Hypothermia in a 6-Week Infant-an Atypical Presentation of Multisystem Inflammatory Syndrome (MIS-C)

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Mukul Pandey ◽  
Keyword(s):  
Organ Dysfunction ◽  
Rare Complication ◽  
Temporal Relation ◽  
Atypical Presentation ◽  
Pediatric Age ◽  
Atypical Case ◽  
Alternative Diagnosis ◽  
Markers Of Inflammation ◽  
Laboratory Markers ◽  
Inflammatory Syndrome

MIS-C is a rare complication of covid-19. The definition across the organizations is based on 6 principle elements: pediatric age, persistence of fever, presence of laboratory markers of inflammation, manifestation of signs or symptoms of organ dysfunction, lacking an alternative diagnosis, and a temporal relation to COVID-19 infection or exposure [1]. We describe an atypical case of MIS-C with myocarditis in a 6-week-old infant presenting with hypothermia rather than fever.

scholarly journals MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN: DIAGNOSTIC MARKERS AND FEATURES OF PHARMACOTHERAPY

2021 ◽  
Vol 17 (1) ◽  
pp. 24-28
Author(s):  
M.V. Кhaitovych ◽  
L.M. Voroniuk ◽  
G.Yu. Borisova ◽  
N.V. Diudenko ◽  
N.M. Miagka
Keyword(s):  
Distress Syndrome ◽  
The United States ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Laboratory Markers ◽  
Mucous Membranes ◽  
Coronavirus Infection ◽  
Polymerase Chain ◽  
Inflammatory Syndrome

Relevance. In 2020, children were hospitalized with fever and multisystem inflammation throughout the world during the COVID-19 pandemic. In the United States, this condition is called MIS-C (Multisystem Inflammatory Syndrome in Children). This syndrome is thought to be similar to the severe course of COVID-19 in adults (cytokine storm). The objective of the work is to evaluate the features of the course and pharmacotherapy of multisystem inflammatory syndrome in children. Materials and methods. The study included 17 children (10 boys and 7 girls) aged 3-16 years (on average – 9.5±3.4 years). Diagnosis of coronavirus infection was performed by polymerase chain reaction with real-time detection, determined the level of immunoglobulins M and G before coronavirus infection. Results. The duration of fever in patients was 5-21 days (average 8.1±4.0 days), the duration of inpatient treatment – 7-35 days (average 15.7±7.0 days). Blood albumin levels were reduced in 53.8% of children; the level of fibrinogen was increased in 88.2% of children, the level of C-reactive protein, ferritin, and D-dimer – in all patients. 15 (88.2%) children had pathology of the digestive system, 13 (76.5%) – cardiovascular system (7 children were diagnosed with carditis, 2 – dilation of coronary arteries, 7 – cardiac arrhythmia). Acute respiratory distress -syndrome was found in a 13-year-old girl, shock - in an 11-year-old boy, 11 children (64.7%) were diagnosed with the pathology of the respiratory system (pleurisy, pneumonia), skin and mucous membranes, and 4 children (23.5%) there were manifestations of central nervous system disorders (meningism, decreased reflexes, ataxia), in 2 (11.8%) – renal failure. On average, each patient had lesions of 3.9 ±1.2 systems. Conclusions. MIS-C was manifested by prolonged fever, high levels of laboratory markers of inflammation, hypoalbuminemia, hypercoagulation, often – pathological manifestations of the cardiovascular, digestive, respiratory systems, skin, and mucous membranes. The treatment included intravenous immunoglobulin, steroids, anticoagulant, and antibacterial therapy and was effective.

An Atypical Presentation of Anton Syndrome in a Patient with Preserved Cognition Despite Multiple Cerebral Infarcts: A Case Report

CNS Spectrums ◽  
2009 ◽  
Vol 14 (1) ◽  
pp. 15-18 ◽  
Author(s):  
Glen P. Davis ◽  
R. Andrew Sewell ◽  
Boaz Levy ◽  
Bruce H. Price ◽  
Miles G. Cunningham
Keyword(s):  
Case Report ◽  
Rare Complication ◽  
Cortical Blindness ◽  
Association Cortex ◽  
Atypical Presentation ◽  
Cerebral Infarcts ◽  
Atypical Case ◽  
Visual Association Cortex ◽  
Advanced Glaucoma ◽  
Visual Problems

Visual anosognosia (Anton syndrome) is a rare complication of cortical blindness that results from injury to the visual association cortex, in which patients who are unable to see deny that they are blind. They sometimes confabulate explanations for their visual problems (“there is not enough light to see”), or endanger themselves in efforts to “prove” that they can see (eg, tripping or walking into walls). Without functioning visual-association centers, these patients lack the concept of sight and are unable to acknowledge their impairment. Usually, Anton syndrome is encountered in patients with bilateral occipital infarcts but no other cause for impaired vision. We present an atypical case of Anton syndrome in which the patient's underlying visual deficit was due to advanced glaucoma.

