Multisystem inflammatory syndrome in children (MIS-C)

Multisystem inflammatory syndrome in children (MIS-C)

• a presumed post-infectious complication of coronavirus disease 2019 (Covid-19)
• caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
• MIS-C has a prominent cardiovascular involvement, including:
  • shock,
  • echocardiographic findings of decreased function,
  • and coronary-artery aneurysms
• case definition of MIS-C stated is based on:
  • serious illness leading to hospitalization,
  • an age of less than 21 years,
  • fever (body temperature, >38.0°C) or report of subjective fever lasting at least 24 hours,
  • laboratory evidence of inflammation, multisystem organ involvement (i.e., involving at least two organ systems),
  • and laboratory-confirmed SARS-CoV-2 infection (positive SARS-CoV-2 real-time reverse-transcriptase- polymerase-chain-reaction [RT-PCR] or antibody test during hospitalization) or an epidemiologic link to a person with suspected or confirmed Covid-19 within 4 weeks before the onset of MIS-C symptoms
• there are similarities between MIS-C and Kawasaki's disease, a vasculitis of childhood that can cause coronary-artery aneurysms and sometimes a shock-like presentation
• evidence shows that initial treatment with intravenous immune globulin (IVIG) plus glucocorticoids was associated with a lower risk of new or persistent cardiovascular dysfunction than IVIG alone (1)

Reference:

1. Son MBF et al. Multisystem Inflammatory Syndrome in Children - Initial Therapy and Outcomes.N Engl J Med. 2021 Jun 16. doi:10.1056/NEJMoa2102605