Who Would Have Predicted Multisystem Inflammatory Syndrome in Children?
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Published on: February 14, 2021
Daniel D Reiff1, Randy Q Cron2
1Division of Rheumatology, Department of Pediatrics, Children's of Alabama, University of Alabama at Birmingham, 1600 7th, Ave. S, CPPN #G10, Birmingham, AL, 35233-1711, USA.
Insights
Multisystem inflammatory disease in children (MIS-C) is a post-COVID-19 condition presenting with diverse symptoms. Early diagnosis and treatment with immunomodulatory therapies like IVIG lead to good outcomes for MIS-C patients.
Area of Science:
- Pediatric infectious diseases
- Immunology
- Cardiology
Background:
- Multisystem inflammatory disease in children (MIS-C) is a novel condition following COVID-19.
- It presents with non-specific symptoms, mimicking Kawasaki disease (KD) and active COVID-19.
Purpose of the Study:
- To review the latest literature on MIS-C.
- Focus on clinical findings, pathophysiology, diagnostics, treatment, and outcomes.
Main Methods:
- Literature review of MIS-C studies.
- Analysis of clinical, laboratory, and imaging data.
- Evaluation of treatment strategies and outcomes.
Main Results:
- MIS-C diagnosis is challenging due to overlapping symptoms with KD and COVID-19.
- Laboratory features, imaging, and history aid diagnosis.
- Immunomodulatory therapies, including IVIG and glucocorticoids, are effective.
Conclusions:
- Prompt recognition and aggressive treatment of MIS-C result in favorable outcomes.
- Longitudinal studies are crucial for understanding long-term cardiac sequelae and recovery.
Purpose Of Review:
Multisystem inflammatory disease in children (MIS-C) is a novel post-infectious phenomenon following coronavirus disease-19 (COVID-19). Herein, we present an in-depth review of the latest MIS-C literature related to clinical findings, pathophysiology, imaging and laboratory studies, treatment algorithms, and disease outcomes.
Recent Findings:
With its non-specific presentation of fever, gastrointestinal symptoms, cardiovascular injury and shock, systemic inflammation, and Kawasaki disease (KD)-like features, MIS-C can be a diagnostic challenge, overlapping with KD and active COVID-19 infection. However, common laboratory features, imaging findings, and historical clues can lead to accurate diagnosis and allow for appropriate treatment with a variety of immunomodulatory therapies, including intravenous immunoglobulin (IVIG). Aggressive treatment of MIS-C leads to good outcomes. Longitudinal studies continue to illuminate long-term cardiac sequelae and recovery. MIS-C presents with fever, KD features, gastrointestinal symptoms, cardiac inflammation, and shock. Early recognition and prompt institution of IVIG and glucocorticoids provide for rapid improvement.