scholarly journals Rare presentation of MIS in adult COVID patient: Case report and review of literature

2021 ◽  
Vol 9 (1) ◽  
pp. 051-053
Author(s):  
Swati Kapoor ◽  
Ashutosh Bhardwaj ◽  
Gitali Bhagawati ◽  
SM Quadri
Keyword(s):  
Rare Complication ◽  
Fatal Outcome ◽  
Young Male ◽  
Age Group ◽  
Pediatric Age ◽  
Review Of Literature ◽  
Patient Case ◽  
Rare Presentation ◽  
Pediatric Age Group ◽  
Inflammatory Syndrome

Multi inflammatory syndrome (MIS) is a rare complication associated with covid-19 with few cases reported in pediatric age group. This entity is not well studied in adults. We report a case of a young male presented to us in very critical condition and was diagnosed as a case of MIS-A (Multi Inflammatory Syndrome - Adult). He was successfully treated with intravenous immunoglobulin, steroids and other supportive measure. By correct and timely diagnosis of this entity, one can prevent fatal outcome.

scholarly journals Hematuria as an Early Sign of Multisystem Inflammatory Syndrome in Children: A Case Report of a Boy With Multiple Comorbidities and Review of Literature

2021 ◽  
Vol 9 ◽  
Author(s):  
Ana Generalić ◽  
Maša Davidović ◽  
Ivanka Kos ◽  
Kristina Vrljičak ◽  
Lovro Lamot
Keyword(s):  
Case Report ◽  
Left Ventricular Systolic Dysfunction ◽  
Past History ◽  
Rare Complication ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Laboratory Findings ◽  
Persistent Fever ◽  
Markers Of Inflammation ◽  
Inflammatory Syndrome

Introduction: While the clinical course of SARS-CoV-2 infection seems to be milder or asymptomatic within the pediatric population, growing attention has been laid to the rare complication elicited by virus, multisystem inflammatory syndrome in children temporarily associated with COVID-19 (MIS-C). Published definition and criteria of MIS-C include persistent fever, multisystem involvement, and elevated markers of inflammation, without obvious microbial inflammation or other plausible diagnosis. However, the aim of this case report is to emphasize the diversity of symptoms of MIS-C, beyond the defined criteria.Case Presentation: We present a 10-year-old boy with 8p23.1 microdeletion syndrome and multiple comorbidities who initially came to our attention due to hematuria, persistent fever, rash, and elevated markers of inflammation. Within the next 2 days, his condition worsened despite the broad-spectrum antibiotic therapy. Assuming his past history of SARS-CoV-2 exposure, MIS-C was suspected. A high level of clinical suspicion was further supported by significant clinical features (vomiting, abdominal pain, conjunctivitis, arrhythmia, and mild left ventricular systolic dysfunction with pleural effusion) along with laboratory findings (elevated ESR, CRP, proBNP, D-dimers and fibrinogen, positive IgG SARS-CoV-2 antibodies, and negative microbiological cultures). The patient was given intravenous immunoglobulin (IVIG) and began to show instantaneous clinical and laboratory improvement.Conclusion: Despite numerous reports of MIS-C cases in children, there are still many uncertainties regarding the clinical presentation and laboratory findings, as well as mechanisms beyond this intriguing disorder. In our case, for the first time hematuria is reported as an early symptom of MIS-C. We strongly believe that reporting various manifestations and outcomes in MIS-C patients will lead to improved diagnosis, treatment, and overall understanding of this novel inflammatory condition.

scholarly journals COVID-19 in Children

2021 ◽  
Vol 41 (1) ◽  
pp. 15-21
Author(s):  
Diana Didović ◽  
Srđan Roglić ◽  
Lorna Stemberger-Marić ◽  
Ivana Valenčak-Ignjatić ◽  
Andrea Nikčević
Keyword(s):  
Clinical Presentation ◽  
Viral Infections ◽  
Rare Complication ◽  
Older Children ◽  
Symptomatic Infection ◽  
Number Of Children ◽  
Multisystem Involvement ◽  
Laboratory Results ◽  
Inflammatory Syndrome

COVID-19 in children accounts for up to 8% of all the cases and is less severe than in adults. This could be an underestimation. A significant number of children are asymptomatic. Symptomatic infection is hard to distinguish from other respiratory tract viral infections based on symptoms and laboratory results. Anosmia is the only symptom in children that is highly suggestive of COVID-19. Infected children mostly have a positive household member. However, the role of children in SARS-CoV-2 transmission is still controversial. Data suggest that schoolchildren have a greater impact in SARS-CoV-2 transmission compared to younger children. Multisystem inflammatory syndrome in children is a new entity reported since April 2020 and is considered a rare complication of SARS-CoV-2 infection. It occurs in previously healthy older children and adolescents presenting with multisystem involvement and elevated inflammatory markers. Most children respond well to immune-modifying therapy. Treatment of COVID-19 in children is based solely on data received from adults and consists of supportive treatment and, in rare occasions, antiviral therapy (remdesivir), corticosteroids (dexamethasone) and monoclonal antibodies (tocilizumab). Further studies in children are needed in order to better understand this disease. This article discusses clinical presentation and therapeutic options for COVID-19 in children.

