Short-term and medium-term clinical outcomes of multisystem inflammatory syndrome in children: a prospective observational cohort study

BACKGROUND

Even though the incidence of Multisystem Inflammatory Syndrome in children (MIS-C) is decreasing cases are still reported across the world. Studying the consequences of MIS-C enhances our understanding of the disease's prognosis. The objective of this study was to assess short- and medium-term clinical outcomes of MIS-C.

METHODS

Prospective observational cohort study at Municipal Children's Hospital Morozovskaya, Moscow, Russia. All children meeting the Royal College of Paediatrics and Child Health (RCPCH), Centers for Disease Control and Prevention (CDC), or the World Health Organization (WHO) MIS-C case definition admitted to the hospital between 17 May and 26 October 2020 were included in the study. All survivors were invited to attend a clinic at 2 and 6 weeks after hospital discharge.

RESULTS

37 children median age 6 years (interquartile range [IQR] 3.3-9.4), 59.5% (22/37) boys were included in the study. 48.6% (18/37) of patients required ICU care. One child died. All children had increased levels of systemic inflammatory markers during the acute event. Echocardiographic investigations identified abnormal findings in 35.1% (13/37) of children. 5.6% (2/36) of children were presenting with any symptoms six weeks after discharge. By six weeks the inflammatory markers were within the reference norms in all children. The echocardiographic evaluation showed persistent coronary dilatation in one child.

CONCLUSIONS

Despite the severity of their acute MIS-C, the majority of children in our cohort fully recovered with none having elevated laboratory markers of inflammation at 6 weeks, few (< 10%) reporting persistent symptoms at 6 weeks, and only one with persistent echocardiographic abnormalities.

AB1263 CHRONIC RECURRENT MULTIFOCAL OSTEOMYELITIS IN CHILDREN: A SINGLE CENTER 10-YEAR EXPERIENCE

Background

Chronic recurrent multifocal osteomyelitis (CRMO) is a chronic autoinflammatory disease that primarily affects the skeleton in the absence of an infectious etiology in children and adolescents. It is an orphan disease with many unclear aspects in terms of diagnosis, treatment and follow-up.

Objectives

To report demographic, clinical and laboratory characteristics of a single center cohort of CRMO patients in Morozovskaya Children’s City Clinical Hospital in Moscow, Russia.

Methods

We retrospectively and prospectively reviewed clinical records of 33 CRMO patients diagnosed between 2011 and 2021 and admitted to Rheumatology Department of Morozovskaya Children’s City Clinical Hospital.

Results

We identified 33 patients with CRMO. Twenty-five (75%) were female. Median age of symptoms onset was 9 [6;12] years. Median delay in diagnosis was 12 month. All patients had bone pain as an initial symptom; fever has been present in 12 patients (63%). Joints involvement was observed in 22 patients (67%) – 39%, 18%, 12%, and 3% of patients had ankle, hip, knee, and shoulder and wrist joints involvement, respectively. All patients had multifocal bone lesions, which were confirmed by radiological methods (CT scan, MRI, scintigraphy). Vertebrae (42.4%) and femur (48.5%) were the most commonly affected bones. One child had a skull lesion (os parietale). Eleven patients (33%) also had sacroiliitis. Other organs involvement was observed 7 patients presented with palmoplantar pustulosis and psoriasis. Histopathological examination has been performed in 24 (73%) patients to confirm the diagnosis. Mean ECR was 43 [28;80] mm/h and CRP – 27 [15;61] mg/L. Twenty-three (69,6%) patients had immunological activity.

Conclusion

From our experience, most of the patients had delay in diagnosis. Laboratory tests showed mild elevation of inflammatory parameters. Seven (21%) patients had psoriasis.

Disclosure of Interests

None declared