MIS-C

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MIS-C for Multisystem Inflammatory Syndrome in Children (German for example: Multisystemic Inflammatory Syndrome in Children ) is a novel clinical picture that occurs in children and adolescents in connection with the infection by SARS-CoV-2 in the course of the 2020 COVID-19 pandemic . Another name is PIMS for Pediatric inflammatory multisystem syndrome or PMIS for Pediatric multisystem inflammatory syndrome . The European Center for Disease Prevention and Control (ECDC) designates the syndrome as Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection ( PIMS-TS ).

MIS-C is similar to Kawasaki syndrome , but is said to have a more severe course. The exact delimitation of both clinical pictures is currently (5/2020) still unclear.

After the American Academy of Pediatrics reported the first cases in April 2020, MIS-C was notified by the Royal College of Paediatrics and Child Health (RPCPH) in early May . At the time, more than a hundred children in New York had MIS-C, three of whom died. 230 cases have been reported in Europe. In May 2020, WHO Director General Ghebreyesus called on medical professionals to work with WHO and national health authorities to "better understand" the syndrome. In many cases, the syndrome does not appear until four to six weeks after infection.

Symptoms

According to the WHO, symptoms are based on previous medical data:

  • fever
  • Gastrointestinal problems such as diarrhea, vomiting, and abdominal pain
  • Skin rash on hands, feet or in the mouth and bilateral, non-purulent conjunctivitis
  • Hypotension or shock
  • Features of a dysfunction of the heart muscle, inflammation of the pericardium or valves of the heart
  • Bleeding disorders

In addition, the patients often have high levels of inflammation in their blood counts , have tested positive for Covid-19 or had a positive antigen test. According to Whittaker, clinical lecturer in pediatric infectious diseases and immunology at Imperial College London, MIS-C "has some overlapping features with Kawasaki syndrome, but differs among other things in laboratory results ". It is not yet possible to say “what proportion of corona-infected children develop MIS-C, since no national monitoring data are yet available in countries with a high incidence ”. It is also still unclear whether the inflammatory syndrome is purely a childhood disease or whether adults could also get it.

diagnosis

According to the US Centers for Disease Control and Prevention (CDC), the following diagnostic guidelines apply:

Age under 21 years; severe course of the disease requiring hospitalization (hospital stay) and involvement of more than two organ systems (heart, kidneys, respiratory tract, hematopoietic system, gastrointestinal tract, skin, nervous system); Fever and increased inflammation values ​​in the laboratory; In addition, no plausible other diagnosis and laboratory evidence of current or recent infection with SARS-CoV-2 through direct virus detection (e.g. RT-PCR ) or serology or COVID-19 exposure in the last four weeks before the onset of symptoms.

Web links

Individual evidence

  1. ↑ Rapid risk assessment: Pediatric inflammatory multisystem syndrome and SARS -CoV-2 infection in children. May 15, 2020, accessed May 18, 2020 .
  2. ↑ Distributed via the CDC Health Alert Network May 14, 2020, 4:45 PM ET CDCHAN-00432. Centers of Diseases Control and Prevention, May 14, 2020, accessed May 16, 2020 .
  3. ↑ tt.com (May 16, 2020)
  4. ↑ https://www.welt.de/wissenschaft/article208022243/Lebensbedrohliche-Kind Krankheit- stellen-Aerzte-vor- Raetsel.html
  5. ↑ MIS-C: WHO investigates Kawasaki-like inflammatory disease in children ; RND of May 18, 2020; accessed on May 28, 2020
  6. ↑ Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19)