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

Martina Giacalone, Eric Scheier, Itai Shavit

2021International Journal of Emergency Medicine36 citationsDOIOpen Access PDF

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.

Topics & Concepts

MedicineProcalcitoninAngiologyKawasaki diseaseDiseaseSystemic inflammatory response syndromeFibrinogenFerritinImmunologyAcute coronary syndromeInflammationInternal medicineImmune systemMyocarditisIntensive care medicineSepsisMyocardial infarctionArteryKawasaki Disease and Coronary ComplicationsCoronary Artery AnomaliesMechanical Circulatory Support Devices