Araştırma Makalesi
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Yıl 2023, Cilt: 9 Sayı: 6 - November 2023, 1380 - 1391, 04.11.2023
https://doi.org/10.18621/eurj.1238842

Öz

Kaynakça

  • 1. Swann OV, Holden KA, Turtle L, Pollock L, Fairfield CJ, Drake TM, et al. Clinical characteristics of children and young people admitted to hospital with covid-19 in United Kingdom: prospective multicentre observational cohort study. BMJ 2020;;370:m3249.
  • 2. Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet 2020;395:1607-8.
  • 3. HAN Archive - 00432 | Health Alert Network (HAN). (2021). Accessed 06 June 2022 https://emergency.cdc.gov/han/2020/han00432.asp
  • 4. Vogel TP, Top KA, Karatzios C, Hilmers DC, Tapia LI, Moceri P, et al. Multisystem inflammatory syndrome in children and adults (MIS-C/A): case definition & guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 2021;39:3037-49.
  • 5. Emeksiz S, Çelikel Acar B, Kibar AE, Özkaya Parlakay A, Perk O, Bayhan Gİ, et al. Algorithm for the diagnosis and management of the multisystem inflammatory syndrome in children associated with COVID‐19. Int J Clin Pract 2021;75:e14471.
  • 6. Giacalone M, Scheier E, Shavit I. Multisystem inflammatory syndrome in children (MIS-C): a mini-review. Int J Emerg Med 2021;14:50.
  • 7. Karagol C, Tehci AK, Gungor A, Ekici Tekin Z, Çelikel E, Aydın F, et al. Delta neutrophil index and C-reactive protein: a potential diagnostic marker of multisystem inflammatory syndrome in children (MIS-C) with COVID-19. Eur J Pediatr 2022;181:775-81.
  • 8. Kline JN, Isbey SC, McCollum NL, Falk MJ, Gutierrez CE, Guse SE, et al. Identifying pediatric patients with multisystem inflammatory syndrome in children presenting to a pediatric emergency department. Am J Emerg Med 2022;51:69-75.
  • 9. Feldstein LR, Rose EB, Horwitz SM, Collins JP, Newhams MM, Son MBF, et al. Multisystem inflammatory syndrome in U.S. children and adolescents. N Engl J Med 2020;383:334-46.
  • 10. Yasuhara J, Watanabe K, Takagi H, Sumitomo N, Kuno T. COVID-19 and multisystem inflammatory syndrome in children: a systematic review and meta-analysis. Pediatr Pulmonol 2021;56:837-48.
  • 11. Roberts JE, Campbell JI, Gauvreau K, Lamb GS, Newburger J, Son MB, et al. Differentiating multisystem inflammatory syndrome in children: a single-centre retrospective cohort study. Arch Dis Child 2022;107:e3.
  • 12. Panigrahy N, Policarpio J, Ramanathan R. Multisystem inflammatory syndrome in children and SARS-CoV-2: a scoping review. J Pediatr Rehabil Med 2020;13:301-16.
  • 13. Sethuraman U, Kannikeswaran N, Ang J, Singer A, Miller J, Haddad R, et al. Multisystem inflammatory syndrome in children associated with novel coronavirus SARS-CoV-2: Presentations to a pediatric emergency department in Michigan. Am J Emerg Med 2021;39:164-7.
  • 14. Hançerli Törün S, Yilmaz Çiftdoğan D, Kara A. Multisystem inflammatory syndrome in children. Turk J Med Sci 2021;51(SI-1):3273-3283.
  • 15. Rostami-Maskopaee F, Ladomenou F, Razavi-Amoli SK, Navaeifar MR, Hajialibeig A, Shahbaznejad L, et al. Clinical characteristics and outcomes of the multisystem inflammatory syndrome in children (MIS-C) following COVID-19 infection in Iran: a multicenter study. PLoS One 2022;17:e0274104.
  • 16. Alkan G, Sert A, Oz SKT, Emiroglu M, Yılmaz R. Clinical features and outcome of MIS-C patients: an experience from Central Anatolia. Clin Rheumatol 2021;40:4179-89.
  • 17. Dufort EM, Koumans EH, Chow EJ, Rosenthal EM, Muse A, Rowlands J, et al. Multisystem inflammatory syndrome in children in New York State. N Engl J Med 2020;383:347-58.
  • 18. Waseem M, Shariff MA, Tay ET, Mortel D, Savadkar S, Lee H, et al. Multisystem inflammatory syndrome in children. J Emerg Med 2022;62:28-37.
  • 19. Whittaker E, Bamford A, Kenny J, Kaforou M, Jones CE, Shah P, et al. Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2. JAMA 2020;324:259-69.
  • 20. Minocha PK, Phoon CKL, Verma S, Singh RK. Cardiac findings in pediatric patients with multisystem inflammatory syndrome in children associated with COVID-19. Clin Pediatr (Phila) 2021;60:119-26.
  • 21. Stankovic C, DeLaroche A, Arora R, Spencer P, Ehrman RR. Laboratory trends in severe MIS-C. Acad Emerg Med 2022;29:1258-60.

