Back المتلازمة الالتهابية متعددة الأجهزة عند الأطفال Arabic Síndrome inflamatòria multisistèmica pediàtrica Catalan Multisystem inflammatory syndrome in children Danish MIS-C German Πολυσυστηματικό φλεγμονώδες σύνδρομο των παιδιών Greek Síndrome inflamatorio multisistémico infantil Spanish PIMS Finnish Syndrome inflammatoire multisystémique chez l'enfant French Sindrom inflamasi multisistem pada anak ID Sindrome infiammatoria multisistemica pediatrica Italian

Multisystem inflammatory syndrome in children

Paediatric multisystem inflammatory syndrome (PMIS/PIMS/PIMS-TS)
Other names
  • Multisystem inflammatory syndrome in children (MIS-C)[1]
  • Multisystem inflammatory syndrome (MIS) in children and adolescents temporally related to COVID-19[2]
  • Paediatric inflammatory multisystem syndrome (PIMS), temporally associated with SARS-CoV-2 infection (PIMS-TS)[3]
  • Kawa-COVID-19[4]
  • Systemic Inflammatory Syndrome in COVID-19 (SISCoV)[5]
TEM image of SARS-CoV-2, the coronavirus responsible for COVID-19:
PMIS / MIS-C is thought to be caused by an unusual biological response to infection in certain children
SpecialtyPaediatrics
SymptomsFever, abdominal pain, diarrhoea/vomiting, low blood pressure, insufficient blood supply (shock), pink eye, "strawberry tongue", rashes, large lymph nodes, swollen hands/feet, neurological disturbances, among others
ComplicationsCardiac dysfunction; coronary artery abnormalities, including aneurysms; acute kidney injury; coagulopathy
Usual onsettypically 2–6 weeks[6] after COVID-19 exposure
CausesSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Diagnostic methodClinical evaluation by specialists
Differential diagnosisAlternative infectious/non-infectious causes, Kawasaki disease
TreatmentIntravenous immunoglobulin (IVIG); corticosteroids; oxygen, supportive care
PrognosisResponse to treatment, generally good; long-term prognosis, unclear[7]
FrequencyRare
Deaths<2% of reported cases

Multisystem inflammatory syndrome in children (MIS-C), or paediatric inflammatory multisystem syndrome (PIMS / PIMS-TS), or systemic inflammatory syndrome in COVID-19 (SISCoV), is a rare systemic illness involving persistent fever and extreme inflammation following exposure to SARS-CoV-2, the virus responsible for COVID-19.[7] Studies suggest that MIS-C occurred in 31.6 out of 100,000 people under 21 who were infected with COVID-19.[8][9] MIS-C has also been monitored as a potential, rare[10] pediatric adverse event following COVID-19 vaccination.[11] Research suggests that COVID-19 vaccination lowers the risk of MIS-C, and in cases where symptoms develop after vaccine, is likely extremely rare or related to factors like recent exposure to COVID-19.[12] It can rapidly lead to medical emergencies such as insufficient blood flow around the body (a condition known as shock).[7] Failure of one or more organs can occur.[13] A warning sign is unexplained persistent fever with severe symptoms following exposure to COVID-19.[14] Prompt referral to paediatric specialists is essential, and families need to seek urgent medical assistance.[7] Most affected children will need intensive care.[7]

All affected children have persistent fever.[7] Other clinical features vary.[14] The first symptoms often include acute abdominal pain with diarrhoea or vomiting.[7] Muscle pain and general tiredness are frequent,[7] and low blood pressure is also common.[15] Symptoms can also include pink eye, rashes, enlarged lymph nodes, swollen hands and feet, and "strawberry tongue".[6] Various mental disturbances are possible.[6] A cytokine storm may take place,[16] in which the child's innate immune system stages an excessive and uncontrolled inflammatory response.[17] Heart failure is common.[15] Clinical complications can include damage to the heart muscle, respiratory distress, acute kidney injury, and increased blood coagulation.[18] Coronary artery abnormalities can develop (ranging from dilatation to aneurysms).[6]

This life-threatening disease has proved fatal in under 2% of reported cases.[7] Early recognition and prompt specialist attention are essential.[19] Anti-inflammatory treatments have been used, with good responses being recorded for intravenous immunoglobulin (IVIG), with or without corticosteroids.[20] Oxygen is often needed.[7] Supportive care is key for treating clinical complications.[18] Most children who receive expert hospital care survive.[7]

Knowledge of this newly described syndrome is evolving rapidly.[21] Its clinical features may appear somewhat similar to Kawasaki disease, a rare disease of unknown origin that typically affects young children, in which blood vessels become inflamed throughout the body.[15] It can also show features of other serious inflammatory conditions of childhood, including toxic shock and macrophage activation syndromes.[15] Nevertheless, it appears to be a separate syndrome.[22] Older children tend to be affected.[23]

This emerging condition has been defined slightly differently (using different names), by the World Health Organization (WHO),[24] the Royal College of Paediatrics and Child Health (RCPCH),[13] and the Centers for Disease Control and Prevention (CDC).[1] Although the condition is thought to follow SARS-CoV-2 viral infection, antigen or antibody tests are not always positive.[3] Exclusion of alternative causes, including bacterial and other infections, is essential for differential diagnosis.[3] Some general clinical guidance has been provided by the RCPCH,[13] the National Institutes of Health,[23] the American College of Rheumatology,[25] and the American Academy of Pediatrics.[26]

