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Normative Laboratory Value Ranges in Pediatric Patients Who Underwent Evaluation for MIS-C

Thomas Graf1, Nathan M Money2, Sindhoosha Malay1

  • 1Department of Pediatrics, Division of Pediatric Hospital Medicine, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio, USA.

Emergency Medicine International
|December 4, 2025
PubMed

Insights

Diagnosing multisystem inflammatory syndrome in children (MIS-C) is difficult. This study found significant differences in lab values between MIS-C and other conditions, helping doctors differentiate diagnoses and reduce unnecessary tests.

Area of Science:

  • Pediatric infectious diseases
  • Clinical immunology
  • Epidemiology

Background:

  • Diagnosis of multisystem inflammatory syndrome in children (MIS-C) presents challenges due to overlapping symptoms with other pediatric conditions.
  • Establishing normative laboratory values is crucial for accurate MIS-C diagnosis.

Purpose of the Study:

  • To establish normative laboratory values for MIS-C patients.
  • To compare laboratory values between MIS-C patients and those evaluated for MIS-C but diagnosed with other conditions.

Main Methods:

  • A multicenter study reviewed records of 1319 patients aged 6 months to 18 years evaluated for MIS-C.
  • Demographics, clinical presentation, and laboratory values were compared between MIS-C and non-MIS-C groups.
  • Final diagnoses and associated laboratory values were documented for all patients.

Main Results:

  • Out of 1319 patients, 293 (22.2%) were diagnosed with MIS-C.
  • MIS-C patients showed significant differences in D-dimer, ferritin, fibrinogen, troponin, and brain natriuretic peptide levels compared to non-MIS-C patients.
  • Common non-MIS-C diagnoses included viral illnesses, acute COVID-19, pyelonephritis, and Kawasaki disease.

Conclusions:

  • Many patients evaluated for MIS-C during the pandemic received alternative diagnoses.
  • These findings can assist pediatricians in differentiating MIS-C from other febrile illnesses.
  • The data may help reduce unnecessary laboratory testing for suspected MIS-C.
Abstract

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