Pub Date : 2024-12-01DOI: 10.1542/peds.2024-068657
Victoria Ronan, Jason M Kane
{"title":"The Importance of Differentiating MIS-C From Other Hyperinflammatory Conditions.","authors":"Victoria Ronan, Jason M Kane","doi":"10.1542/peds.2024-068657","DOIUrl":"10.1542/peds.2024-068657","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1542/peds.2024-066780
Luisa Berenise Gámez-González, Chiharu Murata, Jimena García-Silva, Rolando Ulloa-Gutierrez, Martha Márquez-Aguirre, Itzel Ríos-Olivares, Enrique Faugier-Fuentes, Jesús A Domínguez-Rojas, Adriana Yock-Corrales, Martha I Álvarez-Olmos, Jaime Fernández-Sarmiento, Mónica Velasquez-Méndez, Gabriela Ivankovich-Escoto, Adriana H Tremoulet, Marco A Yamazaki-Nakashimada
Background: Multisystem inflammatory syndrome (MIS-C) represents a diagnostic challenge because of its overlap with Kawasaki disease, Kawasaki disease shock syndrome, and toxic shock syndrome. Macrophage activation syndrome (MAS) is a frequently fatal complication of various pediatric inflammatory disorders and has been reported in MIS-C. Early diagnosis and prompt initiation by immune modulating therapies are essential for effectively managing MAS.
Methods: We conducted a retrospective study to determine the frequency, natural history, diagnostic metrics, treatment, and outcome of MAS in MIS-C within a large cohort of patients across 84 Latin American centers in 16 countries. We compared the clinical and laboratory characteristics between patients with and without MAS.
Results: Among 1238 patients with MIS-C, 212 (17.1%) fulfilled MAS criteria. Gastrointestinal and neurologic manifestations were more frequent in cases where MIS-C was complicated by MAS. Patients presenting with MIS-C complicated by MAS had a mortality rate of 12%, which was higher than those without it. Mortality was associated with MAS, seizures, arthritis, and shock. A ferritin or erythrocyte sedimentation rate ratio of >18.7 exhibited a sensitivity of 88.2% and a specificity of 75% in diagnosing MAS in MIS-C.
Conclusions: MAS in MIS-C patients is associated with increased morbidity and mortality rates in the largest MIS-C Latin American cohort. Early recognition and appropriate management are crucial in improving patient outcomes and reducing mortality rates.
背景：多系统炎症综合征（MIS-C）是一项诊断难题，因为它与川崎病、川崎病休克综合征和中毒性休克综合征重叠。巨噬细胞活化综合征（MAS）是各种儿科炎症性疾病的常见致命并发症，在多系统炎症综合征中也有报道。早期诊断和及时启动免疫调节疗法对有效控制 MAS 至关重要：我们进行了一项回顾性研究，以确定在 16 个国家的 84 个拉丁美洲中心的一大批患者中，MIS-C 中 MAS 的发生频率、自然史、诊断指标、治疗和结果。我们比较了有 MAS 和无 MAS 患者的临床和实验室特征：在 1238 名 MIS-C 患者中，212 人（17.1%）符合 MAS 标准。在 MIS-C 并发 MAS 的病例中，胃肠道和神经系统表现更为常见。MIS-C并发MAS的患者死亡率为12%，高于未并发MAS的患者。死亡率与 MAS、癫痫发作、关节炎和休克有关。在诊断 MIS-C 中的 MAS 时，铁蛋白或红细胞沉降率比值大于 18.7 的敏感性为 88.2%，特异性为 75%：结论：在拉丁美洲最大的 MIS-C 患者队列中，MIS-C 患者的 MAS 与发病率和死亡率的增加有关。早期识别和适当处理对改善患者预后和降低死亡率至关重要。
{"title":"Macrophage Activation Syndrome in MIS-C.","authors":"Luisa Berenise Gámez-González, Chiharu Murata, Jimena García-Silva, Rolando Ulloa-Gutierrez, Martha Márquez-Aguirre, Itzel Ríos-Olivares, Enrique Faugier-Fuentes, Jesús A Domínguez-Rojas, Adriana Yock-Corrales, Martha I Álvarez-Olmos, Jaime Fernández-Sarmiento, Mónica Velasquez-Méndez, Gabriela Ivankovich-Escoto, Adriana H Tremoulet, Marco A Yamazaki-Nakashimada","doi":"10.1542/peds.2024-066780","DOIUrl":"10.1542/peds.2024-066780","url":null,"abstract":"<p><strong>Background: </strong>Multisystem inflammatory syndrome (MIS-C) represents a diagnostic challenge because of its overlap with Kawasaki disease, Kawasaki disease shock syndrome, and toxic shock syndrome. Macrophage activation syndrome (MAS) is a frequently fatal complication of various pediatric inflammatory disorders and has been reported in MIS-C. Early diagnosis and prompt initiation by immune modulating therapies are essential for effectively managing MAS.