There are still no specific findings to diagnose MIS‐C, which therefore can be confused with different clinical conditions. Further data are needed to assist the clinician in the differential diagnosis of MIS‐C and the diagnostic criteria should be updated over time. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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