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SARS-CoV-2-related MIS-C: A key to the viral and genetic causes of Kawasaki disease?
Scopus
Open Access Toplam 137 atıf DOI
Multisystem inflammatory syndrome in children (MIS-C) emerged in April 2020 in communities with high COVID-19 rates. This new condition is heterogenous but resembles Kawasaki disease (KD), a well-known but poorly understood and clinically heterogenous pediatric inflammatory condition for which weak associations have been found with a myriad of viral illnesses. Epidemiological data clearly indicate that SARS-CoV-2 is the trigger for MIS-C, which typically occurs about 1 mo after infection. These findings support the hypothesis of viral triggers for the various forms of classic KD. We further suggest that rare inborn errors of immunity (IEIs) altering the immune response to SARS-CoV-2 may underlie the pathogenesis of MIS-C in some children. The discovery of monogenic IEIs underlying MIS-C would shed light on its pathogenesis, paving the way for a new genetic approach to classic KD, revisited as a heterogeneous collection of IEIs to viruses.
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Hematological Parameters and Inflammatory Markers in Children with Multisystem Inflammatory Syndrome
Scopus
Havuzumuzda Open Access 6 atıf almış
Objective: Multisystem inflammatory syndrome in children (MIS-C), is a newly recognised life-threatening complication of coronavirus disease 2019 (COVID-19). Early determination of clinical severity of the disease is important for early decision of treatment regimens. The aim of this study is to investigate the severity classification value of a number of hematological parameters, inflammatory markers and biochemical tests in patients with MIS-C during the acute stage and after anti-inflammatory treatment. Material and Methods: In this retrospective case-controlled study, 64 children with MIS-C and 95 healthy age and gender matched children were included. Patients were divided into three clinical severity groups; mild, moderate, and severe. Results: Mean platelet volume (MPV), MPV to lymphocyte ratio (MPVLR), d-dimer, ferritin, interleukin 6 (IL-6) levels were significantly higher, while albumin levels were lower in the severe MIS-C group compared to all the other groups on admission. Neutrophil-to-lymphocyte ratio (NLR) and derived (d) NLR (d-NLR) levels were significantly higher in the moderate group compared to the mild group. In the pre-treatm ent period of MIS-C patients had higher MPV, platelet distribution width (PDW) values while they had lower white blood cell, lymphocyte, monocyte, haemoglobin, mean corpuscular volume (MCV), red cell distribution width (RDW), plateletcrit and platelet values compared to the post-treatment group. Lymphocyte, platelets, and haemoglobin levels were significantly higher in the control group compared to the pre-treatment group. Acute phase reactants, NLR, NMR, PLR, d-NLR, MPVLR and systemic inflammatory index were significantly higher in all MIS-C patients on admission compared to the control group. Conclusion: Specific routine laboratory test results may be useful in determining disease severity of MIS-C, possibly predicting the prognosis and early initiation of the appropriate treatment.
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Kurumlar (1)
Selçuk Tip Fakültesi
Konya, Turkey