Multisystem inflammatory syndrome in children (MIS-C): a mini-review

Martina Giacalone,Itai Shavit,Eric Scheier

doi:10.1186/s12245-021-00373-6

Abstract

Multisystem inflammatory syndrome in children (MIS-C) is a novel, life-threatening hyperinflammatory condition that develops in children a few weeks after infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This disease has created a diagnostic challenge due to overlap with Kawasaki disease (KD) and KD shock syndrome. The majority of patients with MIS-C present with the involvement of at least four organ systems, and all have evidence of a marked inflammatory state. Most patients show an increase in the level of at least four inflammatory markers (C-reactive protein, neutrophil count, ferritin, procalcitonin, fibrinogen, interleukin-6, and triglycerides). Therapy is primarily with immunomodulators, suggesting that the disease is driven by post-infectious immune dysregulation. Most patients, even those with severe cardiovascular involvement, recover without sequelae. Since coronary aneurysms have been reported, echocardiographic follow-up is needed.Further study is needed to create uniform diagnostic criteria, therapy, and follow-up protocols.

Highlights

A large percentage of children infected with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) are asymptomatic or mildly symptomatic [1]
Not all patients test positive for SARS-CoV-2 real timepolymerase chain reaction (RT-PCR) on nasal swab, but the majority show serological positivity or an epidemiologic link to SARS-CoV-2 infection [8, 9]
multisystem inflammatory syndrome in children (MIS-C), a SARS-CoV-2-related condition, is a novel pediatric syndrome characterized by the presence of fever, elevated inflammatory markers, and multi-organ involvement

Summary

Introduction

A large percentage of children infected with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) are asymptomatic or mildly symptomatic [1].In April 2020, a novel life-threatening hyperinflammatory condition named multisystem inflammatory syndrome in children (MIS-C) as a complication of SARSCoV-2 in children was first recognized [2–4].MIS-C usually develops 4–6 weeks after SARS-CoV-2 infection [4–6], suggesting that the virus may be a trigger for genetically predisposed individuals [2, 7]. Background A large percentage of children infected with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) are asymptomatic or mildly symptomatic [1]. * Correspondence: itai@pem-database.org 3Pediatric Emergency Department, Rambam Health Care Campus, Haifa, Israel; Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel Full list of author information is available at the end of the article

Results

Conclusion