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Revista argentina de cardiología
versión On-line ISSN 1850-3748
Resumen
RODRIGUEZ KIBRIK, Julián et al. Multisystem Inflammatory Syndrome in Children: The Importance of Early Evaluation of Laboratory Parameters. Rev. argent. cardiol. [online]. 2023, vol.91, n.1, pp.150-170. ISSN 1850-3748. http://dx.doi.org/10.7775/rac.v91.i1.20597.
Background:
Multisystem inflammatory syndrome in children (MIS-C) is an uncommon condition associated with COVID-19 with a wide spectrum of presentations, ranging from Kawasaki-like disease to multisystem involvement with shock. The association between the laboratory characteristics and unfavorable outcome has been described, but the cut-off points associated with higher risk have not yet been defined.
Objective:
The aim of this study was to describe and analyze the characteristics of patients with MIS-C and their associations with the laboratory findings.
Methods:
We conducted an analytical and retrospective study of pediatric patients hospitalized between May 2020 and June 2021 with diagnosis of MIS-C in Hospital General de Niños Dr. Ricardo Gutiérrez (HNRG). The cohort was made up of 23 patients, 17 female (53.13%) and 15 male (46.87%); mean age was 7.67 years (range 0.5-14.91). Ten patients (31.25%) presented shock.
Clinical and echocardiographic data and values of high-sensitive troponin I, N-terminal pro-B-type natriuretic peptide (NT-proB NP), platelets and lymphocytes at the time of diagnosis were obtained and compared between those with shock during evolution (group 1) and those without shock (group 2).
Results:
There was a significant difference in baseline elevated NT-proBNP values between both groups (p = 0.008), but not in tro ponin levels and lymphocyte and platelet counts. Of the 13 patients who required inotropic agents, 58% had baseline lymphopenia (p = 0.006 vs those who did not require inotropic drugs).
Conclusions:
Although mortality due to MIS-C is low, cardiac involvement and hemodynamic impairment may be common. The availability of a commonly used laboratory tool for patient categorization could help to mitigate risks and obtain early referral to specialized centers.
Palabras clave : Systemic Inflammatory Response Syndrome; COVID-19/Complications; Natriuretic Peptide; Brain; Lymphopenia; Thrombocytopenia; Child; Preschool.