新型冠状病毒感染流行背景下的儿童多系统炎症综合征

Multisystem inflammatory syndrome in children in the context of coronavirus disease 2019 pandemic

摘要:

儿童多系统炎症综合征（multisystem inflammatory syndrome in children, MIS-C）是在严重急性呼吸综合征冠状病毒-2（severe acute respiratory syndrome coronavirus 2, SARS-CoV-2）暴发流行的背景下出现的一种多系统受累综合征。MIS-C的临床表现与川崎病类似，但以发热及胃肠道症状为主要表现，严重者可出现中毒性休克和心功能不全。流行病学调查结果表明，大多数MIS-C患儿SARS-CoV-2抗体检测呈阳性。关于MIS-C的发病机制及病理生理过程尚不明确，SARS-CoV-2感染后的免疫失调被认为是主要原因。目前对于MIS-C的治疗以免疫球蛋白及对症支持治疗为主。该文对MIS-C的定义、流行病学、发病机制、临床表现、诊断、治疗及预后等进行了综述。

Abstract:

Multisystem inflammatory syndrome in children (MIS-C) is a complex syndrome characterized by multi-organ involvement that has emerged in the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak. The clinical presentation of MIS-C is similar to Kawasaki disease but predominantly presents with fever and gastrointestinal symptoms, and severe cases can involve toxic shock and cardiac dysfunction. Epidemiological findings indicate that the majority of MIS-C patients test positive for SARS-CoV-2 antibodies. The pathogenesis and pathophysiology of MIS-C remain unclear, though immune dysregulation following SARS-CoV-2 infection is considered a major contributing factor. Current treatment approaches for MIS-C primarily involve intravenous immunoglobulin therapy and symptomatic supportive care. This review article provides a comprehensive overview of the definition, epidemiology, pathogenesis, clinical presentation, diagnosis, treatment, and prognosis of MIS-C.