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Multisystem inflammatory syndrome in children: a case series
Arianne Ditzel Gaspar1, Gabriela de Sio Puetter Kuzma1, Luana Amancio1
1Hospital Pequeno Príncipe, Curitiba, PR, Brazil.
Insights
Multisystem inflammatory syndrome in children (MIS-C) presents with fever, abdominal pain, and potential cardiac issues. Early diagnosis and treatment are crucial due to the severity of this emerging pediatric condition.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Immunology
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is an emerging condition linked to SARS-CoV-2.
- Pediatric tertiary hospitals are increasingly encountering MIS-C cases.
- Understanding the clinical spectrum and management of MIS-C is vital.
Purpose of the Study:
- To describe a case series of MIS-C in a pediatric tertiary care setting.
- To highlight the clinical presentation and management strategies for MIS-C.
- To contribute to the growing body of literature on this pediatric inflammatory syndrome.
Main Methods:
- Retrospective analysis of medical records for pediatric patients meeting MIS-C criteria.
- Inclusion criteria based on Brazilian Ministry of Health and RCPCH guidelines.
- Review of clinical data, laboratory results, and treatment outcomes.
Main Results:
- Six pediatric patients (mean age 126 months) presented with fever and multisystem involvement.
- Common symptoms included abdominal pain, diarrhea, coagulopathy, and elevated inflammatory markers.
- Significant cardiovascular impairment (83%) and mucocutaneous symptoms (83%) were observed; one patient had coronary artery dilation.
- Five patients (83%) received intravenous immunoglobulin and/or pulse methylprednisolone; one patient expired.
- Five out of six patients tested positive for SARS-CoV-2 IgG.
Conclusions:
- This case series adds to the understanding of MIS-C, an emerging pediatric condition.
- The potential severity of MIS-C necessitates early recognition and diagnosis.
- Prompt management following exclusion of infectious causes is critical for patient outcomes.
Objective:
To describe a case series of multisystem inflammatory syndrome in children (MIS-C) in a pediatric tertiary hospital.
Methods:
Patients under the age of 18 years who met MIS-C criteria of the Brazilian Ministry of Health (MH) and/or the Royal College of Paediatrics and Child Health (RCPCH) were included. A retrospective analysis was carried out by reviewing medical records and complementary exams.
Results:
Six pediatric patients with mean age of 126 months were admitted with fever associated with multisystem involvement: all of them had abdominal pain and diarrhea and two underwent appendectomy; 100% had coagulopathy and increased inflammatory markers; 83% had cardiovascular impairment and 60% required vasoactive drugs; 83% had mucocutaneous symptoms and 50% required ventilatory support by invasive mechanical ventilation or non-invasive ventilation. One patient showed coronary artery dilation on echocardiogram. All patients received empiric antibiotic therapies. SARS-CoV-2 IgG testing was positive in five patients. Treatment was performed after excluding infectious causes: five patients (83%) received intravenous immunoglobulin, five patients (83%) pulse methylprednisolone therapy and one (16%) Tocilizumab. One patient died. The average length of stay in Pediatric Intensive Care Unit (PICU) was seven days.
Conclusions:
These cases are added to the literature in construction of this emerging condition. Early diagnosis should be considered due to its potential severity.
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