Background: World Health Organization (WHO) and other Health officials alert clinicians about a rare but severe inflammatory condition seen in children and linked to Corona Virus Disease 2019(COVID-19). The WHO is describing the condition as a multisystem inflammatory syndrome in children (MIS-C) and is recommending clinicians to report those cases to get a better understanding of the disease and clinicians can learn more.Case presentation: We are reporting the clinical course of the youngest case of COVID-19 related MIS-c; a two-week-old term neonate with COVID-19 infection and features suggestive of MIS-C , managed with intravenous immunoglobulin (IVIG), pulse steroid, and interleukin-1 inhibitor (Anakinra).By reviewing the literature, our baby is the first neonatal case who has been diagnosed with MIS-C.Conclusion: COVID-19 infection in pediatrics are likely to present with a mild course; however, some may develop a hyper-inflammatory syndrome. Pediatricians should be aware of such presentation, the clinical course, the management modalities, and inform parents and caregivers about common signs and symptoms. Anakinra may consider as effective second agent in (IVIG and steroid-refractory pediatric cases).
RATIONALE: This is the first study for the etiology and characteristics of the children presenting to the Qatar Pediatric Emergency Centers (PEC) with anaphylaxis. METHODS: Records of patients less than 14 years in the last 6 years were studied. National Institute of Allergy and Infectious Diseases/ Food Allergy and Anaphylaxis Network for Anaphylaxis diagnosis was used for categorization. RESULTS: Of the 1051 files studied, 390 were analyzed to be anaphylaxis with an incidence of 13.3 per 100,000 visits .Females encompassed 31% and mean age was 3 years with 17% below 1 year. Food covered 54% of the etiology with 20% tree nuts, 14% mixed nuts, 5% dairy products, 4% each for sesame seeds and eggs and 2% seafood. Insect venom was 25% with 48% of them black ants, medications 7%, aeroallergens 3% and idiopathic 10%. There was 1 case each for camel milk, latex and MMR vaccine. PICU admission was seen in only 5 asthmatic cases with no fatalities. Recurrent anaphylaxis was seen in 55%, biphasic in 2%. Of the comorbidities, asthma and eczema were 42% and 27% respectively. Adrenaline being first line treatment was injected in 91% and 83% were prescribed auto-injectors upon discharge. While 82% were given a referral for Allergy and Immunology Clinic, 60% were followed up and investigated. CONCLUSIONS: Anaphylaxis is common affecting 1/1000 Qatari pediatric population. While food allergy was the commonest cause, black ant was also prominent. Recognition of anaphylaxis, its etiology and management, both at physician and patient level needs to be achieved.
Hypomagnesemia is a common finding in hospitalized patients mostly overlooked and rarely given as much attention as other electrolyte disturbances. This case report and literature review highlight how hypomagnesemia is common in patients who have a prolonged hospital stay. in addition, we highlight the multiple causes of hypomagnesemia and discuss them further with a literature review.
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