[川崎病与具有川崎病表型的多系统炎症综合征 COVID-19。单中心经验]。

IF 0.5 Q4 PEDIATRICS Andes pediatrica : revista Chilena de pediatria Pub Date : 2024-04-01 Epub Date: 2024-03-15 DOI:10.32641/andespediatr.v95i2.4888
Luis Peña Bustos, Claudia Oviedo Sarmiento, Maria Carolina Rivacoba, Maria Jesús Arriagada Mora, Felipe Veloso Stiiven, Pedro Zambrano Ostaiza
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引用次数: 0

摘要

在儿科,人们观察到一种被称为小儿炎症性多系统综合征(PIMS)的过程与近期感染 SARS-CoV-2 病毒有关。目的:比较大流行前与大流行期间住院病人的临床表现、实验室检测以及带有 PIMS 川崎表型(PIMS-KD)的 KD 的演变情况:对 Exequiel González Cortés 医院的两组患者进行横断面研究:典型 KD(第 1 组)和 PIMS-KD(第 2 组)。研究人员收集了人口统计学、临床和生化方面的详细数据,以及超声心动图、治疗和演变记录。两组均进行了 SARS-CoV-2 IgG 和 IgM 血清学检测:结果:KD 组和 PIMS-KD 组分别有 20 名和 33 名患者。两组患者的年龄、发热天数、白细胞、淋巴细胞和血小板计数、红细胞沉降率(ESR)和住院时间存在差异。在 KD 组中,25% 的患者超声心动图有变化;在 PIMS-K 组中,所有患者都接受了皮质类固醇治疗,25 名患者接受了静脉注射免疫球蛋白(IVIG)治疗。两组患者的临床表现均良好,无并发症和死亡:根据我们的研究获得的数据,我们强调了流行病学联系的重要性,它是区分两种病症的一个重要因素,并强调在对 PIMS-KD 和 KD 患者进行鉴别评估时,需要考虑年龄、发热持续时间、白细胞、淋巴细胞和血小板计数以及心脏受累程度等因素。
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[Kawasaki disease versus Multisystem Inflammatory Syndrome COVID-19 with Kawasaki disease phenotype. Single-center experience].

In pediatrics, a process called Pediatric Inflammatory Multisystem Syndrome (PIMS) associated with recent infection by SARS-CoV-2 virus has been observed. One of its variants presents similarities with Kawasaki disease (KD).

Objective: to compare the clinical presentation, laboratory testing, and evolution of KD with PIMS Kawasaki phenotype (PIMS-KD) in patients hospitalized before the pandemic, compared with the pandemic period.

Patients and method: Cross-sectional study in two groups of patients at the Hospital Exequiel González Cortés: typical KD (group 1) and PIMS-KD (group 2). Data on demographic, clinical, and biochemical details were collected, as well as echocardiogram, treatment, and evolution records. IgG and IgM serology for SARS-CoV-2 was performed in both groups.

Results: In the KD group and the PIMS-KD group, 20 and 33 patients were analyzed, respectively. There were differences in age, days of fever, count of leukocytes, lymphocytes, and platelets, erythrocyte sedimentation rate (ESR), and hospital stay. In 25% of the KD group, there were alterations in the echocardiogram and, in the PIMS-K group, all patients received corticosteroids and 25 patients received intravenous immunoglobulin (IVIG). In both groups, a favorable clinical evolution was observed, characterized by the absence of complications and mortality.

Conclusions: Based on the data obtained in our study, the importance of the epidemiological link is emphasized as an essential factor in differentiating between both pathologies, highlighting the need to consider factors such as age, duration of fever, count of leukocytes, lymphocytes, and platelets, and degree of cardiac involvement, for a differential evaluation between patients with PIMS-KD versus KD.

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