scholarly journals SARS-CoV-2-Induced Multisystem Inflammatory Syndrome in a Young Adult: Case Report

2021 ◽  
Author(s):  
Haldun Bulut ◽  
Alexandra H. E. Herbers ◽  
Ilse M. G. Hageman ◽  
Paetrick M. Netten ◽  
Hendrik J. M. de Jonge ◽  
...  
Keyword(s):  
Macrophage Activation ◽  
Cardiac Involvement ◽  
Toxic Shock ◽  
Adult Case ◽  
Incomplete Kawasaki Disease ◽  
Volume Loading ◽  
Male Athlete ◽  
Life Threatening ◽  
Cardiac Status ◽  
Inflammatory Syndrome

AbstractWe describe a case of a previous healthy 20-year-old male athlete who presented with an atypical clinical profile with multiorgan involvement within five weeks after confirmed SARS-CoV-2 infection, suggestive for multisystem inflammatory syndrome (MIS); MIS is a rare, potentially life-threatening complication associated with SARS-CoV-2. MIS shares similar clinical features compatible with several overlapping lifethreatening hyperinflammatory syndromes, such as incomplete Kawasaki Disease (KD) and toxic shock syndrome (TSS) associated to a cytokine storm suggestive of a macrophage activation syndrome (MAS) without fulfilling the criteria for hemophagocytic lymphohistiocytosis (HLH), that may create a great challenge to distinguish between them. MIS should promptly be considered and treated, as uncontrolled MIS has a high mortality.In MIS cardiac involvement, heart failure may present as an additional problem, especially because volume loading is advised in accordance with proposed therapy. Carefully monitoring of the respiratory and cardiac status in response of resuscitation is therefore warranted.

scholarly journals SARS-CoV-2-induced Multisystem Inflammatory Syndrome in a Young Adult

2021 ◽  
Author(s):  
haldun bulut ◽  
Alexandra H.E. Herbers ◽  
Ilse M.G. Hageman ◽  
Paetrick M. Netten ◽  
Hendrik J.M. de Jonge ◽  
...  
Keyword(s):  
Heart Failure ◽  
Young Adult ◽  
Clinical Features ◽  
Cardiac Involvement ◽  
Volume Loading ◽  
Male Athlete ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Cardiac Status ◽  
Inflammatory Syndrome

Abstract We describe a case of a previous healthy 20-year-old male athlete who presented with an atypical clinical profile with multiorgan involvement five weeks after confirmed SARS-CoV-2 infection, suggestive for multisystem inflammatory syndrome (MIS). MIS is a rare, potentially life-threatening complication associated with SARS-CoV-2 and shares several similar clinical features with overlapping hyperinflammatory syndromes that may create a great challenge to distinguish between them. MIS should promptly be considered and treated, as uncontrolled MIS has a high mortality. In MIS cardiac involvement, heart failure may present as an additional problem, especially because volume loading is advised in accordance with proposed therapy. Carefully monitoring of the respiratory and cardiac status in response of resuscitation is therefore warranted.

scholarly journals A Novel and Severe Clinical Picture Related to COVID-19: Multi-Inflammatory Syndrome in Children

2021 ◽  
Author(s):  
Fatih Haşlak ◽  
Mehmet Yıldız ◽  
Sezgin Şahin ◽  
Amra Adrovic Yıldız ◽  
Kenan Barut ◽  
...  
Keyword(s):  
Macrophage Activation ◽  
Clinical Findings ◽  
Disease Course ◽  
Toxic Shock ◽  
Active Infection ◽  
Severe Clinical Picture ◽  
Life Threatening ◽  
History Of ◽  
Distinct Features ◽  
Inflammatory Syndrome

Preliminary data have suggested that children have milder COVID-19 disease course compared to adults. However, pediatric cases with severe clinical findings caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) are being reported since April 2020. These children have been presented with significant hyperinflammatory states resembling Kawasaki disease, toxic shock syndrome, and macrophage activation syndrome. However, they had several distinct features, as well. Therefore, this novel condition was considered a unique disease and named Multi-inflammatory syndrome in children (MIS-C). Thus, new concerns have been raised regarding the vulnerability of the children. However, it has been realized that this condition is extremely rare. Nonetheless, considering that it is a life-threatening disease and may cause devastating consequences, clinicians should be aware of MIS-C while evaluating children with persistent fever and history of COVID-19 contact or active infection.

