A young child with pediatric multisystem inflammatory syndrome successfully treated with high-dose immunoglobulin therapy.
IDCases
; 28: e01493, 2022.
Article
in English
| MEDLINE | ID: covidwho-1851185
ABSTRACT
Pediatric multisystem inflammatory syndrome (MIS-C) is a disease that presents mainly in older children after coronavirus disease 2019 (COVID-19) and is associated with Kawasaki-like symptoms and multiple-organ failure. The number of cases of MIS-C has increased since April 2020, with reports mainly from Europe and the United States. The reason is unclear, but few cases of MIS-C have been reported in Asian countries, including Japan. No treatment has been established for MIS-C. In this study, we report the case of a young boy treated with IVIg for MIS-C by measuring the cytokine profile over time. A 4-year-old boy presented with Kawasaki disease-like symptoms 28 days after a positive result from polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), meeting the World Health Organization criteria for MIS-C diagnosis. Blood tests showed lower levels of C-reactive protein and ferritin, and no decrease in lymphocyte count (<1000/µL) or more increase in fibrinogen than those reported in Japan for MIS-C in school-aged children and older. Neopterin, interleukin (IL)-6, IL-18, soluble tumor necrosis factor receptor (sTNF-R)I and sTNF-RII were all high at disease onset, but neopterin, IL-6, and sTNF-RII rapidly decreased with fever resolution after the second dose of IVIg, while IL-18 and sTNF-RI decreased bimodally. As far as we can determine, this case represents the youngest identified in Japan. The key point of difference between MIS-C and Kawasaki disease is older age in MIS-C, but attention is also needed in infants.
COVID-19, coronavirus disease 2019; Cytokine, intravenous immunoglobulin (IVIg); IVIg, intravenous immunoglobulin; Kawasaki disease; MIS-C/PIMS, multisystem inflammatory syndrome in children/ pediatric inflammatory multisystem syndrome; Multisystem inflammatory syndrome in children (MIS-C); SARS-CoV-2
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Case report
Topics:
Vaccines
Language:
English
Journal:
IDCases
Year:
2022
Document Type:
Article
Affiliation country:
J.idcr.2022.e01493
Similar
MEDLINE
...
LILACS
LIS