Related Experiment Video
Updated: Sep 10, 2025
Induction of Maternal Immune Activation in Mice at Mid-gestation Stage with Viral Mimic PolyI:C
Published on: March 25, 2016
Both Corticosteroids and Intravenous Immunoglobulin Protect From Aneurysms in Children With Multisystem Inflammatory
Cinta Moraleda1,2, Kamila Ludwikowska3, Irati Gastesi2
1From the Pediatric Infectious Diseases Unit, Pediatrics Deparment, Hospital Universitario 12 de Octubre.
Insights
Multisystem inflammatory syndrome in children (MIS-C) treatments like corticosteroids and intravenous immunoglobulin (IVIG) reduce aneurysm risk. The combination of corticosteroids and IVIG showed the most significant risk reduction in children with MIS-C.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Immunology
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a serious post-COVID-19 condition.
- MIS-C shares similarities with Kawasaki disease, including the risk of coronary artery aneurysms.
- Effective treatments to prevent aneurysms in MIS-C are still under investigation.
Purpose of the Study:
- To identify effective therapies for preventing coronary aneurysms in children with MIS-C.
- To determine associated risk factors for aneurysm development in MIS-C patients.
- To compare the efficacy of different immunomodulatory treatments for MIS-C.
Main Methods:
- A multicenter, ambispective study included 853 children (0-18 years) diagnosed with MIS-C.
- Logistic regression was used to analyze aneurysm risk factors.
- Kaplan-Meier and Cox proportional hazards models assessed treatment efficacy, with post hoc Tukey's tests for comparisons.
Main Results:
- 33 (4%) patients developed aneurysms; the median age was 5.86 years.
- All immunomodulatory treatments (corticosteroids, IVIG, or both) significantly reduced aneurysm risk compared to no treatment.
- Corticosteroids + IVIG showed the greatest risk reduction, though no significant differences were found between the individual or combined therapies in all analyses.
Conclusions:
- Corticosteroids and IVIG, alone or in combination, appear protective against aneurysms in MIS-C.
- The combination of corticosteroids and IVIG demonstrated a significant reduction in aneurysm risk.
- Corticosteroids represent a viable treatment option, particularly when IVIG availability is limited.
Background:
Multisystem inflammatory syndrome in children (MIS-C) is a post-COVID-19 condition resembling Kawasaki disease, including developing coronary aneurysms. Optimal treatment remains uncertain. This study aims to identify effective therapies for preventing aneurysms in MIS-C and associated risk factors.
Methods:
This multicenter, ambispective study included hospitalized patients 0-18 years old with MIS-C between March 2020 and June 2023 from cohorts in Poland, Spain, Catalonia and Colombia. Logistic regression analyzed aneurysm risk factors. Treatment efficacy was assessed using Kaplan-Meier and Cox proportional hazards models, with post hoc Tukey's tests for pairwise comparisons.
Results:
Among 853 patients, 33 (4%) developed aneurysms, with a median age of 5.86 years (interquartile range, 3.00-11.7). All immunomodulatory treatments reduced aneurysm risk compared with no immunomodulatory treatment: corticosteroids + intravenous immunoglobulin (IVIG) [odds ratio (OR): 0.29; 95% confident interval (CI): 0.13-0.68], corticosteroids alone (OR: 0.27; 95% CI: 0.04-1.02) and IVIG alone (OR: 0.49; 95% CI: 0.18-1.28). Kaplan-Meier analysis showed a significantly lower 7-day aneurysm-free probability without immunomodulatory treatment (92%; 95% CI: 87%-96%, P = 0.011). Hazard ratios indicated a reduction in aneurysm risk with corticosteroids+IVIG [hazard ratio (HR) = 0.29; 95% CI: 0.13-0.65], corticosteroids alone (HR = 0.25; 95% CI: 0.06-1.13) and IVIG alone (HR = 0.49; 95% CI: 0.19-1.25), but no significant differences were observed between these treatments. No additional aneurysm risk factors were identified.
Conclusions:
Corticosteroids, IVIG and their combination appear to be protective against aneurysms in children with MIS-C compared with no immunomodulatory treatment. Although the 3 therapies showed no significant differences when compared with each other, only the combination significantly reduced the risk. Corticosteroids may still be a useful option when IVIG is limited.
More Related Videos
09:46Rat Model of Widespread Cerebral Cortical Demyelination Induced by an Intracerebral Injection of Pro-Inflammatory Cytokines
Published on: September 21, 2021
09:20Implanting Glass Spinal Cord Windows in Adult Mice with Experimental Autoimmune Encephalomyelitis
Published on: December 21, 2013
Related Concept Videos
01:14Myocarditis III: Medical Management
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
01:24Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF