Multisystem inflammatory syndrome in children

ABSTRACT

@#Multisystem inflammatory syndrome in children (MIS-C) is a condition which is associated with Coronavirus that mimics Kawasaki Disease (KD) where organ dysfunction is evident which includes the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. This report describes the first case of Multisystem Inflammatory Syndrome in children in Region 1. Our patient is a 3 year old female who presented with sudden onset of high grade fever, abdominal pain and diarrhea, a month after recovering from COVID-19 infection. On admission, the patient was irritable, febrile with conjunctiva! erythema, reddish dry lips, slightly distended and non-tender abdomen, erythematous rash over umbilicus, feet and hands, minimal edema of hands and feet. Laboratories requested showed elevated inflammatory markers, elevated BNP, Troponin I, elevated D-dimer, fibrinogen and prolonged activated partial thromboplastin time (APTT) and prothrombin time (PT) (Appendix A,B,C,H). 2Dechocardiography showed left ventricular dysfunction, moderate mitral regurgitation, minimal pericardia! effusion and right coronary artery ectasia (Appendix F). On second hospital day, she had hypotension hence was transferred to Intensive Care Unit which required initiation of inotropes and close care monitoring. Intravenous lmmunoglobulin (IVlg) and corticosteroids were also started. She was discharged stable and improved on seventh hospital day with a repeat 2D-echocardiogram showing improved left ventricular function and decrease in right coronary artery dilation. Prompt recognition of this syndrome allows clinicians to acquire appropriate laboratory testing, initiate treatment and provide families with accurate prognostic information.