Delineating phenotypes of Kawasaki disease and SARS-CoV-2-related inflammatory multisystem syndrome: a French study and literature review
| Autor: | Fleur Le Bourgeois, Bilade Cherqaoui, Isabelle Koné-Paut, Hélène Yager, Maryam Piram |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Ventricular Dysfunction Right Coronary Disease 030204 cardiovascular system & hematology intensive care unit law.invention Ventricular Dysfunction Left 0302 clinical medicine law hemic and lymphatic diseases Pharmacology (medical) 030212 general & internal medicine Child AcademicSubjects/MED00360 PIMS/MIS-C biology Immunoglobulins Intravenous Intensive care unit Systemic Inflammatory Response Syndrome Myocarditis C-Reactive Protein Phenotype Child Preschool Cohort Platelet aggregation inhibitor Original Article Female France systemic vasculitis medicine.medical_specialty Adolescent Digestive System Diseases intravenous immunoglobulins Mucocutaneous Lymph Node Syndrome Intensive Care Units Pediatric Pericardial Effusion 03 medical and health sciences Clinial Science Rheumatology Internal medicine SARS-CoV-2-related inflammatory multisystem syndrome medicine Humans Immunologic Factors Glucocorticoids Heart Failure Kawasaki disease Aspirin Platelet Count business.industry Sodium C-reactive protein Infant Newborn Case-control study COVID-19 Infant medicine.disease Systemic inflammatory response syndrome shock syndrome Case-Control Studies biology.protein Nervous System Diseases business Platelet Aggregation Inhibitors |
| Zdroj: | Rheumatology Rheumatology (Oxford, England) |
| ISSN: | 1462-0332 1462-0324 |
| Popis: | ObjectiveTo better define the clinical distinctions between the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related paediatric inflammatory multisystem syndrome (PIMS) and Kawasaki disease (KD).MethodsWe compared three groups of patients: group 1, cases from our national historic KD database (KD-HIS), before the SARS-CoV-2 pandemic; group 2, patients with KD admitted to an intensive care unit (KD-ICU) from both our original cohort and the literature, before the SARS-CoV-2 pandemic; and group 3, patients with PIMS from the literature.ResultsKD-HIS included 425 patients [male:female ratio 1.3, mean age 2.8 years (s.d. 2.4)], KD-ICU 176 patients [male:female ratio 1.3, mean age 3.5 years (s.d. 3.1)] and PIMS 404 patients [male:female ratio 1.4, mean age 8.8 years (s.d. 3.7)]. As compared with KD-HIS patients, KD-ICU and PIMS patients had a higher proportion of cardiac failure, digestive and neurological signs. KD-ICU and PIMS patients also had a lower frequency of typical KD-mucocutaneous signs, lower platelet count, higher CRP and lower sodium level. As compared with KD-HIS and KD-ICU patients, PIMS patients were older and more frequently had myocarditis; they also had fewer coronary abnormalities and lower sodium levels. Unresponsiveness to IVIG was more frequent in KD-ICU than KD-HIS and PIMS patients.ConclusionOn clinical grounds, KD-HIS, KD-ICU and PIMS might belong to a common spectrum of non-specific pathogen-triggered hyperinflammatory states. The causes of increasing inflammation severity within the three entities and the different effects on the heart remain to be determined. |
| Databáze: | OpenAIRE |
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