scholarly journals Distinct characteristics of multisystem inflammatory syndrome in children in Poland

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kamila Maria Ludwikowska ◽  
Magdalena Okarska-Napierała ◽  
Natalia Dudek ◽  
Paweł Tracewski ◽  
Jacek Kusa ◽  
...  
Keyword(s):  
Intensive Care ◽  
Macrophage Activation Syndrome ◽  
Macrophage Activation ◽  
Cardiac Involvement ◽  
Pediatric Intensive Care ◽  
Intensive Care Treatment ◽  
Disease Course ◽  
Specific Population ◽  
Inflammatory Syndrome ◽  
Activation Syndrome

AbstractDuring the winter months of 2020/2021 a wave of multisystem inflammatory syndrome in children (MIS-C) emerged in Poland. We present the results of a nationwide register aiming to capture and characterise MIS-C with a focus on severity determinants. The first MIS-C wave in Poland was notably high, hence our analysis involved 274 children. The group was 62.8% boys, with a median age of 8.8 years. Besides one Asian, all were White. Overall, the disease course was not as severe as in previous reports, however. Pediatric intensive care treatment was required for merely 23 (8.4%) of children, who were older and exhibited a distinguished clinical picture at hospital admission. We have also identified sex-dependent differences; teenage boys more often had cardiac involvement (decreased ejection fraction in 25.9% vs. 14.7%) and fulfilled macrophage activation syndrome definition (31.0% vs. 15.2%). Among all boys, those hospitalized in pediatric intensive care unit were significantly older (median 11.2 vs. 9.1 years). Henceforth, while ethnicity and sex may affect MIS-C phenotype, management protocols might be not universally applicable, and should rather be adjusted to the specific population.

Abstract 16566: Presentation and Outcome of Pediatric Multisystem Inflammatory Syndrome Temporally Associated With Sars-cov-2 Pandemic: An International Survey

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Carles Bautista ◽  
Joan Sanchez-de-Toledo ◽  
Clark C Bradley ◽  
Jetrho Herberg ◽  
Fanny Bajolle ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Cardiac Involvement ◽  
Gastrointestinal Symptoms ◽  
Duration Of Symptoms ◽  
Entire Cohort ◽  
Common Presentation ◽  
Increased Risk ◽  
Life Threatening ◽  
The Mean ◽  
Inflammatory Syndrome

Introduction: Following the SARS-CoV-2 pandemic peak, children suffering from a multiorgan inflammatory disease that often leads to shock have been reported. This condition shares features with Kawasaki disease, but its etiopathogenesis is unknown. Hypothesis: We aimed to describe presentation and hospital course for this pediatric inflammatory multisystemic syndrome associated with COVID-19 (PIMS-TS). Methods: Data were collected from a retrospective review of children from 33 participating European, Asian and American sites. Results: We included 183 patients (109 males, 59·6%) with PIMS-TS, at a mean age of 7·0 (±4·7) years. Fifty-six (30·6%) had black ethnicity and obesity was present in 48 (26·2%) cases. Overall, 114/183 (62·3%) had biological evidence of current or recent SARS-CoV-2 infection. At admission, all presented with fever, 117/183 (63·9%) with gastrointestinal symptoms and 79/183 (43·2%) with shock, that was associated with more frequent black ethnicity, higher inflammatory markers and more cardiac involvement. Twenty-seven patients (14·7%) fulfilled criteria for Kawasaki disease. They were younger with no shock, fewer gastrointestinal, cardio-respiratory and neurological symptoms. Among the remaining PIMS-TS patients, 77 (49·3%) had mainly fever and inflammation with less cardiac involvement. For the entire cohort of 183 patients, the mean duration of admission was 8·6 (±5·6) days. Inotropic support, mechanical ventilation and ECMO were indicated in 72 (39·3%), 43 (23·5%) and 4 (2·2%) patients, respectively. Three patients (1·6%) died. A shorter duration of symptoms before admission was a risk factor for worse outcome and for ECMO/death, with 63% increased risk per day reduction (95%CI 0·39-0·93, p=0·03) and with 51·4% increased risk per day reduction (95%CI 0·36-0·9, p=0·03), respectively. Conclusions: We describe the first largest international series of children with PIMS-TS. Life-threatening shock is a common presentation. A shorter duration of symptoms prior to admission characterizes the fulminant form of the disease with potentially worse outcome.

