New Onset of Hepatic Steatosis Post-Severe Multisystem Inflammatory Syndrome in Children (MIS-C): A Case Report

Sica, Rossella; Pennoni, Serena; Penta, Laura; Cara, Giuseppe Di; Verrotti, Alberto

doi:10.3390/ijerph18136961

Cited by 9 publications

(5 citation statements)

References 21 publications

(28 reference statements)

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“…Laboratory findings of our case are in keeping with similar publications on leukopenia and thrombocytopenia [ 20 , 62 , 63 ] high ferritin, abnormal D-dimer, and elevated troponin [ 20 , 46 , 64 , 65 ]. In contrast to other findings, acute kidney injury (AKI) [ 64 , 66 – 69 ], prolonged coagulation profile, abnormal fibrinogen, and abnormal liver function[ 70 – 73 ] were not observed in our case.…”

Section: Discussioncontrasting

confidence: 99%

An 11-Year-Old Saudi Arabian Girl Who Presented with Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with SARS-CoV-2 Infection with Coronary Artery Aneurysm and Cardiac Involvement: A Case Report

et al. 2021

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Patient: Female, 11-year-old Final Diagnosis: Pediatrics multisystem inflammatory syndrome Symptoms: Cough • fever • shortness of breath Medication: — Clinical Procedure: — Specialty: Infectious Diseases Objective: Unusual clinical course Background: Early in the COVID-19 pandemic, children who were infected with severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) with vascular inflammation were described as having a vasculitis similar to Kawasaki’s disease. There are now consensus clinical guidelines that have described the presentation and diagnosis of multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 infection. This report aims to describe a case of MIS-C in an 11-year-old Saudi Arabian girl who presented with coronary artery aneurysm and cardiac involvement. Case Report: We describe an 11-year-old Saudi girl who was asymptomatic for 3 weeks after contracting SARS-CoV-2. Three weeks after suffering a mild flulike illness, she developed a high fever, cough, and severe clinical deterioration within 12 h of admission, including shock, rash, pleural effusion, high inflammatory markers, and a coronary aneurysm. As per current practice, the diagnosis was confirmed as multisystem inflammatory syndrome based on a SARS-CoV-2 test with reverse transcription polymerase chain reaction (RT-PCR) from 2 nasopharyngeal aspirates. Her condition was successfully treated with antibiotics, inotropes, IVIG, aspirin, and Tocilizumab, in addition to high-flow oxygen therapy. Eventually, she was able to return home after fully recovering. Conclusions: The findings in this report suggest that children with MIS-C due to SARS-CoV-2 infection can have a good prognosis, even when they suffer from coronary artery and cardiac involvement. The increasing number of emerging SARS-CoV-2 variants that affect children supports the importance of RT-PCR for the COVID-19 diagnostic test for children with multisystem or cardiovascular inflammation, which may guide the most appropriate clinical management of the variants of MIS-C.

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Section: Discussioncontrasting

confidence: 99%

An 11-Year-Old Saudi Arabian Girl Who Presented with Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with SARS-CoV-2 Infection with Coronary Artery Aneurysm and Cardiac Involvement: A Case Report

et al. 2021

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“…Giannattasio et al [ 53 ] reviewed 55 pediatric patients (mean age 6.5 ± 3.7 years) with MIS-C and showed that 16 patients had acute liver injury (ALI) at admission and 10 more patients developed ALI during observation, ALI was defined by the presence of ALT elevation > 40 U/L. Furthermore, a 14-year-old boy developed MIS-C after SARS-COV-2 infection which was followed by hepatic steatosis, and the researchers also found elevated levels of ALT, AST and indices of cholestasis[ 54 ]. Another 10-month-old boy developed fulminant acute liver failure due to MIS-C[ 55 ].…”

