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Case Report: Two episodes of hyperinflammation in an infant consistent with multisystem inflammatory syndrome in
Markus-Johann Dechant1, Holger Michel1, Michael Kabesch1
1University Children's Hospital Regensburg (KUNO-Clinics), University of Regensburg, Regensburg, Germany.
Insights
Multisystem inflammatory syndrome in children (MIS-C) can recur, presenting diagnostic challenges similar to Kawasaki disease (KD). Early detection of cardiovascular issues is crucial for managing this rare post-SARS-CoV-2 hyperinflammatory condition.
Area of Science:
- Pediatric rheumatology
- Infectious diseases
- Cardiology
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a serious hyperinflammatory condition following SARS-CoV-2 infection.
- Distinguishing MIS-C from Kawasaki disease (KD) can be challenging due to overlapping clinical features.
Observation:
- A 9-month-old infant experienced two distinct episodes of hyperinflammatory disease involving coronary arteries during the COVID-19 pandemic.
- Both episodes met diagnostic criteria for MIS-C, highlighting diagnostic complexities.
Findings:
- Recurrence of postviral hyperinflammatory disease, particularly MIS-C, is rare but documented in this case.
- The case underscores the diagnostic overlap between MIS-C and KD, especially in recurrent presentations.
Implications:
- Clinicians must consider the possibility of recurrent MIS-C, even when Kawasaki disease is suspected.
- Close patient follow-up and regular monitoring for cardiovascular sequelae are essential for early intervention.
Abstract:
Multisystem inflammatory syndrome in children (MIS-C) is a hyperinflammatory disease that occurs after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report a 9-month-old male infant with two episodes of hyperinflammatory disease, each involving the coronary arteries, within a short period of time during the SARS-CoV-2 pandemic. Although both episodes met the official criteria for MIS-C, this case illustrates the difficulty in distinguishing MIS-C from its main differential diagnosis, Kawasaki disease (KD). Recurrence of postviral hyperinflammatory disease is rare. Compared with KD, the recurrence of MIS-C is even rarer, but clinicians should be aware of this possibility. Our case also emphasizes the need to follow up these patients closely and to detect sequelae regularly, especially cardiovascular sequelae, at an early stage.
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