scholarly journals Children’s Multisystem Inflammatory Syndrome, Associated With a New Coronavirus Infection (COVID-19): Relevant Information and Clinical Observation

2020 ◽  
Vol 17 (3) ◽  
pp. 219-229 ◽  
Author(s):  
Marina G. Kantemirova ◽  
Yulia Yu. Novikova ◽  
Dmitry Yu. Ovsyannikov ◽  
Seda Kh. Kurbanova ◽  
Anastasia A. Glazyrina ◽  
...  
Keyword(s):  
Information Search ◽  
Medical Records ◽  
Macrophage Activation ◽  
Clinical Observation ◽  
Relevant Information ◽  
Toxic Shock ◽  
Pubmed Database ◽  
Coronavirus Infection ◽  
Search For Information ◽  
Inflammatory Syndrome

Background. New coronaviral infection (COVID-19) in most cases has less severe course in children than in adults. However, there were reports from the number of European countries and from United States (from March 2020) about children with new disease with signs of Kawasaki disease (KD) and toxic shock syndrome (TSS). So it has received one of the names children’s multisystem inflammatory syndrome (CMIS) associated with COVID-19. The aim of the study is to summarize up-to-date information about this disease.Methods. Information search in PubMed database, CDC (USA) and WHO websites, Search for information in PubMed database, on CDC (USA) and WHO websites, analysis of the medical records of observed patient with CMIS.Results. Clinical and laboratoryinstrumental manifestation and outcomes of CMIS in 120 children from Italy, France, Switzerland, England, USA with similar signs were analyzed. Proposed international diagnostic criteria of the disease in comparison with other phenotypically similar diseases (KD, shock syndrome at KD, TSS of Staphylococcal and Streptococcal etiology, macrophage activation syndrome), clinical observation of patient, algorithm of evaluation and management of patients with CMIS are presented.

COVID-19 CHALLENGE, IN WHICH A THREE-YEAR-OLD GIRL WON

2021 ◽  
Vol 74 (10) ◽  
pp. 2530-2534
Author(s):  
Halyna O. Lytvyn ◽  
Mariia V. Stasiv ◽  
Volodymyr R. Mishchuk ◽  
Iryna Yu. Avramenko
Keyword(s):  
Clinical Laboratory ◽  
Successful Outcome ◽  
Toxic Shock ◽  
Ministry Of Health ◽  
Virus Rna ◽  
Life Saving ◽  
Life Threatening ◽  
Coronavirus Infection ◽  
Inflammatory Syndrome ◽  
Ventilation Of The Lungs

Since March 11, coronavirus infection has become an intercontinental problem – a pandemic has developed.Ukraine (until December 2019) ranks 17th in the world in the number of Covid-19 cases. Although according to statistics, the children are the least vulnerable group for coronavirus infection, unfortunately, severe and serious complications such as pneumonia, Kawasaki disease and Kawasaki-like syndrome, Multisystem inflammatory syndrome in children, toxic shock syndrome, myocarditis occur in children, too. As of the end of November, according to the Ministry of Health in Ukraine, 732,625 cases of coronavirus were laboratory- confirmed, including 13,720 children. According to the Lviv Regional Laboratory Center of the Ministry of Health, in the Lviv region since the beginning of the Covid-19 pandemic, among 46078 of all infected were about 5-6% of children. To analyze clinical, laboratory features of severe coronavirus infection complicated by bilateral pneumonia with acute respiratory distress syndrome (ARDS) in a three-year-old girl who was on V-V ECMO for one week and mechanical ventilation of the lungs for 28 days. The diagnosis was confirmed by detection of SARS-CoV-2 virus RNA by PCR, X-ray and ultrasound examination of the lungs. The disease had a dramatic course but a successful outcome. Life-threatening conditions associated with COVID-19 in children are much less common than in adult patients. However, in some cases, when critical hypoxemia is not eliminated by traditional methods of respiratory support, ECMO can become a life-saving technology and with its timely usage in pediatric patients.