Section: Indirect Pathophysiological Mechanismsmentioning

confidence: 99%

COVID-19 and liver dysfunction in children: Current views and new hypotheses

Yun¹,

Feng²,

Zhang³

2023

World J Hepatol

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Coronavirus disease 2019 (COVID-19) poses an extremely serious global impact on public healthcare for individuals of all ages, including children. Increasing evidence has shown that liver abnormalities are commonly found in children with COVID-19, and age-related features in innate and adaptive response have been demonstrated. However, there are few reports and studies on COVID-19 related liver injury in children, and the data are scattered. So that many contradictions have arose. This situation is not only due to the serious ethical issues in studying pediatric patients with COVID-19, but also because of the short duration and wide coverage of the COVID-19 epidemic, the severity and complexity of clinical cases varied, as did the inclusion criteria for case reporting and patient outcomes. Therefore, we totaled the incidences, characteristics and pathomechanism of liver injury in children since the COVID-19 outbreak. The etiology of COVID-19-related liver injury is divided into three categories: (1) The direct mechanism involves severe acute respiratory syndrome coronavirus 2 binding to angiotensin-converting enzyme 2 in the liver or bile duct to exert direct toxicity; (2) the indirect mechanisms include an inflammatory immune response and hypoxia; and (3) COVID-19-related treatments, such as mechanical ventilation and antiviral drugs, may cause liver injury. In summary, this minireview provides fundamental insights into COVID-19 and liver dysfunction in children.

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“…This indicates the presence of acute hepatitis with clinical jaundice without biliary obstruction in SARS-CoV-2 infection. 5 Sica et al demonstrated a new onset of hepatic steatosis in a 14-year-old boy patient with SARS-CoV-2 infection, which may be one of the sequelae of severe manifestations of COVID-19, known as MIS-C. 17 Fulminant acute hepatitis was also declared in an The acute liver laceration was found in confirmed COVID-19 infants aged 55 days, with recorded AST levels of 100 U/dL, ALT 84 U/dL, total bilirubin 33.7 mg/dL, and direct 25.2 mg/dL. 18 Moreover, Zhu et al mentioned that 2 of 10 newborns from mothers with confirmed COVID-19 had elevated liver enzyme levels.…”

Section: Manifestations Of Liver Injury In Pediatric Covid-19 Patientsmentioning

confidence: 99%

Liver Injury in Children with COVID-19: A Systematic Review

Wibowo

Sari

Irawan

2023

Arch Pediatr Gastr Hepatol Nutr

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Background: The rapid global spread of coronavirus disease 2019 (COVID-19) infection has become a major health issue with high morbidity and mortality rates. COVID-19 in children showed different unique presentations. Besides respiratory symptoms, a growing body of evidence indicates multi-organ manifestation, including liver involvement. In this regard, several data supported an association between COVID-19 infection and liver injury in adults, while on the other hand, there is compelling but currently limited evidence in children. In this systematic review, we summarize data of updated literature regarding the evidence of acute liver injury in children with COVID-19. Methods: Online scientific articles were explored on PubMed and Google Scholar databases using keywords. The systematic review was performed under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines Results: The literature search yielded 238 articles, of which 16 were identified as relevant to the topic and met the inclusion criteria. A total of 564 pediatric patients were confirmed positive for COVID-19 by PCR examination, involving 298 (52.9%) boys and 266 (47.1%) girls with an age range of 1 day - 17 years. Liver injuries have been reported in pediatric COVID-19 patients, with prevalence ranging from 1.5 to 52%. Conclusion: SARS-CoV-2 virus infection in children shows a unique presentation. Several reports suggest that liver injury correlates with the severity of COVID-19 disease. Therefore, monitoring liver function in COVID-19 patients is important to assess the prognosis.

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New Onset of Hepatic Steatosis Post-Severe Multisystem Inflammatory Syndrome in Children (MIS-C): A Case Report

Cited by 9 publications

References 21 publications

An 11-Year-Old Saudi Arabian Girl Who Presented with Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with SARS-CoV-2 Infection with Coronary Artery Aneurysm and Cardiac Involvement: A Case Report

An 11-Year-Old Saudi Arabian Girl Who Presented with Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with SARS-CoV-2 Infection with Coronary Artery Aneurysm and Cardiac Involvement: A Case Report

COVID-19 and liver dysfunction in children: Current views and new hypotheses

Liver Injury in Children with COVID-19: A Systematic Review

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