Résumé
Objective: To analyze the clinical characteristics of children with multisystem inflammatory syndrome (MIS-C) associated with SARS-CoV-2 in China, and to improve the understanding of MIS-C among pediatricians. Methods: Case series study.Collect the clinical characteristics, auxiliary examinations, treatment decisions, and prognosis of 64 patients with MIS-C from 9 hospitals in China from December 2022 to June 2023. Results: Among the 64 MIS-C patients, 36 were boys and 28 were girls, with an onset age being 2.8 (0.3, 14.0) years. All patients suffered from fever, elevated inflammatory indicators, and multiple system involvement. Forty-three patients (67%) were involved in more than 3 systems simultaneously, including skin mucosa 60 cases (94%), blood system 52 cases (89%), circulatory system 54 cases (84%), digestive system 48 cases (75%), and nervous system 24 cases (37%). Common mucocutaneous lesions included rash 54 cases (84%) and conjunctival congestion and (or) lip flushing 45 cases (70%). Hematological abnormalities consisted of coagulation dysfunction 48 cases (75%), thrombocytopenia 9 cases (14%), and lymphopenia 8 cases (13%). Cardiovascular lesions mainly affected cardiac function, of which 11 patients (17%) were accompanied by hypotension or shock, and 7 patients (12%) had coronary artery dilatation.Thirty-six patients (56%) had gastrointestinal symptoms, 23 patients (36%) had neurological symptoms. Forty-five patients (70%) received the initial treatment of intravenous immunoglobulin in combination with glucocorticoids, 5 patients (8%) received the methylprednisolone pulse therapy and 2 patients (3%) treated with biological agents, 7 patients with coronary artery dilation all returned to normal within 6 months. Conclusions: MIS-C patients are mainly characterized by fever, high inflammatory response, and multiple organ damage. The preferred initial treatment is intravenous immunoglobulin combined with glucocorticoids. All patients have a good prognosis.
Sujets)
Mâle , Enfant , Femelle , Humains , Immunoglobulines par voie veineuse/usage thérapeutique , Coagulation sanguine , COVID-19 , Chine/épidémiologie , Maladies du tissu conjonctif , Anévrysme coronarien , Fièvre , Syndrome de réponse inflammatoire généralisée/thérapieRésumé
Objective To investigate the epidemiological characteristics and clinical prognosis of Kawasaki disease(KD) in Jilin pro-vince for recent 10 years.Methods The survey forms unified of standard KD epidemiology were used and sent to the province′s 32 hospitals above the county and city level with pediatric in-patients,in order to conduct a survey on the KD children during 10 years period from Jan.1,1999 to Dec.31,2008.SPSS 15.0 software was used to analyze the data.Results There were 93.75% of the survey forms came back.Five hundred and seventy-seven KD cases were reported from the 32 hospitals of 8 districts.The incidence of KD was of an increasing trend.It was 18 cases in 1999,while it was up to 122 cases in 2008.Male patients were 382 cases(66.2%),female patients were 195 cases(33.8%).The ratio of male and female was 1.96 to 1.The age of patients varied from 58 days to 14 years,those under 5 years of age accounted of 88.73%.Fourteen(2.4%) cases were found to have the sequelae of coronary artery disease.The ratio of male and female was 3.671.The younger the age,the higher the incidence of cardiac sequelae.The mainest cardiac sequelae was coronary artery ectasia.The time of visiting was(7.58?4.63) days after the onset.The KD children from 4 minority peoples including 50 cases accounted for 8.7%.The disease occurred all over the year,and had obvious season peak.Coronary artery lesions accounted for 63.26%.There was no death during acute pe-riod.The recurrence rate was 0.5%.Conclusions The incidence of KD in Jilin is in an increasing trend.The age and gender distribution are not exactly the same to pre-vious reports.There are two seasonal peaks including summer and winter,which is different to previous reports of domestic,United State,Japan.