scholarly journals Challenges of Pediatric Multisystem Inflammatory Syndrome Associated with Covid-19 - A Series of Clinical Cases

2020 ◽  
Vol 1 (4) ◽  
pp. 01-03
Author(s):  
Ninel Revenco
Keyword(s):  
Macrophage Activation ◽  
Clinical Presentation ◽  
Signs And Symptoms ◽  
Clinical Aspects ◽  
Toxic Shock ◽  
Epidemiological Evidence ◽  
Organ Systems ◽  
The Republic ◽  
Inflammatory Syndrome ◽  
Inflammation Parameters

Background According to the first SARS-CoV-2 pandemic data, signs and symptoms were less frequently reported among pediatric patients versus adults. Later in April, was described as the multisystem inflammatory syndrome in children (MIS-C) associated with COVID -19. The clinical presentation of MIS-C includes fever, simultaneous involvement of two or more organ systems, altered inflammation parameters and laboratory or epidemiological evidence of SARS-CoV-2 infection. MIS-C features some similar clinical aspects with Kawasaki disease, toxic shock syndrome, and secondary hemophagocytic lymph histiocytosis syndrome / macrophage activation syndrome. This review describes the clinical features of 7 cases of MIS-C treated in the Republic of Moldova.

scholarly journals Macrophage Activation Syndrome in Adults: A Retrospective Case Series

2021 ◽  
Vol 9 ◽  
pp. 232470962110264
Author(s):  
Taylor Warmoth ◽  
Malvika Ramesh ◽  
Kenneth Iwuji ◽  
John S. Pixley
Keyword(s):  
Macrophage Activation Syndrome ◽  
Macrophage Activation ◽  
Pediatric Patients ◽  
Inflammatory Diseases ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
Case Series ◽  
Adult Patients ◽  
Retrospective Case ◽  
Life Threatening ◽  
Activation Syndrome

Macrophage activation syndrome (MAS) is a form of hemophagocytic lymphohistocytosis that occurs in patients with a variety of inflammatory rheumatologic conditions. Traditionally, it is noted in pediatric patients with systemic juvenile idiopathic arthritis and systemic lupus erythematous. It is a rapidly progressive and life-threatening syndrome of excess immune activation with an estimated mortality rate of 40% in children. It has become clear recently that MAS occurs in adult patients with underlying rheumatic inflammatory diseases. In this article, we describe 6 adult patients with likely underlying MAS. This case series will outline factors related to diagnosis, pathophysiology, and review present therapeutic strategies.

scholarly journals Death of unknown cause? Post-mortem diagnosis of fulminant course of an EBV-associated secondary hemophagocytic lymphohistiocytosis

2021 ◽  
Author(s):  
Josia Fauser ◽  
Stefan Köck ◽  
Eberhard Gunsilius ◽  
Andreas Chott ◽  
Andreas Peer ◽  
...  
Keyword(s):  
Immune Response ◽  
Case Report ◽  
Macrophage Activation ◽  
Post Mortem ◽  
Life Threatening ◽  
Appropriate Therapy ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up ◽  
Secondary Hemophagocytic Lymphohistiocytosis

SummaryHLH is a life-threatening disease, which is characterized by a dysregulated immune response with uncontrolled T cell and macrophage activation. The often fulminant course of the disease needs a fast diagnostic work-up to initiate as soon as possible the appropriate therapy. We present herein the case of a 71-year-old patient with rapidly progressive hyperinflammatory syndrome, which post mortem resulted in the diagnosis of EBV-associated HLH. With this case report, we intend to highlight the relevance of the HScore in the diagnosis of HLH, to create a greater awareness for EBV as a trigger of HLH, and to demonstrate the importance of treating EBV-associated HLH as early as possible.

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