| Abstract [eng] |
Objective. To describe pediatric multisystem inflammatory syndrome associated with SARS-CoV-2 based on the recent scientific literature and to summarize the key diagnostic and therapeutic approaches and treatment outcome of PIMS-TS. Methods. PubMed and UpToDate databases were searched for the literature review. Scientific articles regarding multisystem inflammatory syndrome published in English language between the years 2019 and 2023 were included. Data on the incidence of Kawasaki disease and PIMS-TS in paediatric populations were obtained from the Institute of Hygiene and Vilniaus University Hospital Santaros Klinikos. Results. 61 sources of literature were analysed and described. Multisystem inflammatory syndrome is not characterised by pathognomonic features or specific abnormalities in laboratory parameters. For the diagnosis of multisystem inflammatory syndrome, it is important to consider the entirety of the clinical presentation, laboratory and imaging findings (≥2 body systems affected, evidence of a past or current SARS-CoV-2 infection, elevated inflammatory markers). Intravenous immunoglobulin (IVIG) is the first-line treatment and in the absence of a positive effect, glucocorticoids and biological therapy are recommended. In many cases, during the acute phase deviating laboratory findings reach normal levels after prescribed treatment. ECG and echocardiogram changes normalise in the first 6 months after the acute phase in the majority of patients. Currently there is no evidence that the multisystem inflammatory syndrome leads to long-term residual effects. Conclusion. The diagnosis of multisystem inflammatory syndrome is complex and requires a multidisciplinary approach. The exact pathogenesis is not known, therefore according to international treatment guidelines, immunoglobulin is the first-line drug of choice, and in the absence of a positive response to treatment, glucocorticoids or immunomodulatory agents are recommended. Laboratory parameters normalize in the first few days after treatment, while cardiovascular changes normalize in most children within the first 6 months. |
