Diagnosis and treatment of paediatric multisystem inflammatory syndrome / A gyermekkori koronavírus-fertozést követo sokszervi gyulladás diagnosztikája és kezelése.

Összefoglaló. A SARS-CoV-2-fertozés ritka gyermekkori szövodménye a sokszervi gyulladás, angol terminológiával paediatric inflammatory multisystem syndrome (PIMS). Két vagy több szerv érintettségével járó, súlyos tünetekkel induló betegségrol van szó, amelynek tünetei átfedést mutatnak a Kawasaki-betegséggel, a toxikus sokk szindrómával és a makrofágaktivációs szindrómával. A PIMS-betegek intenzív terápiás osztályon vagy intenzív terápiás háttérrel rendelkezo intézményben kezelendok, ahol biztosítottak a kardiológiai ellátás feltételei is. A szükséges immunterápia a klinikai prezentációtól függ. A jelen közleményben a szerzok a releváns nemzetközi irodalom áttekintését követoen ajánlást tesznek a PIMS diagnosztikai és terápiás algoritmusára. Orv Hetil. 2021; 162(17): 652-667. Summary. Pediatric inflammatory multisystem syndrome (PIMS) is a rare complication of SARS-CoV-2 infection in children. PIMS is a severe condition, involving two or more organ systems. The symptoms overlap with Kawasaki disease, toxic shock syndrome and macrophage activation syndrome. PIMS patients should be treated in an intensive care unit or in an institution with an intensive care background, where cardiological care is also provided. The required specific immunotherapy depends on the clinical presentation. In this paper, after reviewing the relevant international literature, the authors make a recommendation for the diagnostic and therapeutic algorithm for PIMS. Orv Hetil. 2021; 162(17): 652-667.

[Subacute cardiotoxicity caused by anthracycline therapy in children: can dexrazoxane prevent this effect?]. / Az antraciklinek kardiotoxikus hatásának kivédése gyermekekben.

OBJECTIVES: The use of anthracyclines are limited by their cardiotoxic side effects (first of all congestive cardiomyopathy). In this study we analyzed the anthracycline-induced cardiotoxicity and the possible preventive role of dexrazoxane in children. PATIENTS: 158 anthracycline-treated long-term survivors could be analyzed. Sixty-one children received dexrazoxane (group D) and 97 patients received anthracyclines only (group C). METHODS: Cardiac ultrasound examinations (ECHO) and electrocardiograms (ECG) were performed regularly from the beginning of chemotherapy and yearly thereafter. Shortening fraction (FS) was used as indicator of the ventricular function. RESULTS: The incidence of reduced left ventricular function (FS) was 13.4% in C, and 8.2% in D (p=ns). Two years after completion of the chemotherapy FS was reduced in 13.7% in C and 0% in D, respectively (p=0.056), and 5 years after therapy in 11.0% in C and 2.4% in D, respectively (P=0.034). Left chamber wall diameter was abnormal in systole in 6% in C and 2% in D, in diastole in 11% in C and 7% in D (p=ns) after 3 years of follow-up. CONCLUSION: Anthracycline-induced subacute cardiotoxicity can be significantly diminished by the concomitant use of dexrazoxane. For the final conclusions longer follow-up is necessary.

[Childhood liver tumor in Hungary: two interesting clinical cases] / Gyermekkori májtumor Magyarországon: két rendhagyó klinikai eset.

Hepatic tumors account for 0.5-2% of all childhood tumors in Hungary, based of the data last ten years. More than half of the cases were histologically malignant. The worldwide incidence of malignant hepatic tumors is 1.6 / 1 million. Here we present two patients with hepatoblastoma. In the first case the size of the initially inoperable tumor diminished following the chemotherapy and total surgical resection became possible. No sign of relapse occurred so far. The second case included a congenital hepatic tumor which was remarkable because of its unusual clinical presentation and histology.