Clusters of new cases have been reported two to six weeks after local peaks in viral transmission.[6] The disease is thought to be driven by a delayed biological mechanism in certain predisposed children.[20] The European Centre for Disease Prevention and Control (ECDC) has rated risk to children in Europe as being 'low' overall, based on a 'very low' likelihood of a child developing this 'high impact' disease.[3] Regarding ethnicity, the condition seems to affect more children of African, Afro-Caribbean, and Hispanic descent, whereas Kawasaki disease affects more of East Asian ancestry.[19] Initial reports regarded children in various parts of Europe and the United States, and it was unclear to what extent the condition had gone unrecognized elsewhere.[24] Reports have since emerged of cases in various other countries around the world.[27][28] In adults, a similar condition has occasionally been reported, which has been called multisystem inflammatory syndrome in adults (MIS-A).[29]

  1. ^ a b Cite error: The named reference CDC2020 was invoked but never defined (see the help page).
  2. ^ "Case Report Form for suspected cases of multisystem inflammatory syndrome (MIS) in children and adolescents temporally related to COVID-19". www.who.int. World Health Organization. Archived from the original on 24 June 2020.
  3. ^ a b c d "Rapid risk assessment: Paediatric inflammatory multisystem syndrome and SARS-CoV-2 infection in children" (PDF). European Centre for Disease Prevention and Control. 15 May 2020. Archived from the original on 15 May 2020.
  4. ^ Cite error: The named reference Pouletty2020 was invoked but never defined (see the help page).
  5. ^ Dhar D, Dey T, Samim MM, et al. (2021). "Systemic inflammatory syndrome in COVID-19-SISCoV study: systematic review and meta-analysis". Pediatric Research. 91 (6): 1334–1349. doi:10.1038/s41390-021-01545-z. PMC 8128982. PMID 34006982.
  6. ^ a b c d e Cite error: The named reference ACR1 was invoked but never defined (see the help page).
  7. ^ a b c d e f g h i j k Cite error: The named reference Ahmed2020 was invoked but never defined (see the help page).
  8. ^ "Multisystem Inflammatory Syndrome in Children (MIS-C): Information for Healthcare Providers About Talking with Families and Caregivers". Centers for Disease Control. Retrieved 3 June 2024.
  9. ^ Payne, Amanda B.; Gilani, Zunera; Godfred-Cato, Shana (2021). "Incidence of Multisystem Inflammatory Syndrome in Children Among US Persons Infected With SARS-CoV-2". JAMA Netw Open. doi:10.1001/jamanetworkopen.2021.16420. PMC 8193431.
  10. ^ Zhang M, Zhang P, Liang Y, et al. (2022). "A systematic review of current status and challenges of vaccinating children against SARS-CoV-2". Journal of Infection and Public Health. 15 (11): 1212–1224. doi:10.1016/j.jiph.2022.10.006. PMC 9557115. PMID 36257126.
  11. ^ "Adverse Events Following Immunization (AEFIs) for COVID-19 in Ontario: December 13, 2020 to January 30, 2022" (PDF). Public Health Ontario. Retrieved 11 February 2022.
  12. ^ Jain, Eisha; Donowitz, Jeffrey R.; Aarons, Elizabeth; Marshall, Beth C.; Miller, Michael P. (May 2022). "Multisystem Inflammatory Syndrome in Children after SARS-CoV-2 Vaccination". Emerging Infectious Diseases. 28 (5): 990–993. doi:10.3201/eid2805.212418. PMC 9045439. PMID 35275051.
  13. ^ a b c "Guidance - Paediatric multisystem inflammatory syndrome temporally associated with COVID-19 (PIMS)". RCPCH. Royal College of Paediatrics and Child Health. May 2020. Archived from the original on 16 June 2020.
  14. ^ a b Cite error: The named reference AAP-interim was invoked but never defined (see the help page).
  15. ^ a b c d Cite error: The named reference Sperotto2020 was invoked but never defined (see the help page).
  16. ^ Cite error: The named reference Rowley2020 was invoked but never defined (see the help page).
  17. ^ Cite error: The named reference Alunno2020 was invoked but never defined (see the help page).
  18. ^ a b Cite error: The named reference Aronoff2020 was invoked but never defined (see the help page).
  19. ^ a b Cite error: The named reference ACRdraft was invoked but never defined (see the help page).
  20. ^ a b Cite error: The named reference Rajapakse2020 was invoked but never defined (see the help page).
  21. ^ Cite error: The named reference WNY2020 was invoked but never defined (see the help page).
  22. ^ Cite error: The named reference Abrams2020 was invoked but never defined (see the help page).
  23. ^ a b Cite error: The named reference NIHchildren was invoked but never defined (see the help page).
  24. ^ a b Cite error: The named reference WHO2020 was invoked but never defined (see the help page).
  25. ^ Cite error: The named reference Pond2020 was invoked but never defined (see the help page).
  26. ^ Hester, M (21 July 2020). "AAP issues interim guidance for MIS-C". Contemporary Pediatrics. Archived from the original on 21 July 2020.
  27. ^ Cite error: The named reference Jiang2020 was invoked but never defined (see the help page).
  28. ^ Cite error: The named reference Ulloa2020 was invoked but never defined (see the help page).
  29. ^ Cite error: The named reference Morris2020 was invoked but never defined (see the help page).

Rich TVX News Network Site

Rich TVX News Network Info

© MMXXIII Rich X Search. We shall prevail. All rights reserved. Rich X Search