The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.
Distinct clinical and immunological features of SARS–CoV-2–induced multisystem inflammatory syndrome in children
Open accessAbstract
BACKGROUNDPediatric SARS-CoV-2 infection can be complicated by a dangerous hyperinflammatory condition termed multisystem inflammatory syndrome in children (MIS-C). The clinical and immunologic spectrum of MIS-C and its relationship to other inflammatory conditions of childhood have not been studied in detail.METHODSWe retrospectively studied confirmed cases of MIS-C at our institution from March to June 2020. The clinical characteristics, laboratory studies, and treatment response were collected. Data were compared with historic cohorts of Kawasaki disease (KD) and macrophage activation syndrome (MAS).RESULTSTwenty-eight patients fulfilled the case definition of MIS-C. Median age at presentation was 9 years (range: 1 month to 17 years); 50% of patients had preexisting conditions. All patients had laboratory confirmation of SARS-CoV-2 infection. Seventeen patients (61%) required intensive care, including 7 patients (25%) who required inotrope support. Seven patients (25%) met criteria for complete or incomplete KD, and coronary abnormalities were found in 6 cases. Lymphopenia, thrombocytopenia, and elevation in inflammatory markers, D-dimer, B-type natriuretic peptide, IL-6, and IL-10 levels were common but not ubiquitous. Cytopenias distinguished MIS-C from KD and the degree of hyperferritinemia and pattern of cytokine production differed between MIS-C and MAS. Immunomodulatory therapy given to patients with MIS-C included intravenous immune globulin (IVIG) (71%), corticosteroids (61%), and anakinra (18%). Clinical and laboratory improvement were observed in all cases, including 6 cases that did not require immunomodulatory therapy. No mortality was recorded in this cohort.CONCLUSIONMIS-C encompasses a broad phenotypic spectrum with clinical and laboratory features distinct from KD and MAS.FUNDINGThis work was supported by the National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases; the National Institute of Allergy and Infectious Diseases; Rheumatology Research Foundation Investigator Awards and Medical Education Award; Boston Children's Hospital Faculty Career Development Awards; the McCance Family Foundation; and the Samara Jan Turkel Center.
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Self-citationMultisystem Inflammatory Syndrome in U.S. Children and Adolescents
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Self-citationHyperinflammatory shock in children during COVID-19 pandemic
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Cited by
Immunopathology of Hyperinflammation in COVID-19
Gustine, J. N., & Jones, D. (2021) · The American Journal of Pathology · doi:10.1016/j.ajpath.2020.08.009 · Cited by 516
Multisystem inflammatory syndrome in children related to COVID-19: a systematic review
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Self-citationLocal and systemic responses to SARS-CoV-2 infection in children and adults
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Metadata
- Authors
- Lee, P. Y., Day-Lewis, M., Henderson, L. A., Friedman, K. G., Lo, J., Roberts, J. E., Lo, M. S., Platt, C. D., Chou, J., Hoyt, K. J., Baker, A. L., Banzon, T. M., Chang, M. H., Cohen, E., de Ferranti, S. D., Dionne, A., Habiballah, S., Halyabar, O., Hausmann, J. S., Hazen, M. M., Janssen, E., Meidan, E., Nelson, R. W., Nguyen, A. A., Sundel, R. P., Dedeoglu, F., Nigrovic, P. A., Newburger, J. W., & Son, M. B. F.
- Venue
- Journal of Clinical Investigation
- Published
- 2020-10-05
- Volume
- 130
- Issue
- 11
- Pages
- 5942-5950
- ISSN
- 0021-9738 (ISSN-L)
- 1558-8238
- OpenAlex
- W3043906604
- Cited by
- 396
- References
- 38
- FWCI
- 68.18
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Lee, P. Y., Day-Lewis, M., Henderson, L. A., Friedman, K. G., Lo, J., Roberts, J. E., Lo, M. S., Platt, C. D., Chou, J., Hoyt, K. J., Baker, A. L., Banzon, T. M., Chang, M. H., Cohen, E., de Ferranti, S. D., Dionne, A., Habiballah, S., Halyabar, O., Hausmann, J. S., . . . Son, M. B. F. (2020). Distinct clinical and immunological features of SARS–CoV-2–induced multisystem inflammatory syndrome in children. Journal of Clinical Investigation. https://doi.org/10.1172/jci141113
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