Novel Presentation of Pediatric Inflammatory Multisystem Syndrome Temporally Associated with COVID-19

Abstract

Pediatric inflammatory multisystem syndrome temporally associated with coronavirus disease 2019 (COVID-19) is an emerging rare disease reported in children 4 to 6 weeks after a usually asymptomatic COVID-19 infection. Though it usually presents as a Kawasaki-like illness or toxic shock syndrome, other multisystem presentations have been reported. Presentation as hemiplegia, however, is rare. Here, we describe a child with acute hemiplegia and rapidly progressive shock, who responded dramatically to steroids and intravenous immunoglobulin and experienced a full recovery. By reporting this case, we wish to add to the literature this atypical presentation of this novel disease, and highlight the importance of quickly diagnosing and treating this life-threatening disease.

Thrombotic Events in MIS-C Patients: A Single Case Report and Literature Review

“…We retrospectively reviewed the clinical history of 60 MIS-C patients who experienced TEs (37 studies) and we collected epidemiological, clinical, laboratory, and treatment data ( Table 1 ) [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ].…”

“…Arterial thrombosis was involved the central nervous system in 25 patients (41.7%), pulmonary arteries in 8 (13.3%), and coronary arteries in 6 (10%). Renal arteries were affected in four patients (6.7%), whereas thrombosis of carotid arteries, peripheric systemic arteries, and the aorta were reported in two patients (3.3%) [ 10 , 11 , 12 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 22 , 24 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 35 , 36 , 37 , 38 , 40 , 41 , 42 , 43 , 44 , 45 , 47 ]. Venous thrombosis affected the deep veins of the lower and upper limbs in six (10%) and five (8.3%) of patients, respectively [ 10 , 15 , 21 , 27 , 43 ].…”

“…Inotropic support was required in 24 patients (24%) [ 11 , 13 , 14 , 17 , 18 , 19 , 21 , 22 , 24 , 26 , 27 , 30 , 31 , 32 , 33 , 36 , 37 , 38 , 39 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 49 ].…”

“…Heparin was administered to 35 patients (74.4%), and antiplatelet therapy to 20 (42.5%). Nine patients (19.1%) underwent thrombectomy, six (12.8%) received thrombolysis treatment, and in one case (2.1%) apixaban was used [ 11 , 12 , 13 , 14 , 17 , 18 , 19 , 21 , 24 , 26 , 27 , 28 , 29 , 30 , 31 , 33 , 36 , 37 , 38 , 39 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ].…”