Spectrum of Multisystem Inflammatory Syndrome in Children (MIS-C)-a Report of Three Cases
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Published on: September 7, 2022
Shruti Jain1, Archana Kashyap1, Amitabh Singh1
1Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029 India.
Insights
Multisystem inflammatory syndrome in children (MIS-C) can present differently and critically in pediatric patients. Early recognition and prompt management are crucial for improving outcomes in children with MIS-C.
Area of Science:
- Pediatrics
- Infectious Diseases
- Critical Care Medicine
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a serious condition linked to COVID-19.
- Understanding MIS-C's diverse clinical presentations is vital for timely diagnosis and treatment.
Observation:
- Three critically ill pediatric patients (ages 1-12) with MIS-C presented with fever, conjunctivitis, GI symptoms, and skin rash.
- Clinical signs included shock, coagulopathy, and multiorgan dysfunction.
- Elevated inflammatory markers (CRP, ESR, D-dimers) were noted in all cases.
Findings:
- All patients required intensive care, including oxygen, fluid resuscitation, inotropes, and antibiotics.
- Treatment involved steroids, with two patients receiving intravenous immunoglobulin.
- Outcomes varied, with one fatality and two discharges.
Implications:
- COVID-19 can lead to severe MIS-C in children with varied presentations.
- Early identification and prompt, aggressive management are essential for pediatric MIS-C cases.
- This case series highlights the need for heightened clinical suspicion and preparedness in managing pediatric inflammatory syndromes.
Abstract:
We report three cases of multisystem inflammatory syndrome in children (MIS-C) during July 2020 from a tertiary care hospital with different clinical presentations and course of management. This will guide in better management of children with MIS-C. All three patients, aged 1 to 12 years old, were critically ill. They presented with common features of MIS-C, such as fever, conjunctival congestion, gastrointestinal involvement, and skin manifestations. Clinical features were suggestive of shock, coagulopathy, and multiorgan involvement. Laboratory findings revealed raised inflammatory markers, including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and D-dimers (DD). All patients required intensive care with oxygen therapy, fluid resuscitation, inotropic agents, and broad-spectrum antibiotics. All patients received steroids, and two patients were given intravenous immunoglobulin. One patient died, and the remaining two patients were discharged. Our findings confirmed that COVID-19 may cause severe disease in children, and the presentation may vary, requiring early recognition and timely management.
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