Síndrome Inflamatorio Multisistémico Pediátrico asociado a COVID-19 revisión de la presentación clínica y patogenia.
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Introducción: El Síndrome Inflamatorio Multisistémico (MIS) es un trastorno de hiperinflamación que ha emergido como una preocupación significativa durante la pandemia de la COVID-19. Este síndrome afecta también a la población pediátrica, y las notificaciones de casos de Síndrome Inflamatorio Multisistémico en Niños (MIS-C) han aumentado en todo el mundo. Se observa una incidencia particularmente elevada en pacientes hispanos y afrodescendientes, alcanzando hasta un 23 % en Latinoamérica. Aunque no se ha establecido un vínculo directo entre MIS-C y el virus SARS-CoV-2, las investigaciones sugieren una conexión inmunológica tardía, mediada por un desequilibrio en la expresión de Th17/Threg, autoanticuerpos y complejos inmunes, especialmente en niños genéticamente susceptibles y/o con un medio endógeno alterado.
Métodos: En esta revisión teórica, se llevó a cabo una exhaustiva búsqueda bibliográfica en las bases de datos MEDLINE, LILACS y Google Académico. Se recopilaron datos relevantes sobre los mecanismos patogénicos e inmunológicos que contribuyen al desarrollo del MIS-C, así como información sobre su presentación clínica y su relación con otros síndromes inflamatorios de la infancia.
Resultados: MIS-C afecta predominantemente el sistema digestivo, cardiovascular y/o neurológico, manifestándose con fiebre, marcadores inflamatorios significativamente elevados y síntomas de disfunción orgánica. Comparte similitudes con la Enfermedad de Kawasaki, el Síndrome de Choque Tóxico y el Síndrome de Activación de Macrófagos; las investigaciones han confirmado que MIS-C presenta perfiles inmunes y de laboratorio singulares, estableciéndolo como una entidad clínica distinta.
Conclusiones: Esta revisión destaca la importancia de reconocer el Síndrome Inflamatorio Multisistémico en Niños como consecuencia de la infección por SARS-CoV-2. No se ha establecido completamente la conexión causal, los datos iniciales respaldan la existencia de MIS-C como una entidad clínica única. Comprender los mecanismos inmunológicos involucrados, así como las características clínicas distintivas, es esencial para la identificación temprana y el manejo adecuado de esta enfermedad en la población pediátrica.
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