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Systematic Scoring Analysis for Intestinal Inflammation in a Murine Dextran Sodium Sulfate-Induced Colitis Model
Published on: February 14, 2021
Abdominal manifestation of multisystemic inflammatory syndrome in children
Iván José Ardila Gómez1,2,3,4, Pilar Pérez López5,2,6,3,4, Darling Carvajal Duque1,3,4
1Pediatric Critical Care, Colombia.
Summary:
Multisystemic inflammatory syndrome (MIS-C) can develop as a complication of SARS CoV-2 infection, involving the gastrointestinal system mainly by vasoconstriction, edema, glandular hyperplasia, and a procoagulant state leading to direct tissue injury.
Method:
ology: a series of cases including 8 patients with MIS-C treated in two highly complex institutions is presented. These patients, had abdominal symptoms of surgical management.
Results:
The average age was 9.5 years and the most frequent symptoms were fever, abdominal pain, diarrhea (100%); in addition, 87.5% presented shock. The diagnosis of SARS CoV-2 was confirmed by RT-PCR test in 37.5%, antigen 12.5% and the rest of the patients showed IgM and IgG antibodies. In laboratories, the increase in acute phase reactants, Erythrocyte Sedimentation Rate (ESR), C-reactive protein, procalcitonin, as well as troponin, D dimer and proBNP, is highlighted. The surgical outcome documented 2 patients with a normal appendix, 3 patients with edematous appendicitis, and 3 patients with complicated appendicitis.
Conclusions:
patients with MIS-C display abdominal symptoms similar to those present in surgical emergencies and a non-negligible number of cases require surgical exploration. This condition poses a new differential diagnosis to the surgical abdomen in pediatric patients.
Insights
Multisystemic inflammatory syndrome in children (MIS-C) following SARS-CoV-2 infection can cause severe abdominal symptoms mimicking surgical emergencies. Early recognition is crucial for appropriate pediatric care and surgical intervention when necessary.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Pediatric Surgery
Background:
- Multisystemic inflammatory syndrome in children (MIS-C) is a rare but serious complication of SARS-CoV-2 infection.
- MIS-C often presents with gastrointestinal symptoms that can mimic acute surgical abdominal conditions.
Observation:
- A series of 8 pediatric patients with MIS-C and surgical abdominal symptoms were analyzed.
- Patients presented with fever, abdominal pain, diarrhea, and shock, necessitating surgical evaluation.
- Diagnostic workup included RT-PCR, antigen tests, antibody detection, and laboratory markers of inflammation and cardiac strain.
Findings:
- Laboratory results showed elevated acute phase reactants (ESR, CRP, procalcitonin), troponin, D-dimer, and proBNP.
- Surgical findings included normal appendix, edematous appendicitis, and complicated appendicitis in the studied cohort.
- MIS-C patients exhibited abdominal symptoms mimicking surgical emergencies, with a significant need for surgical exploration.
Implications:
- MIS-C represents a critical differential diagnosis for acute surgical abdomen in pediatric populations.
- Early recognition and appropriate management are crucial to prevent severe outcomes in children with MIS-C.
- This study highlights the complex interplay between viral infection, systemic inflammation, and gastrointestinal manifestations in pediatric patients.
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