Addition of Corticosteroids to Immunoglobulins Is Associated With Recovery of Cardiac Function in Multi-Inflammatory Syndrome in Children

Belhadjer, Zahra; Auriau, Johanne; Méot, Mathilde; Oualha, Mehdi; Renolleau, Sylvain; Houyel, Lucile; Bonnet, Damien

doi:10.1161/circulationaha.120.050147

Cited by 96 publications

(90 citation statements)

References 6 publications

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“…The early use of ANA prompted a rapid and sub-stained LEVF improvement over one day from admission. Our results further support the assumption that an aggressive, early and overtime immunomodulatory approach in PIMS-TS patients with myocardial involvement may induce a faster time to recovery, as quickly damping the cytokine storm [ 2 , 3 ]. However, the cumulative effect of ANA in combination with subsequent IVIG and steroid use could be advocated as effective in restoring a normal LVEF.…”

supporting

confidence: 83%

Fast recovery of cardiac function in PIMS-TS patients early using intravenous anti-IL-1 treatment

et al. 2021

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supporting

confidence: 83%

Fast recovery of cardiac function in PIMS-TS patients early using intravenous anti-IL-1 treatment

et al. 2021

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“…Given the use of different criteria to define MIS-C, the clinical characteristics of children with this syndrome varied significantly between reports and remained poorly defined (Table 3 ) [ 19 – 36 ]. This is clearly evidenced by a systematic review of the studies published from 25 April 2020 through 29 June 2020, including preprint manuscripts uploaded to medRxiv and bioRxiv [ 32 ].…”

Section: Clinical Manifestations and Laboratory Testsmentioning

confidence: 99%

“…This is clearly evidenced by a systematic review of the studies published from 25 April 2020 through 29 June 2020, including preprint manuscripts uploaded to medRxiv and bioRxiv [ 32 ]. Eight studies, including 440 patients (59% males, age 7–10 years), were analyzed [ 13 , 26 , 31 – 36 ]. When all the children were considered together regardless of classification criteria, gastrointestinal and dermatologic/mucocutaneous symptoms were the most common clinical manifestations of MIS-C as they were detected in 87% and 73% of children, respectively.…”

Section: Clinical Manifestations and Laboratory Testsmentioning

confidence: 99%

“…They can manifest during the first phase of MIS-C or develop later and generally appear in school-aged, previously healthy children. In a retrospective study that enrolled 35 patients with MIS-C and cardiovascular abnormalities, the median delay from the onset of clinical symptoms to heart failure was 6 days, median age at admission was 10 years, and co-morbidities—mainly overweight—were present in only about one-quarter of cases [ 36 ]. No case had underlying cardiac disease.…”

Section: Clinical Manifestations and Laboratory Testsmentioning

confidence: 99%

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Multisystem Inflammatory Syndrome in Children Related to SARS-CoV-2

Esposito

Principi

2021

Pediatr Drugs

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Although data on the incidence and severity of new coronavirus disease 2019 due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection showed more significant disease among adults and the elderly, a clinical manifestation characterized by a multisystem inflammatory syndrome was described in children (MIS-C). It was initially thought to be specific to children, but recent reports have shown that it can also occur in adults. MIS-C is characterized by a number of multisystemic manifestations resembling other known previously described illnesses, mainly Kawasaki disease, especially in cases with shock, toxic shock syndrome, and macrophage activation syndrome. Available literature shows that our knowledge of MIS-C is largely incomplete. Its development in strict relation with SARS-CoV-2 infection seems documented and, in most cases, can be considered a post-infectious manifestation secondary to an abnormal immune response for some aspects, similar to that seen in adults several days after SARS-CoV-2 infection. However, in a minority of cases, a clinical picture with symptoms fulfilling criteria for MIS-C diagnosis develops during the acute phase of SARS-CoV-2 infection. It is highly likely that the criteria currently used to diagnose MIS-C are too broad, meaning that children with different diseases are included. As clarity on the pathogenesis of MIS-C is lacking, different therapeutic approaches have been used, but no specific therapy is currently available. Further studies are urgently needed to improve our definition of MIS-C, to define the real impact on child health, and to elucidate the best clinical and therapeutic approach and true prognosis.

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“…Emerging evidence suggests that children previously diagnosed with COVID-19 are susceptible to MIS-C (formerly called pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 [PIMS-TS]) [ 67 ]. Patients with MIS-C typically present very ill, with evidence of severe inflammation in multiple organ systems, commonly with cardiac involvement, as evidenced by the 3 patients with MIS-C in the series by Di Nardo, all of whom presented with cardiac injury requiring V–A ECLS [ 65 ].…”

Section: Indications and Contraindicationsmentioning

confidence: 99%

Pediatric and neonatal extracorporeal life support: current state and continuing evolution

2021

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The use of extracorporeal life support (ECLS) for the pediatric and neonatal population continues to grow. At the same time, there have been dramatic improvements in the technology and safety of ECLS that have broadened the scope of its application. This article will review the evolving landscape of ECLS, including its expanding indications and shrinking contraindications. It will also describe traditional and hybrid cannulation strategies as well as changes in circuit components such as servo regulation, non-thrombogenic surfaces, and paracorporeal lung-assist devices. Finally, it will outline the modern approach to managing a patient on ECLS, including anticoagulation, sedation, rehabilitation, nutrition, and staffing.

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Addition of Corticosteroids to Immunoglobulins Is Associated With Recovery of Cardiac Function in Multi-Inflammatory Syndrome in Children

Cited by 96 publications

References 6 publications

Fast recovery of cardiac function in PIMS-TS patients early using intravenous anti-IL-1 treatment

Fast recovery of cardiac function in PIMS-TS patients early using intravenous anti-IL-1 treatment

Multisystem Inflammatory Syndrome in Children Related to SARS-CoV-2

Pediatric and neonatal extracorporeal life support: current state and continuing evolution

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