Distinguishing Features of Patients Evaluated for Multisystem Inflammatory Syndrome in Children
| Autor: | Joanne S Chiu, Michael S. Kelly, Neil D. Fernandes, Audrey V. Carr, Manuella Lahoud-Rahme, Brian M. Cummings |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Troponin T business.industry 030208 emergency & critical care medicine Retrospective cohort study General Medicine Emergency department Odds ratio Procalcitonin 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Internal medicine Acute care Pediatrics Perinatology and Child Health Epidemiology Emergency Medicine medicine Young adult business |
| Zdroj: | Pediatric Emergency Care. 37:179-184 |
| ISSN: | 1535-1815 0749-5161 |
| DOI: | 10.1097/pec.0000000000002344 |
| Popis: | OBJECTIVES: Given the significant overlap of multisystem inflammatory syndrome in children (MIS-C) with other common childhood illnesses presenting to the emergency department, extensive workup of this syndrome has become necessary. Nevertheless, little has been published on the factors differentiating MIS-C from other conditions in the acute care setting. We investigated differences in presentation and laboratory studies between suspected versus confirmed MIS-C patients. METHODS: This was a retrospective cohort study on patients 21 years or younger undergoing investigation for possible MIS-C at a single institution between April 21 and July 1, 2020. The primary outcome was diagnosis of MIS-C or an alternative final diagnosis. Clinical features and laboratory findings from initial presentation were collected and analyzed. RESULTS: A total of 106 patients (median, 4 years; 55.7% male) were included, of whom 17 (16%) of 106 met the criteria for MIS-C. Multisystem inflammatory syndrome in children patients were significantly more likely to report a coronavirus disease 2019 exposure (odds ratio (OR), 13.17 [3.87-44.9]), have gastrointestinal symptoms (OR, 3.81 [1.02-14.19]), and have a significantly higher odds of having abnormal laboratory values including high-sensitivity troponin T (OR, 13 [4.0-42.2]), N-terminal B-type natriuretic peptide (OR, 8.4 [2.3-30.1]), D-dimer (OR, 13 [1.6-103]), and ferritin (OR, 7.8 [2.2-27.2]). There were also differences between groups in inflammatory markers: C-reactive protein (median, 134.45 mg/L vs 12.6 mg/L; P < 0.05) and procalcitonin (1.71 ng/mL vs 0.14 ng/mL; P < 0.001). CONCLUSIONS: Higher elevations in key laboratory studies may help to distinguish between MIS-C patients and non-MIS-C patients presenting to the emergency department. |
| Databáze: | OpenAIRE |
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