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Recognizing a MIS-Chievous Cause of Acute Viral Gastroenteritis
Rohit Josyabhatla1,2, Ankur A Kamdar2,3, Shabba A Armbrister1
1Division of Gastroenterology, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.
Frontiers in Pediatrics
|November 15, 2021
Summary
Children with severe diarrhea and shock, initially negative for SARS-CoV-2, were diagnosed with MIS-C. Early recognition of MIS-C lab findings is crucial for prompt treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Gastroenterology
Background:
- Viral enteritis typically causes 2-4 day vomiting/diarrhea in children, managed with supportive care.
- A recent case series identified three children with severe, rapidly progressing diarrhea and hypotensive shock.
Purpose of the Study:
- To describe a case series of children presenting with severe gastrointestinal symptoms and shock.
- To highlight the association between these symptoms and MIS-C, even with initial negative SARS-CoV-2 tests.
- To emphasize key laboratory findings for early MIS-C recognition.
Main Methods:
- Retrospective review of three pediatric cases with severe diarrhea and shock.
- Clinical evaluation, laboratory testing (including SARS-CoV-2 molecular tests), and serologic analysis.
Main Results:
- All three children, initially testing negative for SARS-CoV-2 via nasopharyngeal swab, were diagnosed with MIS-C.
- Patients presented with severe dehydration and hypotensive shock.
- Cardinal laboratory findings included lymphopenia, elevated acute phase reactants, and hypoalbuminemia.
- Serologic evidence suggested a distinct pathophysiological mechanism for SARS-CoV-2 related diarrhea, without villus cell injury.
Conclusions:
- MIS-C can manifest with severe gastrointestinal symptoms and rapid clinical deterioration in children.
- Early identification of specific laboratory markers is vital for diagnosing MIS-C.
- The pathophysiology of SARS-CoV-2 related diarrhea may differ from other infectious causes.
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