PDF(Pubmed)
Abstract：
Within 6 months of the coronavirus pandemic, a new disease entity associated with a multisystem hyperinflammation syndrome as a result of a previous infection with the SARS-CoV-2 virus is increasingly being identified in children termed Multisystem Inflammatory Syndrome in Children (MIS-C) and more recently in adults(MIS-A). Due to its clinical similarity with Kawasaki Disease, some institutions have used intravenous immunoglobulins and steroids as first line agents in the management of the disease. We seek to find how effective intravenous immunoglobulin therapy is across these two disease entities. A comprehensive English literature search was conducted across PubMed, MEDLINE, and EMBASE databases using the keywords multisystem inflammatory syndrome in children/adults and treatment. All major online libraries concerning the diagnosis and treatment of MIS-C and MIS-A were searched. Relevant papers were read, reviewed, and analyzed. The use of intravenous immunoglobulins (IVIG) and steroids for the treatment of multisystemic inflammatory syndrome in children(MIS-C) is well established and recommended by multiple pediatric governing institutions. However, there is still no optimal treatment guideline or consensus on the use of IVIG in adults. The use of IVIG in both the child and adult populations may lower the risk of treatment failure and the need for adjunctive immunomodulatory therapy. Despite the promising results of IVIG use for the management of MIS-C and MIS-A, considering the pathophysiological differences between MIS-C and MIS-A, healthcare professionals need to further assess the differences in disease risk and treatment. The optimal dose, frequency, and duration of treatment are still unknown, more research is needed to establish treatment guidelines.
摘要：
在冠状病毒大流行的6个月内，一种新的疾病实体与以前感染过SARS-CoV-2病毒的多系统炎症综合征相关,在儿童中越来越多地被发现,称为儿童多系统炎症综合征(MIS-C),最近在成人中被发现(MIS-A).由于其与川崎病的临床相似性，一些机构使用静脉注射免疫球蛋白和类固醇作为治疗这种疾病的一线药物。我们试图找到在这两种疾病实体中静脉注射免疫球蛋白治疗的有效性。在PubMed进行了全面的英语文献检索，MEDLINE,和EMBASE数据库使用关键词儿童/成人多系统炎症综合征和治疗。搜索了所有有关MIS-C和MIS-A诊断和治疗的主要在线图书馆。相关论文被阅读，reviewed,并分析。使用静脉内免疫球蛋白（IVIG）和类固醇治疗儿童多系统炎症综合征（MIS-C）已得到公认，并被多个儿科管理机构推荐。然而,对于在成人中使用IVIG仍没有最佳治疗指南或共识.在儿童和成人人群中使用IVIG可能会降低治疗失败的风险，并需要辅助免疫调节治疗。尽管IVIG用于管理MIS-C和MIS-A的结果令人鼓舞，考虑到MIS-C和MIS-A的病理生理差异，医疗保健专业人员需要进一步评估疾病风险和治疗方面的差异.最佳剂量,频率,治疗时间仍然未知，需要更多的研究来建立治疗指南.
