COVID-19-associated multisystem inflammatory syndrome in children: Experiences of three centres in Turkey

• Published in: Modern rheumatology Vol. 32; no. 2; pp. 460 - 466
• Main Authors: Salman, Hakan, Aslan, Nagehan, Akçam, Mustafa, Arslan, Müjgan, Akkuzu, Emine, Yılmaz Keskin, Ebru, Açarı, Ceyhun, Keskin, Mahmut, Atar, Müge, Köşker, Muhammet, Sinanoğlu, Selçuk, Çetin, Hasan, Akçam, Füsun Zeynep
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 28.02.2022
• Subjects: Child; COVID-19 - complications; Humans; Original; SARS-CoV-2; Systemic Inflammatory Response Syndrome - complications; Systemic Inflammatory Response Syndrome - diagnosis; Turkey; United States; United States; Turkey; COVID-19; gastrointestinal; Kawasaki disease; multisystem inflammatory syndrome in children; pandemic
• ISSN: 1439-7595; 1439-7609
• DOI: 10.1093/mr/roab042

The pathogenesis and clinical manifestations of the multisystem inflammatory syndrome in children (MIS-C) has not yet been fully elucidated and there is no clear consensus on its treatment yet. To evaluate our patients diagnosed with MIS-C and present them to the literature in order to contribute to the better understanding of this new disease, which entered paediatric practice with the SARS-CoV-2 peak. In this study, 17 MIS-C cases diagnosed according to the Centers for Disease Control and Prevention criteria were included. Of the patients, 7 (41.2%) had a comorbidity. Gastrointestinal system involvement was the most prominent in the patients (70.6%). Laparotomy was performed in 3 patients due to acute abdomen. Two patients had neurological involvement. Of the patients, 15 (88.2%) received intravenous immunoglobulin and 13 (76.5%) received both intravenous immunoglobulin and methylprednisolone. Two patients received invasive mechanical ventilation and 4 patients received high flow rate nasal cannula oxygen therapy. One of our patients who needed invasive mechanical ventilation and high vasoactive-inotrope support died despite all supportive treatments including plasmapheresis and extracorporeal membrane oxygenation. MIS-C picture can have a fatal course and may present with severe gastrointestinal and neurological signs. Unnecessary laparotomy should be avoided.