Differential diagnosis for multiple systemic inflammatory syndrome in children: clinical and laboratory clues

Yıl 2023, Cilt: 9 Sayı: 6 - November 2023, 1380 - 1391, 04.11.2023
https://doi.org/10.18621/eurj.1238842

Öz

Objectives: We aimed to identify biochemical markers and clinical findings with high sensitivity and specificity that can be used in the differential diagnosis of patients suspected of having Multisystem Inflammatory Syndrome in Children (MISC) in the pediatric emergency department (PED). Moreover, we also examined early warning signs for predicting severe MIS-C patients requiring admission to intensive care unit (ICU).

Methods: We conducted a retrospective analysis of patients presenting to the PED with suspected MIS-C. Patient records were assessed for initial complaints, physical examination findings, laboratory and ımaging test results, diagnoses, and follow-up plans. Patients diagnosed with MIS-C were categorized as the MIS-C group, while others were categorized as the non-MIS-C group. Comparisons were made between these two groups.

Results: A total of 266 patients were included, with 68 diagnosed with COVID-19-associated MIS-C, including 20 monitored in the pediatric ICU. MIS-C patients had higher mean age, hospitalization, and ICU admission rates compared to non-MIS-C. MIS-C group showed higher prevalence of respiratory symptoms, hematological involvement, and shock. We observed lymphopenia, thrombocytopenia, hyponatremia, and elevated levels of blood C-reactive protein (CRP), procalcitonin, triglycerides, troponin, Brain Natriuretic Peptide (BNP), D-dimer, and fibrinogen in the MIS-C group. ICU patients had higher procalcitonin, aspartate aminotransferase, alanine aminotransferase, triglycerides, troponin, BNP, and ferritin levels, and lower sodium levels.

Conclusions: COVID-19-associated MIS-C group had higher rates of respiratory symptoms, hematological involvement, and shock. Lymphopenia, thrombocytopenia, elevated CRP, and D-dimer can guide MIS-C differential diagnosis. Additional tests (procalcitonin, troponin, BNP, triglycerides, ferritin) are recommended for high-suspicion cases. Patients with elevated BNP levels may require ICU admission.