</p><p><strong>Methods: </strong>We conducted a retrospective study to determine the frequency, natural history, diagnostic metrics, treatment, and outcome of MAS in MIS-C within a large cohort of patients across 84 Latin American centers in 16 countries. We compared the clinical and laboratory characteristics between patients with and without MAS.</p><p><strong>Results: </strong>Among 1238 patients with MIS-C, 212 (17.1%) fulfilled MAS criteria. Gastrointestinal and neurologic manifestations were more frequent in cases where MIS-C was complicated by MAS. Patients presenting with MIS-C complicated by MAS had a mortality rate of 12%, which was higher than those without it. Mortality was associated with MAS, seizures, arthritis, and shock. A ferritin or erythrocyte sedimentation rate ratio of >18.7 exhibited a sensitivity of 88.2% and a specificity of 75% in diagnosing MAS in MIS-C.</p><p><strong>Conclusions: </strong>MAS in MIS-C patients is associated with increased morbidity and mortality rates in the largest MIS-C Latin American cohort. Early recognition and appropriate management are crucial in improving patient outcomes and reducing mortality rates.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1542/peds.2024-067261
Kate R Woodworth, Samantha Distler, Daniel J Chang, Jackie Luong, Suzanne Newton, Amanda Akosa, Lauren Orkis, Bethany Reynolds, Cynthia Carpentieri, Teri Willabus, Anthony Osinski, Hanna Shephard, Umme-Aiman Halai, Caleb Lyu, Lindsey Sizemore, Amy Sandul, Van T Tong
Objective: To assess the frequency of hepatitis C virus (HCV) testing among a population-based cohort of perinatally exposed children and identify factors associated with testing.
Methods: Using a population-based surveillance cohort of perinatally exposed children born from 2018 to 2020 from 4 US jurisdictions (Georgia; Massachusetts; Allegheny County, Pennsylvania; and Los Angeles County, California), we describe the frequency, timing, and type of HCV testing among children and identify characteristics associated with having an HCV test result by the age of 2 to 3 years. Data were obtained from electronic laboratory reporting, vital records, and medical records.
Results: Of 803 perinatally exposed children, 7 (1%) died before the age of 24 months. Of 796 children, health departments were unable to find medical records or laboratory reports for 181 (23%). Among those with medical record abstraction at 24 months or testing reported before the age of 3 years (n = 615), 50% had an HCV test. The majority (70% of those tested) were tested for HCV antibodies at the age of 18 months or later, although 9% had an HCV nucleic acid test at ages 2 to <6 months. No characteristics examined were found to be significantly associated with having testing reported.
Conclusions: In this surveillance report, we identify the gaps in current testing among children perinatally exposed to hepatitis C. Provider education and resources for health departments for follow-up and linkage to care can improve the identification of children requiring treatment, a vital piece of HCV elimination.
