Common bone marrow signature in COVID-19-associated multisystem inflammatory syndrome in children: A first-wave small case series experience

被引:3
作者
De Ioris, Maria Antonietta [1 ]
Scarselli, Alessia [2 ]
Bracaglia, Claudia [3 ,4 ]
Perrotta, Daniela [5 ]
Bernardi, Stefania [6 ]
Santilli, Veronica [6 ]
Ceglie, Giulia [1 ,7 ]
Fabozzi, Francesco [1 ,7 ]
Agrati, Chiara [8 ]
Prencipe, Giusi [3 ,4 ]
Alaggio, Rita [9 ]
Mastronuzzi, Angela [1 ]
De Vito, Rita [9 ]
机构
[1] IRCCS, Bambino Gesu Childrens Hosp, Dept Haematol Oncol Cell & Gene Therapy, Rome, Italy
[2] IRCCS, Bambino Gesu Childrens Hosp, Pediat Emergency Dept DEA, Pediat Unit, Rome, Italy
[3] IRCCS, Bambino Gesu Childrens Hosp, Div Rheumatol, Rome, Italy
[4] IRCCS, Bambino Gesu Childrens Hosp, Lab ImmunoRheumatol, Rome, Italy
[5] IRCCS, Bambino Gesu Childrens Hosp, Dept Anesthesia & Crit Care, Rome, Italy
[6] IRCCS, Bambino Gesu Childrens Hosp, Pediat Acad Dept, Rome, Italy
[7] Univ Tor Vergata, Rome, Italy
[8] IRCCS Natl Inst Infect Dis L Spallanzani, Cellular Immunol Lab, Rome, Italy
[9] IRCCS, Dept Pathol, Bambino Gesu Childrens Hosp, Rome, Italy
关键词
bone marrow; MIS-C; SARS-CoV-2; COVID-19; INFECTION;
D O I
10.1002/pbc.29919
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The hyper-inflammatory response, also known as multisystem inflammatory syndrome in children (MIS-C), represents a major concern in children with SARS-CoV-2 infection. We report bone marrow features of three patients with MIS-C who were diagnosed during the first wave of the SARS-CoV-2 pandemic. A bone marrow evaluation was performed at onset of the inflammatory condition in order to exclude secondary hemophagocytic lymphohistiocytosis (sHLH). The bone marrows of the patients presented common features: the erythroid and megakaryocytic lineages were prominently affected and hemophagocytosis was moderately increased, differently than observed in sHLH. Megakaryocytopoiesis was increased, representing a peculiar feature of MIS-C differing from sHLH. SARS-CoV-2 RT-PCR and viral panel were studied in bone marrow aspiration samples. MIS-C is a rare complication of SARS-CoV-2 infections in children. An immuno-dysregulation considering both innate and adaptive immunity together with vascular inflammation and endothelial dysfunction play a major role. Our observations, although limited due to the small sample size, suggest that there are unique features in the bone marrow of patients with MIS-C that are likely secondary to immuno-dysregulation, and there are notable differences in bone marrow features compared to those reported in sHLH.
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