ABSTRACT
BACKGROUND AND AIM: Multisystem inflammatory syndrome in children (MIS-C) is a syndrome of fatal multisystem inflammation. This case report aims to describe our successful experience in managing children with MIS-C associated with previous SARS-CoV-2 infection and to help clinicians identify the spectrum of MIS-C signs and symptoms. METHOD(S): Case Reports RESULTS: A 6-year-old previously healthy boy was referred to our hospital with fever, dyspnea, vomiting, and abdominal pain for seven days before admission. Leucocytosis, elevated inflammatory and cardiac biomarkers were noted. Renal and liver function decreased. An echocardiogram showed dilated LV with EF 30% and a normal chest x-ray. High anti-SARSCoV- 2 titer (>250 U/mL) with negative for SARS-CoV-2 RTPCR was in accordance with the previous infection 8 weeks prior. He received intravenous furosemide, dobutamine, ceftriaxone, intravenous immunoglobulin (IVIG), and heparin in the pediatric intensive care unit and was discharged on the 11th day of treatment. The second case was a 10-yearold boy admitted to the hospital with a high fever (41.5O C), conjunctival hyperemia, diarrhea, and diffused abdominal pain for two days before hospitalization. History of COVID-19 was noted in the previous 4 weeks. Laboratory blood examination showed thrombocytopenia, elevated inflammatory markers, D-dimer, NT-pro BNP, negative for SARS-CoV-2 RT-PCR, and positive for IgG SARS-CoV2. Echocardiogram and chest x-ray were unremarkable. He received ceftriaxone, IVIG, Methylprednisolone, and enoxaparin. The patient was discharged after eight days of hospitalization. CONCLUSION(S): These two cases presented MIS-C following a history of mild COVID-19 infection. The successful management relied on the proper and timely administration of IVIG, corticosteroid, and anticoagulant.