Multisystem Inflammatory Syndrome in Children Admitted to a Tertiary Pediatric Intensive Care Unit

• Published in: Journal of pediatric intensive care 2023-03, Vol.12 (1), p.037-043
• Main Authors: Gün, Emrah, Kendirli, Tanıl, Botan, Edin, Türker, Nazmiye, Gurbanov, Anar, Balaban, Burak, Gencay, Ali Genco, Arga, Gül, Karagözlü, Selen, Ramoglu, Mehmet Gökhan, Özdemir, Halil, Ucar, Tayfun, Tutar, Ercan, Ciftci, Ergin
• Format: Article
• Language: English
• Subjects: Original; Original Article
• ISSN: 2146-4618; 2146-4626
• DOI: 10.1055/s-0041-1733943

Abstract Background  Multisystem inflammatory syndrome in children (MIS-C) is characterized by persistent fever, abdominal pain, vomiting, diarrhea, rash, conjunctivitis, headaches, and mucocutaneous manifestations and it can cause circulatory dysfunction, resulting in hypotension, shock, and end-organ injury in the heart and other organs and possibly death. In this study, we aimed to analyze the clinical spectrum, treatment options and outcomes of children with MIS-C who were admitted to our pediatric intensive care (PICU). Materials and Methods  Clinical and laboratory findings and treatment of the patients admitted to the PICU with MIS-C between April 2020 and January 2021 were recorded, and their outcomes were evaluated. Results  Nineteen patients with a median age of 12.5 years (interquartile range (IQR): 5.8–14.0 years) were admitted. Eleven (57.8%) were males. The most frequent clinical and laboratory features were fever (100%), abdominal pain (94.7%), rash (63.1%), headache (68.4%), diarrhea (47.3%), seizure (10.5%), cardiac dysfunction (52.6%), acute kidney injury (26.3%), lymphopenia (84.2%), and thrombocytopenia (36.8%). However, 8 patients needed mechanical respiratory support, 11 patients needed inotropes, 2 patients needed plasma exchange, and 1 patient needed continuous renal replacement therapy. All patients received corticosteroids, 17 patients (89.2%) received intravenous immunoglobulin, 2 patients received anakinra, 10 patients received acetylsalicylic acid, and 6 patients received enoxaparin. Median PICU length of stay was 3 days (IQR: 2–5) and only one patient died. Conclusion  In conclusion, MIS-C may present with a variety of clinical manifestations, and it can lead to life-threatening critical illness. Most children need intensive care and the response to immunomodulation is usually favorable.