Multisystemic Inflammatory Syndrome in Children Associated With SARS-CoV-2 Infection: A Case Series Report in a Pediatric Center in Mexico

Miguel Garcia-Dominguez, Yanin Angeles-Meneses, Angelica Lares-Payan, Carlos Alberto Velazquez-Rios, Edgardo Tostado Morales, Giordano Perez-Gaxiola

Abstract


We report four cases of patients with multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, of which three patients presented characteristics of Kawasaki disease (KD). All presented fever of more than 3 days, and gastrointestinal involvement, significant increase in C-reactive protein (CRP), polymorphonuclear cells, procalcitonin, D-dimer, fibrinogen and troponin, lymphopenia and hypoalbuminemia. Myocardial involvement was observed in two patients. All were treated with fluids resuscitation and vasoactive therapy, 75% received intravenous immunoglobulin (IVIG) and systemic steroids. Two patients developed a transient acute kidney injury, one patient presented as acute appendicitis and developed a bilateral pleural effusion. One patient required a second dose of IVIG and boluses of methylprednisolone. None required mechanical ventilation and there were no deaths.




J Med Cases. 2020;11(12):375-378
doi: https://doi.org/10.14740/jmc3584

Keywords


SARS-CoV-2; COVID-19; Multisystem inflammatory syndrome in children; Kawasaki disease; Kawasaki disease shock syndrome; Myocarditis

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