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Multi-system inflammatory syndrome in children (MIS - C)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Multisystem inf lammatory 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

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