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与新型冠状病毒肺炎(SARS-CoV-2)相关的儿童炎症性多系统综合征:大流行中的新挑战

Pediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2: a New Challenge amid the Pandemic.

作者信息

Lawrensia Sherly, Henrina Joshua, Wijaya Ellen, Suciadi Leonardo Paskah, Saboe Aninka, Cool Charlotte Johanna

机构信息

School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jl. Pluit Raya No. 2, RT 21/RW 08, Penjaringan, Kota Jakarta Utara, Daerah Khusus Ibukota Jakarta, 14440 Indonesia.

Siloam Heart Institute, Siloam Hospital Kebon Jeruk, Jl. Perjuangan No.8, RT.14/RW.10, Kb. Jeruk, Kec. Kb. Jeruk, Kota Jakarta Barat, Daerah Khusus Ibukota Jakarta, 11530 Indonesia.

出版信息

SN Compr Clin Med. 2020;2(11):2077-2085. doi: 10.1007/s42399-020-00602-8. Epub 2020 Oct 22.

Abstract

Initially, SARS-CoV-2 infection had been reported as a relatively mild case in children than in adults. Nevertheless, recent evidence found that a subset of children then developed a significant systemic inflammatory response that resembles atypical/typical Kawasaki's disease (KD) and toxic shock syndrome. This novel clinical syndrome later identified as pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). In contrast with KD, PIMS-TS appears to occur in children at an older age with a predominance of gastrointestinal symptoms, hemodynamic instability, and myocardial dysfunction. However, the exact pathomechanism remains to be understood. Nevertheless, the post-viral immunological reaction is postulated to be the underlying mechanistic underpinnings. The multifaceted nature of the PIMS-TS' course underlines the need for early recognition and multispecialty care and management.

摘要

最初,有报道称,与成人相比,儿童感染新型冠状病毒2(SARS-CoV-2)的病例相对较轻。然而,最近有证据发现,一部分儿童随后出现了明显的全身炎症反应,类似于非典型/典型川崎病(KD)和中毒性休克综合征。这种新的临床综合征后来被确定为与SARS-CoV-2相关的儿童炎症性多系统综合征(PIMS-TS)。与KD不同,PIMS-TS似乎在年龄较大的儿童中出现,主要表现为胃肠道症状、血流动力学不稳定和心肌功能障碍。然而,确切的发病机制仍有待了解。尽管如此,病毒感染后的免疫反应被认为是潜在的机制基础。PIMS-TS病程的多方面性质凸显了早期识别以及多专科护理和管理的必要性。

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