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Published on: June 24, 2020
Multisystem inflammatory syndrome in children (MIS-C) in pregnancy can mimic new-onset pre-eclampsia: A case report
Khrystyna Levytska1, Lorene Temming2, Jason Dranove3
1Department of Obstetrics and Gynecology, Atrium Health, 1000 Blythe Blvd, Charlotte, NC 28203, USA.
Insights
Pregnant women with multisystem inflammatory syndrome in children (MIS-C) may develop symptoms mimicking pre-eclampsia. Expectant management of these symptoms is advised, avoiding preterm delivery for a potential MIS-C misdiagnosis.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Infectious Diseases
- Maternal-Fetal Medicine
Background:
- Pregnant women with coronavirus disease 2019 (COVID-19) face higher risks of severe illness and adverse outcomes.
- Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious complication of SARS-CoV-2 infection in pediatric populations.
Observation:
- A healthy 16-year-old pregnant patient in her second trimester presented with MIS-C.
- Following treatment with intravenous immunoglobulin, she developed transient hypertension, proteinuria, and elevated liver enzymes.
Findings:
- The observed symptoms were attributed to MIS-C rather than pre-eclampsia.
- This case highlights the diagnostic challenge of differentiating MIS-C complications from severe pre-eclampsia in pregnant adolescents.
Implications:
- Provides guidance for expectant management of MIS-C-related maternal complications, including hypertension, proteinuria, and transaminitis.
- Suggests avoiding premature delivery based on symptoms that may be secondary to MIS-C, thus improving maternal and fetal outcomes.
- Emphasizes the importance of considering MIS-C in pregnant patients presenting with symptoms overlapping with pre-eclampsia.
Introduction:
Pregnant women affected by coronavirus disease 2019 (COVID-19) are at increased risk of severe disease, admission to an intensive care unit, and adverse pregnancy outcomes. In contrast, children typically experience a mild form of COVID-19. Nonetheless, there is a risk of multisystem inflammatory syndrome in children (MIS-C) following a SARS-CoV-2 infection.
Case:
A healthy 16-year-old, G1P0, presented with MIS-C in the second trimester and was treated with intravenous immunoglobulin. She subsequently developed transient mild hypertension, proteinuria, and transaminitis, which ultimately was thought to be secondary to MIS-C rather than pre-eclampsia.
Discussion:
MIS-C is an important COVID-19 complication in pediatric patients. This case offers guidance on expectant management of hypertension, transaminitis, and proteinuria during an episode of MIS-C in pregnant patients, as opposed to preterm delivery for a misdiagnosis of severe pre-eclampsia.
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