MULTISISTEMSKI INFLAMATORNI SINDROM UDRUŽEN SA COVID-19 U DECE: ETIOPATOGENEZA, KLINIČKA PREZENTACIJA I TERAPIJA

Stasa Krasic; Milica Bajčetić; Vladislav Vukomanović

doi:10.5937/mp75-41612

Stasa Krasic Institut za zdravstenu zaštitu majke i deteta Srbije "Dr Vukan Čupić"
Milica Bajčetić
Vladislav Vukomanović

DOI: https://doi.org/10.5937/mp75-41612

Ključne reči: MIS-C, COVID-19, oksidativni stres, terapija

Sažetak

Multisistemski inflamatorni sindrom kod dece (MIS-C) udružen sa infekcijom izazvanom korona virusom– 19 (COVID-19) je po život opasno stanje, koje nastaje kao posledica citokinske oluje i hiperinflamacije kod genetski predisponirane dece nakon simptomske ili asimptomske infekcije izazvane SARS-CoV-2. Etiopatogeneza ovog inflamatornog poremećaja još uvek nije razjašnjena, ali endotoksemija i značajna mikro- i markovaskularna oštećenja dovode do povećane sinteze reaktivnih vrsta i smanjene raspoloživosti i/ili povećane potrošnje antioksidanasa što rezultira poremećajem redoks homeostaze. S obzirom na tešku kliničku sliku i potencijalno životno ugrožavajuće stanje neophodna je rana primena imunomodulatorne terapije. Iako jasne preporuke za terapiju MIS-C nisu donete, ključnu ulogu u terapiji imaju IVIG i kortikosteroidi. Osim antiinflamatornog, pokazano da IVIG ima i antioksidativno dejstvo dok za kortikosteroide još uvek nema podatka o modulaciji stepena oksidativnog stresa kod pacijenata sa MIS-C udruženog sa COVID-19, ali je primena kortikosteroida pokazala promptno poboljšanje kliničkog nalaza, hematoloških i biohemijskih parametara, EKG zapisa i ehokardiografskog nalaza kod pacijenata za MIS-C povezanog sa COVID-19.

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