Inflammatory Bowel Disease Presenting With Concurrent COVID-19 Multisystem Inflammatory Syndrome

Area of Science:

• Pediatric Gastroenterology
• Infectious Diseases
• Immunology

Background:

• Coronavirus disease 2019 (COVID-19) can trigger postinfectious multisystem inflammatory syndrome in children (MIS-C).
• MIS-C is characterized by cytokine storm and multiorgan dysfunction, frequently impacting the gastrointestinal system.
• Inflammatory bowel disease (IBD) involves chronic inflammation of the digestive tract.

Observation:

• A 16-year-old male presented with severe gastrointestinal symptoms including abdominal pain, diarrhea, and hematochezia, meeting criteria for systemic inflammatory response syndrome.
• Initial investigations revealed elevated inflammatory markers such as ferritin, D-dimer, C-reactive protein, and interleukins.
• Endoscopic procedures showed severe active gastroduodenitis and patchy colitis.

Findings:

• The patient was diagnosed with concurrent MIS-C and severe inflammatory bowel disease.
• Treatment involved a combination of corticosteroids, intravenous immunoglobulin, and infliximab.
• Symptomatic improvement was observed over a three-week period.

Implications:

• This case underscores the potential for severe gastrointestinal manifestations of MIS-C, mimicking or exacerbating IBD.
• Further research is warranted to understand the impact of COVID-19 and MIS-C on pre-existing or newly presenting inflammatory disorders.
• Early recognition and comprehensive management are crucial for patients presenting with overlapping MIS-C and IBD symptoms.