{"title":"Hepatitis C Virus Testing Among Perinatally Exposed Children: 2018 to 2020.","authors":"Kate R Woodworth, Samantha Distler, Daniel J Chang, Jackie Luong, Suzanne Newton, Amanda Akosa, Lauren Orkis, Bethany Reynolds, Cynthia Carpentieri, Teri Willabus, Anthony Osinski, Hanna Shephard, Umme-Aiman Halai, Caleb Lyu, Lindsey Sizemore, Amy Sandul, Van T Tong","doi":"10.1542/peds.2024-067261","DOIUrl":"10.1542/peds.2024-067261","url":null,"abstract":"<p><strong>Objective: </strong>To assess the frequency of hepatitis C virus (HCV) testing among a population-based cohort of perinatally exposed children and identify factors associated with testing.</p><p><strong>Methods: </strong>Using a population-based surveillance cohort of perinatally exposed children born from 2018 to 2020 from 4 US jurisdictions (Georgia; Massachusetts; Allegheny County, Pennsylvania; and Los Angeles County, California), we describe the frequency, timing, and type of HCV testing among children and identify characteristics associated with having an HCV test result by the age of 2 to 3 years. Data were obtained from electronic laboratory reporting, vital records, and medical records.</p><p><strong>Results: </strong>Of 803 perinatally exposed children, 7 (1%) died before the age of 24 months. Of 796 children, health departments were unable to find medical records or laboratory reports for 181 (23%). Among those with medical record abstraction at 24 months or testing reported before the age of 3 years (n = 615), 50% had an HCV test. The majority (70% of those tested) were tested for HCV antibodies at the age of 18 months or later, although 9% had an HCV nucleic acid test at ages 2 to <6 months. No characteristics examined were found to be significantly associated with having testing reported.</p><p><strong>Conclusions: </strong>In this surveillance report, we identify the gaps in current testing among children perinatally exposed to hepatitis C. Provider education and resources for health departments for follow-up and linkage to care can improve the identification of children requiring treatment, a vital piece of HCV elimination.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1542/peds.2024-069114ID
Maria Lee, Sara Anvari
{"title":"CD23+ IgG1+ Memory B Cells Are Poised to Switch to Pathogenic IgE Production in Food Allergy.","authors":"Maria Lee, Sara Anvari","doi":"10.1542/peds.2024-069114ID","DOIUrl":"https://doi.org/10.1542/peds.2024-069114ID","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"154 Suppl 4","pages":"S25"},"PeriodicalIF":6.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1542/peds.2024-069114IL
Natalie Trotto, Vivian Hernandez-Trujillo
{"title":"Desensitization And Remission After Peanut Sublingual Immunotherapy in 1- To 4-Year-Old Peanut-Allergic Children: A Randomized, Placebo-Controlled Trial.","authors":"Natalie Trotto, Vivian Hernandez-Trujillo","doi":"10.1542/peds.2024-069114IL","DOIUrl":"https://doi.org/10.1542/peds.2024-069114IL","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"154 Suppl 4","pages":"S30"},"PeriodicalIF":6.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1542/peds.2024-069114KG
Joyce E Yu
{"title":"Effect of Radon Exposure on Asthma Morbidity in the School Inner-City Asthma Study.","authors":"Joyce E Yu","doi":"10.1542/peds.2024-069114KG","DOIUrl":"https://doi.org/10.1542/peds.2024-069114KG","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"154 Suppl 4","pages":"S40"},"PeriodicalIF":6.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1542/peds.2024-069114LG
Sarah Campbell, Elizabeth Wisner
{"title":"Effect of the Telemedicine Enhanced Asthma Management Through the Emergency Department (TEAM-ED) Program on Asthma Morbidity: A Randomized Controlled Trial.","authors":"Sarah Campbell, Elizabeth Wisner","doi":"10.1542/peds.2024-069114LG","DOIUrl":"https://doi.org/10.1542/peds.2024-069114LG","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"154 Suppl 4","pages":"S47"},"PeriodicalIF":6.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1542/peds.2024-069114IN
Asna Sulaiman, Lindsey Moore
{"title":"Omalizumab for the Treatment of Multiple Food Allergies.","authors":"Asna Sulaiman, Lindsey Moore","doi":"10.1542/peds.2024-069114IN","DOIUrl":"https://doi.org/10.1542/peds.2024-069114IN","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"154 Suppl 4","pages":"S31"},"PeriodicalIF":6.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1542/peds.2024-069114IK
John M Kelso
{"title":"Open-Label Study of the Efficacy, Safety, and Durability of Peanut Sublingual Immunotherapy in Peanut-Allergic Children.","authors":"John M Kelso","doi":"10.1542/peds.2024-069114IK","DOIUrl":"https://doi.org/10.1542/peds.2024-069114IK","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"154 Suppl 4","pages":"S29"},"PeriodicalIF":6.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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