multisystem inflammatory syndrome in children (MIS-C)
Last edited 06/2021 and last reviewed 08/2021
Multisystem inf lammatory syndrome in children (MIS-C)
- a presumed post-infectious complication of coronavirus disease 2019 (Covid-19)
- caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
- MIS-C has a prominent cardiovascular involvement, including:
- shock,
- echocardiographic findings of decreased function,
- and coronary-artery aneurysms
- case definition of MIS-C stated is based on:
- serious illness leading to hospitalization,
- an age of less than 21 years,
- fever (body temperature, >38.0°C) or report of subjective fever lasting at least 24 hours,
- laboratory evidence of inflammation, multisystem organ involvement (i.e., involving at least two organ systems),
- and laboratory-confirmed SARS-CoV-2 infection (positive SARS-CoV-2 real-time reverse-transcriptase- polymerase-chain-reaction [RT-PCR] or antibody test during hospitalization) or an epidemiologic link to a person with suspected or confirmed Covid-19 within 4 weeks before the onset of MIS-C symptoms
- there are similarities between MIS-C and Kawasaki's disease, a vasculitis of childhood that can cause coronary-artery aneurysms and sometimes a shock-like presentation
- evidence shows that initial treatment with intravenous immune globulin (IVIG) plus glucocorticoids was associated with a lower risk of new or persistent cardiovascular dysfunction than IVIG alone (1)
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