Multisystem inflammatory syndrome Children

As the illness is so new, symptoms are still being documented and they may vary from child to child.

The main thing to watch for is a persistent fever that lasts 24 hours or longer, child appear fatigued and ill, or loss of appetite or not drinking enough fluids.
Specific features of multisystem inflammatory syndrome in Children ( MIS-C) include –
• Kawasaki-like symptoms
Rash, blood-shot eyes, swollen hands and feet, cracked lips, a swollen tongue that looks like a strawberry and an enlarged lymph node in the neck.
• Toxic shock -like symptoms
Severe flu-like symptoms with high fever, as well as a suburn- like rash, low blood pressure, and a very high heart rate.
• Gastrointestinal symptoms
Diarrhoea, vomitting, abdominal pain
• Respiratory symptoms
Persistent cough and shortness of breath, that have been reported in COVID-19, may or may not be present.
Emergency warning signs of MIS-C
• Severe stomach pain
• Difficulty breathing
• Pale, gray or blue-colored Skin, lips or mail beds- depending on skin tone
• New confusion
• In ability to wake up or stay awake
Causes of MIS- C

The exact cause of MIS-C is not known yet, but it appears to be an excessive immune response related to COVID-19.
Many children with MIS-C have a positive antibody test result. This means they have had a recent infection with the COVID-19 virus.
Some may have a current infection with the virus.
Risk Factors of MIS-C
Most children with MIS-C are between the ages of 3-12 years old, with an average age of 8 years.
Some cases have aIso occurred in older Children and babies.
Complications of MIS-C

Without early diagnosis and appropriate management and treatment, MIS-C can lead to severe problems with vital organs,such as the heart, lungs or kidneys. In rare cases, MIS-C could result in permanent damage or even death.
Diagnosis of MIS-C
An antibody test with a positive result means that the child’s immune system developed blood proteins that fought the COVID virus.
In addition to doing antibody testing and a clinical assessment, doctors may order some of these tests to look for inflammation and other signof MIS-C:

• Lab tests, such as blood and urine tests, including tests that look for an abnormal level of inflammatory markers in the blood
• Imaging tests such as a Chest X-ray, an echocardiogram, an abdominal ultrasound or a CT-scan
Treatment of MIS-C

Most children with MIS-C need to be treated in a hospital’s paediatric intensive care unit.Treatment usually involves supportive care and measures to reduce inflammation in any affected vital organs to protect them from permanent damage.
Supportive care may include-
• Fluids, if dehydration is  present
• Oxygen to help with breathing
• Blood pressure medications to normalize low BP related to shock or to help with heart function
• Ventilator support
• Medication like aspirin or heparin to reduce risk of blood clots
Treatment to reduce swelling and inflammation may include –
• Antibiotics
• Steroid therapy
• Intravenous immunoglobulin (IVIG)
• Targeted therapies aimed at reducing high levels of proteins called cytokines, which can cause inflammation.