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The Multifaceted Presentation of the Multisystem Inflammatory Syndrome in Children: Data from a Cluster Analysis

Background: The aim of this study was to evaluate the outcomes of patients with the multisystem inflammatory syndrome in children (MIS-C) according to phenotypes of disease and define the prognostic factors for the severe course. Methods: This cross-sectional study included 293 patients with MIS-C f...

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Autores principales: Sönmez, Hafize Emine, Çağlayan, Şengül, Otar Yener, Gülçin, Başar, Eviç Zeynep, Ulu, Kadir, Çakan, Mustafa, Guliyeva, Vafa, Bağlan, Esra, Öztürk, Kübra, Demirkol, Demet, Demir, Ferhat, Karadağ, Şerife Gül, Özdel, Semanur, Aktay Ayaz, Nuray, Sözeri, Betül
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8950548/
https://www.ncbi.nlm.nih.gov/pubmed/35330065
http://dx.doi.org/10.3390/jcm11061742
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author Sönmez, Hafize Emine
Çağlayan, Şengül
Otar Yener, Gülçin
Başar, Eviç Zeynep
Ulu, Kadir
Çakan, Mustafa
Guliyeva, Vafa
Bağlan, Esra
Öztürk, Kübra
Demirkol, Demet
Demir, Ferhat
Karadağ, Şerife Gül
Özdel, Semanur
Aktay Ayaz, Nuray
Sözeri, Betül
author_facet Sönmez, Hafize Emine
Çağlayan, Şengül
Otar Yener, Gülçin
Başar, Eviç Zeynep
Ulu, Kadir
Çakan, Mustafa
Guliyeva, Vafa
Bağlan, Esra
Öztürk, Kübra
Demirkol, Demet
Demir, Ferhat
Karadağ, Şerife Gül
Özdel, Semanur
Aktay Ayaz, Nuray
Sözeri, Betül
author_sort Sönmez, Hafize Emine
collection PubMed
description Background: The aim of this study was to evaluate the outcomes of patients with the multisystem inflammatory syndrome in children (MIS-C) according to phenotypes of disease and define the prognostic factors for the severe course. Methods: This cross-sectional study included 293 patients with MIS-C from seven pediatric rheumatology centers. A two-step cluster analysis was performed to define the spectrum of disease and their outcomes were compared between each group. Results: Four subgroups were identified as follows: cluster I, predominantly Kawasaki-like features (n = 100); cluster II, predominantly MAS-like features (n = 34); cluster III, predominantly LV dysfunction (n = 47); cluster IV, other presentations (n = 112). The duration of fever was longer in cluster II and the length of hospitalization was longer in both clusters II and III. Laboratory findings revealed lower lymphocyte and platelet counts and higher acute phase reactants (APRs) in cluster II, while patients in cluster IV showed less inflammation with lower APRs. The resolution of abnormal laboratory findings was longer in clusters II and III, while it was shortest in cluster IV. Seven patients died. Among them, four belonged to cluster II, while three were labeled as cluster III. Patients with severe course had higher levels of neutrophil–lymphocyte ratio, mean platelet volume, procalcitonin, ferritin, interleukin-6, fibrinogen, D-Dimer, BNP, and troponin-I, and lower levels of lymphocyte and platelet counts. Conclusion: As shown, MIS-C is not a single disease presenting with various clinical features and outcomes. Understanding the disease spectrum will provide individualized management.
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spelling pubmed-89505482022-03-26 The Multifaceted Presentation of the Multisystem Inflammatory Syndrome in Children: Data from a Cluster Analysis Sönmez, Hafize Emine Çağlayan, Şengül Otar Yener, Gülçin Başar, Eviç Zeynep Ulu, Kadir Çakan, Mustafa Guliyeva, Vafa Bağlan, Esra Öztürk, Kübra Demirkol, Demet Demir, Ferhat Karadağ, Şerife Gül Özdel, Semanur Aktay Ayaz, Nuray Sözeri, Betül J Clin Med Article Background: The aim of this study was to evaluate the outcomes of patients with the multisystem inflammatory syndrome in children (MIS-C) according to phenotypes of disease and define the prognostic factors for the severe course. Methods: This cross-sectional study included 293 patients with MIS-C from seven pediatric rheumatology centers. A two-step cluster analysis was performed to define the spectrum of disease and their outcomes were compared between each group. Results: Four subgroups were identified as follows: cluster I, predominantly Kawasaki-like features (n = 100); cluster II, predominantly MAS-like features (n = 34); cluster III, predominantly LV dysfunction (n = 47); cluster IV, other presentations (n = 112). The duration of fever was longer in cluster II and the length of hospitalization was longer in both clusters II and III. Laboratory findings revealed lower lymphocyte and platelet counts and higher acute phase reactants (APRs) in cluster II, while patients in cluster IV showed less inflammation with lower APRs. The resolution of abnormal laboratory findings was longer in clusters II and III, while it was shortest in cluster IV. Seven patients died. Among them, four belonged to cluster II, while three were labeled as cluster III. Patients with severe course had higher levels of neutrophil–lymphocyte ratio, mean platelet volume, procalcitonin, ferritin, interleukin-6, fibrinogen, D-Dimer, BNP, and troponin-I, and lower levels of lymphocyte and platelet counts. Conclusion: As shown, MIS-C is not a single disease presenting with various clinical features and outcomes. Understanding the disease spectrum will provide individualized management. MDPI 2022-03-21 /pmc/articles/PMC8950548/ /pubmed/35330065 http://dx.doi.org/10.3390/jcm11061742 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sönmez, Hafize Emine
Çağlayan, Şengül
Otar Yener, Gülçin
Başar, Eviç Zeynep
Ulu, Kadir
Çakan, Mustafa
Guliyeva, Vafa
Bağlan, Esra
Öztürk, Kübra
Demirkol, Demet
Demir, Ferhat
Karadağ, Şerife Gül
Özdel, Semanur
Aktay Ayaz, Nuray
Sözeri, Betül
The Multifaceted Presentation of the Multisystem Inflammatory Syndrome in Children: Data from a Cluster Analysis
title The Multifaceted Presentation of the Multisystem Inflammatory Syndrome in Children: Data from a Cluster Analysis
title_full The Multifaceted Presentation of the Multisystem Inflammatory Syndrome in Children: Data from a Cluster Analysis
title_fullStr The Multifaceted Presentation of the Multisystem Inflammatory Syndrome in Children: Data from a Cluster Analysis
title_full_unstemmed The Multifaceted Presentation of the Multisystem Inflammatory Syndrome in Children: Data from a Cluster Analysis
title_short The Multifaceted Presentation of the Multisystem Inflammatory Syndrome in Children: Data from a Cluster Analysis
title_sort multifaceted presentation of the multisystem inflammatory syndrome in children: data from a cluster analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8950548/
https://www.ncbi.nlm.nih.gov/pubmed/35330065
http://dx.doi.org/10.3390/jcm11061742
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