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Recognizing a MIS-Chievous Cause of Acute Viral Gastroenteritis.
Josyabhatla, Rohit; Kamdar, Ankur A; Armbrister, Shabba A; Daniel, Rhea; Boukas, Konstantinos; Smith, Keely G; Van Arsdall, Melissa R; Kakarala, Kokila; Flores, Anthony R; Wanger, Audrey; Liu, Yuying; Rhoads, Jon Marc.
  • Josyabhatla R; Division of Gastroenterology, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.
  • Kamdar AA; Children's Memorial Hermann Hospital, Houston, TX, United States.
  • Armbrister SA; Children's Memorial Hermann Hospital, Houston, TX, United States.
  • Daniel R; Division of Rheumatology, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.
  • Boukas K; Division of Gastroenterology, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.
  • Smith KG; Division of Gastroenterology, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.
  • Van Arsdall MR; Children's Memorial Hermann Hospital, Houston, TX, United States.
  • Kakarala K; Children's Memorial Hermann Hospital, Houston, TX, United States.
  • Flores AR; Division of Critical Care Medicine, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.
  • Wanger A; Children's Memorial Hermann Hospital, Houston, TX, United States.
  • Liu Y; Division of Pediatric Hospital Medicine, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.
  • Rhoads JM; Division of Gastroenterology, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.
Front Pediatr ; 9: 748368, 2021.
Article in English | MEDLINE | ID: covidwho-1518519
ABSTRACT
Historically, children evaluated for vomiting and diarrhea secondary to viral enteritis have symptoms lasting 2-4 days and respond to supportive care, including oral rehydration and anti-emetics if required. Recently, within a 14-day timespan, we encountered three children with severe diarrhea who rapidly became dehydrated and went into hypotensive shock. Although SARS-CoV-2 molecular tests were negative by nasopharyngeal swab, all were later found to have MIS-C. This small case series underscores features reported in previous larger studies and emphasizes the rapid clinical evolution of this condition. We highlight the importance of early recognition of cardinal laboratory findings characteristic of MIS-C (i.e., lymphopenia, markedly elevated acute phase reactants, and hypoalbuminemia). We also show serologic evidence that the pathophysiological mechanism of SARS-CoV-2 related diarrhea may differ from other causes of dehydrating vomiting and diarrhea, with no serologic evidence of villus cell injury.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study Language: English Journal: Front Pediatr Year: 2021 Document Type: Article Affiliation country: Fped.2021.748368

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study Language: English Journal: Front Pediatr Year: 2021 Document Type: Article Affiliation country: Fped.2021.748368