Multisystem inflammatory syndrome in children presenting as acute severe necrotizing pancreatitis: A case report

Area of Science:

• Pediatric critical care medicine
• Infectious diseases
• Gastroenterology

Background:

• Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition.
• MIS-C can present with diverse and severe gastrointestinal and vascular complications.
• Thrombosis is an increasingly recognized, severe manifestation of MIS-C.

Purpose of the Study:

• To report a unique case of MIS-C presenting with severe pancreatitis and extensive venous thrombosis.
• To highlight the complex and varied clinical manifestations of MIS-C.
• To emphasize the importance of considering MIS-C in severe, atypical pediatric presentations.

Main Methods:

• Case report of a pediatric patient with MIS-C.
• Detailed clinical presentation including acute pancreatitis, hyperglycemia, acidosis, and venous thrombosis (splenic, superior mesenteric, portal).
• Treatment regimen included intravenous immune globulin, corticosteroids, antibiotics, anticoagulation, and fluid drainage.

Main Results:

• The patient experienced moderately severe acute pancreatitis and significant venous thrombosis.
• The patient showed a positive response to the comprehensive treatment strategy.
• Successful management of MIS-C-associated complications was achieved.

Conclusions:

• MIS-C can manifest with a wide spectrum of severe symptoms, including gastrointestinal and vascular issues.
• Aggressive and tailored treatment is crucial for managing severe MIS-C complications.
• A high index of suspicion is warranted for unusual MIS-C cases unresponsive to standard therapies.