Gaspar AD, Kuzma GDSP, Amancio L, Floriani I, Bezerra VN, Bortolon GC, de Siqueira APV, Machado MP, Machado ACDS, Camargo CF, João PRD. Multisystem inflammatory syndrome in children: a case series.
Rev paul pediatr 2022;
40:e2021046. [PMID:
35442269 PMCID:
PMC8983013 DOI:
10.1590/1984-0462/2022/40/2021046]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/07/2021] [Indexed: 01/01/2023]
Abstract
Objective:
To describe a case series of multisystem inflammatory syndrome in children (MIS-C) in a pediatric tertiary hospital.
Methods:
Patients under the age of 18 years who met MIS-C criteria of the Brazilian Ministry of Health (MH) and/or the Royal College of Paediatrics and Child Health (RCPCH) were included. A retrospective analysis was carried out by reviewing medical records and complementary exams.
Results:
Six pediatric patients with mean age of 126 months were admitted with fever associated with multisystem involvement: all of them had abdominal pain and diarrhea and two underwent appendectomy; 100% had coagulopathy and increased inflammatory markers; 83% had cardiovascular impairment and 60% required vasoactive drugs; 83% had mucocutaneous symptoms and 50% required ventilatory support by invasive mechanical ventilation or non-invasive ventilation. One patient showed coronary artery dilation on echocardiogram. All patients received empiric antibiotic therapies. SARS-CoV-2 IgG testing was positive in five patients. Treatment was performed after excluding infectious causes: five patients (83%) received intravenous immunoglobulin, five patients (83%) pulse methylprednisolone therapy and one (16%) Tocilizumab. One patient died. The average length of stay in Pediatric Intensive Care Unit (PICU) was seven days.
Conclusions:
These cases are added to the literature in construction of this emerging condition. Early diagnosis should be considered due to its potential severity.
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