Manejo da MIS-C: um protocolo prático
DOI:
https://doi.org/10.34117/bjdv9n3-219Keywords:
MIS-C, COVID-19, imunoglobulina, kawasaki-like, inflamatóriaAbstract
Em abril de 2020, os primeiros casos descrevendo um novo distúrbio hiperinflamatório associado ao COVID-19 afetando crianças e adolescentes foram relatados pela primeira vez no Reino Unido e na Itália. Esses pacientes apresentavam manifestações graves semelhantes à doença de Kawasaki, sendo essa caracterizada por uma vasculite sistêmica pediátrica que pode se manifestar com várias características clínicas, incluindo aneurismas da artéria coronária. Crianças diagnosticadas com MIS-C podem apresentar um amplo espectro de características clínicas e gravidade da doença. Até 80% dos pacientes foram admitidos na UTI, com 10% dos pacientes necessitando de ventilação mecânica. Dos 93 pacientes com ecocardiogramas, 52% apresentaram anormalidades (principalmente disfunção ventricular), 32% derrame pericárdico e 9% aneurismas de artéria coronária. Setenta por cento dos pacientes foram tratados com Imunoglobulina intravenosa (IVIG), 64% receberam glicocorticoides sistêmicos e 48% receberam IVIG e glicocorticoides sistêmicos. American College of Rheumatology publicou diretrizes clínicas para MIS-C. Eles incluíram um alto nível de consenso para a administração de altas doses de imunoglobulina intravenosa (IVIG) (2 g/kg com base no peso corporal ideal), glicocorticóides ou ambos como agentes de primeira linha.
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