Kaynakça

  • 1. Swann OV, Holden KA, Turtle L, Pollock L, Fairfield CJ, Drake TM, et al. Clinical characteristics of children and young people admitted to hospital with covid-19 in United Kingdom: prospective multicentre observational cohort study. BMJ 2020;;370:m3249.
  • 2. Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet 2020;395:1607-8.
  • 3. HAN Archive - 00432 | Health Alert Network (HAN). (2021). Accessed 06 June 2022 https://emergency.cdc.gov/han/2020/han00432.asp
  • 4. Vogel TP, Top KA, Karatzios C, Hilmers DC, Tapia LI, Moceri P, et al. Multisystem inflammatory syndrome in children and adults (MIS-C/A): case definition & guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 2021;39:3037-49.
  • 5. Emeksiz S, Çelikel Acar B, Kibar AE, Özkaya Parlakay A, Perk O, Bayhan Gİ, et al. Algorithm for the diagnosis and management of the multisystem inflammatory syndrome in children associated with COVID‐19. Int J Clin Pract 2021;75:e14471.
  • 6. Giacalone M, Scheier E, Shavit I. Multisystem inflammatory syndrome in children (MIS-C): a mini-review. Int J Emerg Med 2021;14:50.
  • 7. Karagol C, Tehci AK, Gungor A, Ekici Tekin Z, Çelikel E, Aydın F, et al. Delta neutrophil index and C-reactive protein: a potential diagnostic marker of multisystem inflammatory syndrome in children (MIS-C) with COVID-19. Eur J Pediatr 2022;181:775-81.
  • 8. Kline JN, Isbey SC, McCollum NL, Falk MJ, Gutierrez CE, Guse SE, et al. Identifying pediatric patients with multisystem inflammatory syndrome in children presenting to a pediatric emergency department. Am J Emerg Med 2022;51:69-75.
  • 9. Feldstein LR, Rose EB, Horwitz SM, Collins JP, Newhams MM, Son MBF, et al. Multisystem inflammatory syndrome in U.S. children and adolescents. N Engl J Med 2020;383:334-46.
  • 10. Yasuhara J, Watanabe K, Takagi H, Sumitomo N, Kuno T. COVID-19 and multisystem inflammatory syndrome in children: a systematic review and meta-analysis. Pediatr Pulmonol 2021;56:837-48.
  • 11. Roberts JE, Campbell JI, Gauvreau K, Lamb GS, Newburger J, Son MB, et al. Differentiating multisystem inflammatory syndrome in children: a single-centre retrospective cohort study. Arch Dis Child 2022;107:e3.
  • 12. Panigrahy N, Policarpio J, Ramanathan R. Multisystem inflammatory syndrome in children and SARS-CoV-2: a scoping review. J Pediatr Rehabil Med 2020;13:301-16.
  • 13. Sethuraman U, Kannikeswaran N, Ang J, Singer A, Miller J, Haddad R, et al. Multisystem inflammatory syndrome in children associated with novel coronavirus SARS-CoV-2: Presentations to a pediatric emergency department in Michigan. Am J Emerg Med 2021;39:164-7.
  • 14. Hançerli Törün S, Yilmaz Çiftdoğan D, Kara A. Multisystem inflammatory syndrome in children. Turk J Med Sci 2021;51(SI-1):3273-3283.
  • 15. Rostami-Maskopaee F, Ladomenou F, Razavi-Amoli SK, Navaeifar MR, Hajialibeig A, Shahbaznejad L, et al. Clinical characteristics and outcomes of the multisystem inflammatory syndrome in children (MIS-C) following COVID-19 infection in Iran: a multicenter study. PLoS One 2022;17:e0274104.
  • 16. Alkan G, Sert A, Oz SKT, Emiroglu M, Yılmaz R. Clinical features and outcome of MIS-C patients: an experience from Central Anatolia. Clin Rheumatol 2021;40:4179-89.
  • 17. Dufort EM, Koumans EH, Chow EJ, Rosenthal EM, Muse A, Rowlands J, et al. Multisystem inflammatory syndrome in children in New York State. N Engl J Med 2020;383:347-58.
  • 18. Waseem M, Shariff MA, Tay ET, Mortel D, Savadkar S, Lee H, et al. Multisystem inflammatory syndrome in children. J Emerg Med 2022;62:28-37.
  • 19. Whittaker E, Bamford A, Kenny J, Kaforou M, Jones CE, Shah P, et al. Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2. JAMA 2020;324:259-69.
  • 20. Minocha PK, Phoon CKL, Verma S, Singh RK. Cardiac findings in pediatric patients with multisystem inflammatory syndrome in children associated with COVID-19. Clin Pediatr (Phila) 2021;60:119-26.
  • 21. Stankovic C, DeLaroche A, Arora R, Spencer P, Ehrman RR. Laboratory trends in severe MIS-C. Acad Emerg Med 2022;29:1258-60.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Çocuk Sağlığı ve Hastalıkları, Acil Tıp
Bölüm Original Article
Yazarlar

Yüksel Bıcılıoğlu 0000-0003-4531-3978

Tuğçe Nalbant 0000-0002-7408-2382

Alper Çiçek 0000-0001-9684-2736

Esin Ergönül 0000-0003-0126-8108

Gamze Gökalp 0000-0001-9467-3617

Gülsah Demir 0000-0001-7841-4682

Şefika Bardak 0000-0003-1211-6943

Emel Berksoy 0000-0002-6831-1353

Erken Görünüm Tarihi 18 Ağustos 2023
Yayımlanma Tarihi 4 Kasım 2023
Gönderilme Tarihi 22 Ocak 2023
Kabul Tarihi 26 Temmuz 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 9 Sayı: 6 - November 2023

Kaynak Göster

AMA Bıcılıoğlu Y, Nalbant T, Çiçek A, Ergönül E, Gökalp G, Demir G, Bardak Ş, Berksoy E. Differential diagnosis for multiple systemic inflammatory syndrome in children: clinical and laboratory clues. Eur Res J. Kasım 2023;9(6):1380-1391. doi:10.18621/eurj.1238842

e-ISSN: 2149-3189 


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