A Case of COVID-19-Associated Pediatric Multisystem Inflammatory Syndrome in Shock Managed by Cytokine Filtration

Multisystem inflammatory syndrome in children (MIS-C) after COVID-19 has been recognized as a complication arising due to cytokine storm. Several management strategies including intravenous immunoglobulin and immunomodulators have been reported. This case report highlights the use of a cytokine filt...

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Bibliographic Details
Published in:Case reports in pediatrics 2022-02, Vol.2022, p.3373289-5
Main Authors: Lalwani, Priyanka, Baskaran, Subashini, Uribe, Diego Arango, Ramaiah, Anil, Saqib, Aqdas, ElMesserey, Mohammed, Fathi, Emad M., Tabata, Yuichi, Fink, Christoph, Pallavidino, Marco
Format: Article
Language:English
Subjects:
Case Report
Case reports
Coronary vessels
Coronaviruses
COVID-19
Cytokine storm
Cytokines
Enzymes
Fever
Infections
Intensive care
Medical technology
Multisystem inflammatory syndrome in children
Pathophysiology
Pediatrics
Sepsis
Serology
Severe acute respiratory syndrome coronavirus 2
Steroids
Tumor necrosis factor-TNF
Veins & arteries
Viral infections
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Summary:Multisystem inflammatory syndrome in children (MIS-C) after COVID-19 has been recognized as a complication arising due to cytokine storm. Several management strategies including intravenous immunoglobulin and immunomodulators have been reported. This case report highlights the use of a cytokine filter (oXiris®) in the management of MIS-C. Cytokine filters eliminate cytokines and reduce the demand for vasopressors in patients with other inflammatory conditions. A 7-year-old child with prolonged fever, vomiting, hypotension, elevated inflammatory mediators, and dilatation of coronary arteries on echocardiography was found to have positive SARS-CoV-2 IgG and PCR. He was diagnosed as MIS-C and was managed in the pediatric intensive care unit. He required ventilatory support, vasopressors, and continuous renal replacement therapy (CRRT) with a cytokine filter. He showed marked improvement within 24 hours of initiating CRRT. Cytokine filters may have a potential role in the management of severely ill children due to MIS-C. To our knowledge, this is the first report of successful use of the oXiris® membrane in MIS-C. However, further case series and controlled trials are needed to establish its use in this condition.
ISSN:2090-6803
2090-6811
DOI:10.1155/2022/3373289