Pediatrik Multisistem İnflamatuvar Hastalıkta (MIS-C) Gastrointestinal Sistem Tutulumu: 47 Olgunun Tek Merkez Deneyimi

Abstract

Abstract
 Backgraound/Aims: Multisystem inflammatory syndrome in children (MIS-C) is a hyperinflammatory syndrome which was newly described during the coronavirus disease 2019 (COVID-19) pandemic in children and characterized by fever, inflammation, multiorgan dysfunction. One of the major clinical presentation is gastrointestinal system involvement. The aim of the study is to evaluate the clinical course and outcome according to the severity of gastrointestinal presentation, focusing on MIS-C cases with gastrointestinal system involvement.
 Methods: We performed a retrospective study of 47 MIS-C patients with gastrointestinal involvement in our clinic between October 2020 and March 2022. The patients were divided into two groups according to the severity of gastrointestinal involvement. The groups were compared in terms of demographic characteristics, gastrointestinal symptoms, laboratory parameters, other system involvement, length of hospital stay, treatment modalities, and clinical outcomes.
 Results: According to the severity of gastrointestinal system involvement, 44.7% (n=21) of the cases were mild to moderate, 55.3% (n=26) were severe. The most common gastrointestinal symptoms at presentation were abdominal pain (78.7%), vomiting (59.6%), and nausea (55.3%). Transaminase elevation was present in 29.8% of the cases. The most common radiological findings were ascites (36.2%) and pancreatic edema (27.7%). In cases presenting with acute pancreatitis (n=9), intensive care unit admission rates (n=6) were statistically significantly higher. Brain natriuretic peptide (p=0.020) and d-dimer (p=0.032) were statistically significantly higher in the severe group than in the mild to moderate group. 
 Conclusions: In a significant part of the MIS-C cases with gastrointestinal involvement, severe findings is observed. Especially in cases presenting with pancreatitis, a more severe clinical course may be observed. Therefore, when managing patients presenting with gastrointestinal symptoms, the evaluation for pancreatitis is essential.