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Unique Complications of MIS-C and Its Treatment: Encephalopathy in a Child with MIS-C Who Developed Life-Threatening

Luke Burton1, Ananya Manchikalapati1, Chrystal Rutledge1

  • 1University of Alabama at Birmingham, Birmingham, AL, USA.

Case Reports in Critical Care
|November 1, 2022
PubMed

Insights

A child with multisystem inflammatory syndrome (MIS-C) developed severe gastrointestinal bleeding after treatment. This rare complication may be linked to MIS-C

Area of Science:

  • Pediatric rheumatology
  • Pediatric infectious diseases
  • Pediatric neurology

Background:

  • Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition associated with COVID-19.
  • Early diagnosis and treatment are crucial for managing MIS-C, which can affect multiple organ systems.

Observation:

  • A previously healthy 11-year-old male presented with shock and neurological symptoms, diagnosed with MIS-C.
  • Brain MRI revealed cytotoxic edema of the corpus callosum, a characteristic finding in some MIS-C cases.
  • The patient experienced severe gastrointestinal hemorrhage following treatment with IVIG, steroids, and aspirin.

Findings:

  • Angiography identified active bleeding from duodenal arteries, successfully treated with coil embolization.
  • The case suggests a potential link between MIS-C vasculitis, anti-inflammatory, and antithrombotic therapies and GI bleeding.
  • Unique radiologic features of MIS-C were observed.

Implications:

  • Highlights potential treatment complications in MIS-C patients, including GI hemorrhage.
  • Emphasizes the need for careful monitoring of MIS-C patients, especially those receiving anticoagulation or antiplatelet therapy.
  • Contributes to understanding the diverse clinical and radiologic manifestations of MIS-C.

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