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SARS-CoV2 Related Multi System Inflammatory Syndrome in a Child with Chronic Kidney Disease: Case Report

Francesca Stefanachi1, Elisa Benetti1, Germana Longo1

  • 1Department of Women's and Children's Health, Paediatric Nephrology, Dialysis and Transplant Unit, University Hospital of Padova, Padua, Italy.

SN Comprehensive Clinical Medicine
|June 30, 2021
PubMed

Insights

This case report details a severe multisystemic inflammatory syndrome in children (MIS-C) case in a pediatric patient with end-stage renal disease (ESRD) on dialysis and hypertension. Chronic kidney disease may increase the risk of severe SARS-CoV-2 illness.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Multisystemic inflammatory syndrome in children (MIS-C) is a rare but serious condition associated with SARS-CoV-2.
  • Most pediatric patients with kidney disease experience mild SARS-CoV-2 infections.
  • Children with end-stage renal disease (ESRD) and comorbidities like hypertension may be at higher risk for severe outcomes.

Purpose of the Study:

  • To report the first case of MIS-C in a pediatric patient with chronic kidney disease (CKD) on renal replacement therapy (RRT).
  • To highlight the potential role of CKD, dialysis status, and severe hypertension in the development of severe SARS-CoV-2 related illness.

Main Methods:

  • Case report of a 2-year-old male with ESRD on peritoneal dialysis and severe hypertension.
  • Clinical presentation and instrumental findings compatible with MIS-C following SARS-CoV-2 infection.
  • Literature review on pediatric MIS-C and kidney disease.

Main Results:

  • The patient presented with severe SARS-CoV-2 related illness, multiorgan failure, and required intensive care.
  • Clinical and instrumental features were consistent with MIS-C.
  • This is the first reported case of MIS-C in a child with CKD.

Conclusions:

  • Pediatric patients with CKD, particularly those on RRT and with severe hypertension, may be at increased risk for severe SARS-CoV-2 related disease and MIS-C.
  • CKD, dialysis status, and severe hypertension are potential crucial factors in developing severe forms of SARS-CoV-2 related illness.
  • Further research is needed to understand the interplay between kidney disease and MIS-C severity in pediatric populations.

Keywords:
COVIDCase reportChronic kidney diseaseCoronavirusMIS-CPaediatric

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