Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2.

Authors

  • Gihad Alsaeed
  • Taqwa A M Ahmed
  • Faith D Moore
  • Tamer Rizk
  • Mohamed Alsaeed
  • Wadha Helal Alotaibi
  • Ibrahim Alsaeed

DOI:

https://doi.org/10.47672/ajhmn.674

Keywords:

Multisystem inflammatory syndrome in children, Pediatric inflammatory multisystem syndrome, Severe acute respiratory syndrome 2, MIS-C.PIMS, COVID-19, SARS-CoV-2, Hyper inflammatory shock, Pediatric, Kawasaki disease.

Abstract

Second wave of the new coronavirus (SARS-CoV-2) has been declared throughout the world. It has been always thought that children are the least affected group. A new childhood disease, referred to as MIS-C (Multisystem Inflammation Syndrome) or PIMS-TS (Pediatric Inflammatory Multiorgan Syndrome Temporally related to SARS-CoV-2) was first recognized in April 2020. Shock and multiorgan failure affected some of those children that required intensive care; others were clinically similar to Kawasaki disease or toxic shock. The clinical evidence suggests that this inflammatory multisystem syndrome is temporally associated with severe acute respiratory syndrome corona virus 2. Many clinical uncertainties regarding this new disease rapidly became apparent in prevalence, clinical phenotypes, variable severity, clinical course, and optimal management. We aim to increase awareness of this syndrome regarding the diagnosis and management of children with suspected PIMS-TS by presenting two clinical cases and illustrating the available medical literature in regards to establishing the diagnosis and the appropriate therapeutic interventions. SARS-Cov-2 related medical impacts on children seem not well clarified yet. When a PIMS-TS case is suspected then full investigations should be done, children who have persistent fever associated with abdominal pain, diarrhea ,vomiting ,cough, neurologic symptoms should have primary blood tests to identify PIMS-TS: full blood count, CRP: C-reactive protein,  BUN: Blood Urea Nitrogen, Cr: Creatinine, Electrolytes and liver function. Multidisciplinary team approach seems mandatory from the very beginning. Despite the use of IVIG in the treatment of all diagnosed cases, steroids in regular doses could be a good alternative and requires further investigative evaluations.

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Author Biographies

Gihad Alsaeed

Department of pediatrics

Dr. Sulaiman Al-Habib Hospital Riyadh, Saudi Arabia

Taqwa A M Ahmed

Department of pediatrics

Dr. Sulaiman Al-Habib Hospital Riyadh, Saudi Arabia

Faith D Moore

Dalhousie Medical School Saint John, Canada

Tamer Rizk

Dalhousie Medical School Saint John, Canada

 

Mohamed Alsaeed

Pavia Medical School, Lombardy, Italy

 

Wadha Helal Alotaibi

King Fahad Medical City, Riyadh, Saudi Arabia

 

Ibrahim Alsaeed

Humanitas Medical School, Milano, Italy

 

References

CDC. Centers for Disease Control and Prevention. Information for Healthcare providers about multisystem inflammatory syndrome in children (MIS-C). https://www.cdc.gov/mis-c/hcp. December 18, 2020. Lauren A. Henderson

Mubbasheer Ahmad. Shailesh Advani. Kevin Chorath.et al. Multisystem inflammatory syndrome in children: A systematic review. The Lancet Journal. Volume 26,100527, September 01,2020.

Rachel Hardwood, Benjamin Allin, D Phil. Christine E Jones, Elizabeth Whittaker et al. A national consensus management pathway for pediatric inflammatory multisystem syndrome temporally associated with COVID 19 (PIMS-TS): results of a national Delphi process. The Lancet journal. September 18, 2020. DOI:https://doi.org/10.1016/S2352-4642 (20)30304-7

RCPCH. Royal college of paediatrics and child health. Paediatric multisystem inflammatory temporally associated with COVID-19(PIMS)-guidance for clinicians. https://www.rcpch.ac.uk/resources/paediatrics . May 2020.

Riphagen S, Gomez X, Gonzales-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic Lancet 2020; May 7. doi: 10.106/S0140-6736(20)31094-1

Scott W. Canna .Kevin G. Friedman .Mark Gorelik .Sivia K. Lapidus .et al. American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV"2 and Hyperinflammation in Pediatric COVID"19: Version 1. https://onlinelibrary.wiley.com/doi/10.1002/art.41454.

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Published

2021-03-10

How to Cite

Alsaeed, G. ., Ahmed, T. ., Moore, F. ., Rizk, T. ., Alsaeed, M. ., Alotaibi, W. ., & Alsaeed, I. . (2021). Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2. American Journal of Health, Medicine and Nursing Practice, 6(1), 51 – 58. https://doi.org/10.47672/ajhmn.674

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