Role of Lung Ultrasonography (LUS) as a Tool for Evaluating Children with Pediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS).

BACKGROUND: Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) is a novel entity. The inflammatory process involves the circulatory, digestive, respiratory, and central nervous systems, as well as the skin. Making a diagnosis requires extensive differential diagnoses, including lung imaging. The aim of our study was to retrospectively assess the pathologies found in lung ultrasound (LUS) in children diagnosed with PIMS-TS and to evaluate the usefulness of the examination in diagnostics and monitoring. METHODS: The study group consisted of 43 children diagnosed with PIMS-TS, in whom LUS was performed at least three times, including on admission to hospital, on discharge, and 3 months after disease onset. RESULTS: Pneumonia (mild to severe) was diagnosed in 91% of the patients based on the ultrasound image; the same number had at least one pathology, including consolidations, atelectasis, pleural effusion, and interstitial or interstitial-alveolar syndrome. By the time of discharge, the inflammatory changes had completely regressed in 19% of the children and partially in 81%. After 3 months, no pathologies were detected in the entire study group. CONCLUSION: LUS is a useful tool for diagnosing and monitoring children with PIMS-TS. Inflammatory lesions of the lungs resolve completely when the generalized inflammatory process subsides.

Biochemical and cardiovascular predictors of PIMS-TS risk in children after COVID-19 recovery: preliminary results of the LATE-COVID-Kids Study.

Introduction: We aimed to characterize biochemical and cardiovascular predictors of the paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) risk based on the data from the LATE-COVID-Kids study. Methods: 148 consecutive COVID-19 convalescents hospitalized for the clinical evaluation after the acute phase of COVID-19 were classified into two groups related to symptoms: 33 children finally diagnosed with PIMS-TS and 115 children without PIMS-TS (control group). Results: PIMS-TS children were significantly younger (6.79 ±4.57 vs. 9.10 ±4.94 years). After adjustment, in comparison to those without, PIMS-TS children had a higher level of antithrombin III (111 ±9.30 vs. 105 ±11.4), higher heart rate (HR)/min (100 (89.0-111) vs. 90 (79.7-100)) and sinus rhythm (p = 0.03) but lower PQ interval (p = 0.02) on admission to hospital. The lymphocytes (absolute count and percentage) were significantly higher in children with PIMS-TS, and the opposite results were obtained for IgA and neutrophils. Furthermore, children with PIMS-TS had a higher level of thyroid stimulating hormone (2.76 (2.16-4.18) vs. 2.36 (1.73-2.83)) and red cell distribution width (p < 0.005) compared to those without. Conclusions: It is the first data on the possible predictors of PIMS-TS risk in the Long-COVID period. These results need to be further validated to next create the PIMS SCORE algorithm, which might enable the effective prediction of children with the risk of PIMS-TS occurrence after COVID-19 recovery.

Prevalence of atopic dermatitis in infants during the first six months of life: authors' observations.

INTRODUCTION: Atopic dermatitis (AD) is a frequent chronic skin disease in infants. It creates great difficulties, both diagnostic and therapeutic. AIM: To assess the prevalence of atopic dermatitis in infants during the first 6 months of life. MATERIAL AND METHODS: The analysis comprised 2256 children at the age of not more than 6 months, treated at the 2(nd) Department of Paediatrics and Allergology of the Polish Mother's Memorial Hospital in Lodz, Poland, during seven years. Out of all the patients, children with cutaneous changes were isolated, and the location, type and aetiology of changes were assessed. RESULTS: Dermal changes were diagnosed in 471 children, including 391 (17.3% of all the patients) with atopic dermatitis. Out of the children with AD, IgE-dependent allergy was identified in 39.9%. Cow's milk protein was the most frequent sensitising allergen. In 71.6% of the infants, cutaneous changes were disseminated and involved at least two areas of the body. All of them were strongly itching. An applied elimination diet, together with anti-allergic medications in some of the children, provided a clear clinical improvement. CONCLUSIONS: Performed studies demonstrated the prevalence of atopic dermatitis in 17.3% of examined children. The changes in children with AD were disseminated, what was confirmed already at the infantile age. The obtained clinical improvement after the applied therapy indicates a relationship between the observed symptoms and allergic disease.

[Food allergy as a cause of constipation in children in the first three years of life - own observations]. / Alergia pokarmowa jako przyczyna zaparc u dzieci w pierwszych trzech latach zycia na podstawie obserwacji wlasnych.

BACKGROUND: Constipation is a frequent cause of seeking paediatric advice and concerns up to 15% of the child population. AIM OF THE STUDY: Estimation of the role of allergy in the etiology of constipation in children during the fi rst three years of life. MATERIAL AND METHODS: Retrospective analysis was performed in 9489 children treated in 2nd Department of Pediatrics and Allergology of the Polish Mother's Memorial Hospital in Lodz in the years 1998- 2008. Among them there was a group of children with constipation diagnosed according to the Rome III Criteria. Anamnesis, course of disease and physical examination performed of each child guided further differential diagnosis Confirmation of food allergy diagnosis was positive result of provocation-elimination challenge with harmful food, and in case of some children additionally increased serum concentrations of allergenspecific IgE antibodies. In children with food allergy elimination diet was implemented. RESULTS: Chronic constipation was diagnosed in 136 children (1.43%). The most frequent cause of constipation in the examined children was allergy to cow's milk proteins, (n=99; 72.8%). The others were: psychogenic factors (n=10; 7.3%), dysbacteriosis of digestive system (n=7; 5.1%), anatomical defects of digestive tract (n=6; 4.4%), disorders of nervous system (n=6; 4.4%), overdose of Vit. D3 (n=3; 2.2%), Down Syndrome (n=2; 1.4%), celiac disease (n=1; 0.7%), abdominal tumour (neuroblastoma) (n=1; 0.7%) and cystic fibrosis (n=1; 0.7%). Clinical improvement after introduction of the elimination diet was observed in all children with food allergy. CONCLUSIONS: 1. In the fi rst three years of life cow milk allergy was the most frequent cause of constipation; 2. Incidence of food allergy as the reason of constipation decreased with age of the examined children.