Phagocyte-specific calcium-binding S100 proteins as clinical laboratory markers of inflammation

2004 ◽  
Vol 344 (1-2) ◽  
pp. 37-51 ◽  
Author(s):  
Dirk Foell ◽  
Michael Frosch ◽  
Clemens Sorg ◽  
Johannes Roth
Keyword(s):  
Calcium Binding ◽  
Clinical Laboratory ◽  
S100 Proteins ◽  
Markers Of Inflammation ◽  
Laboratory Markers

scholarly journals A Rare Presentation of Transfusional Hemochromatosis: Hypogonadotropic Hypogonadism

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Rifki Ucler ◽  
Erdal Kara ◽  
Murat Atmaca ◽  
Sehmus Olmez ◽  
Murat Alay ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Iron Overload ◽  
Organ Dysfunction ◽  
Hypogonadotropic Hypogonadism ◽  
Thalassemia Major ◽  
Iron Deposition ◽  
Cellular Damage ◽  
Atypical Presentation ◽  
Rare Presentation ◽  
Parenchymal Cells

Hemochromatosis is a disease caused by extraordinary iron deposition in parenchymal cells leading to cellular damage and organ dysfunction.β-thalassemia major is one of the causes of secondary hemochromatosis due to regular transfusional treatment for maintaining adequate levels of hemoglobin. Hypogonadism is one of the potential complications of hemochromatosis, usually seen in patients with a severe iron overload, and it shows an association with diabetes and cirrhosis in adult patients. We describe a patient with mild transfusional hemochromatosis due toβ-thalassemia major, presenting with central hypogonadism in the absence of cirrhosis or diabetes. Our case showed an atypical presentation with hypogonadotropic hypogonadism without severe hyperferritinemia, cirrhosis, or diabetes. With this case, we aim to raise awareness of hypogonadotropic hypogonadism in patients with intensive transfused thalassemia major even if not severe hemochromatosis so that hypogonadism related complications, such as osteoporosis, anergia, weakness, sexual dysfunction, and infertility, could be more effectively managed in these patients.

scholarly journals COVID-19 and Treatment and Immunization of Children—The Time to Redefine Pediatric Age Groups is Here

2021 ◽  
Vol 12 (2) ◽  
pp. e0010
Author(s):  
Klaus Rose ◽  
◽  
Jane M. Grant-Kels ◽  
Earl B. Ettienne ◽  
Oishi Tanjinatus ◽  
...  
Keyword(s):  
United States ◽  
Age Groups ◽  
Drug Approval ◽  
The United States ◽  
The Body ◽  
Kawasaki Syndrome ◽  
Pediatric Age ◽  
Prevention And Treatment ◽  
Control And Prevention ◽  
Inflammatory Syndrome

Children are infected with coronavirus disease 2019 (COVID-19) as often as adults, but with fewer symptoms. During the first wave of the COVID-19 pandemic, multisystem inflammatory syndrome (MIS) in children (MIS-C), with symptoms similar to Kawasaki syndrome, was described in young minors testing positive for COVID-19. The United States (US) Centers for Disease Control and Prevention (CDC) defined MIS-C as occurring in <21-year-olds, triggering hundreds of PubMed-listed papers. However, postpubertal adolescents are no longer children biologically; the term MIS-C is misleading. Furthermore, MIS also occurs in adults, termed MIS-A by the CDC. Acute and delayed inflammations can be triggered by COVID-19. The 18th birthday is an administrative not a biological age limit, whereas the body matures slowly during puberty. This blur in defining children leads to confusion regarding MIS-C/MIS-A. United States and European Union (EU) drug approval is handled separately for children, defined as <18-year-olds, ascribing non-existent physical characteristics up to the 18th birthday. This blur between the administrative and the physiological meanings for the term child is causing flawed demands for pediatric studies in all drugs and vaccines, including those against COVID-19. Effective treatment of all conditions, including COVID-19, should be based on actual physiological need. Now, the flawed definition for children in the development of drugs and vaccines and their approval is negatively impacting prevention and treatment of COVID-19 in minors. This review reveals the necessity for redefining pediatric age groups to rapidly establish recommendations for optimal prevention and treatment in minors.

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