We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
A POST COVID MULTI SYSTEMIC INFLAMMATORY SYNDROME VERSUS AN ATYPICAL KAWASAKI DISEASE -- A CASE REPORT.
- Authors
Amram, Yael; Bodescu, Virginia
- Abstract
Background: Multi-systemic inflammatory syndrome(MIS-C) is a rare complication of COVID-19 in children. It is a hyper-inflammation state marking a severe illness and involvement of multiple organ systems. Kawasaki disease(KD), is an acute medium-sized vasculitis. It is a rare disease of an unknown etiology but is mostly preceded by an infectious disease. Both conditions usually present with fever, rash, cervical lymphadenopathy, neurological symptoms, and extremity changes. But Kawasaki usually involves conjunctivitis and oral mucosal changes while MIS-C has mostly presented GI symptoms, myocarditis, and coagulopathy. Material and methods: This paper is a case report of a 2.10-year-old boy with a COVID infection history, suspected with MIS-C later to be diagnosed with an atypical Kawasaki disease. It is a rare case involving both complications, highlighting the differences between the 2 conditions. Results: A 2.10-year-old presented to the emergency department after several days with rhinorrhea, dysphagia, and fever unresponsive to antipyretics. The labs came back with a marked elevation of inflammatory markers, D-dimers, and increased anti-SARSCOV2 antibodies. For this reason, it was concluded to be a multi-systemic inflammatory syndrome of COVID. The treatment began with corticosteroids, anticoagulants, diuretics, rehydration, and symptomatic infusions. A day after, a right peripheral facial paresis was detected during the physical examination, and a treatment with group B vitamins and Piracetam was initiated. In the next 2 days, the fever has subsided and the inflammatory markers have decreased. Until he suddenly developed a fever again but this time accompanied by a rash, pancytopenia, and an increase in LDH, transaminases, ferritin, and d-dimers. Treatment with IV IG has begun and a cardiology exam revealed coronary dilations. An anticoagulant and an antiaggregant were added to the treatment and even though not all criteria were filled, a Kawasaki diagnosis was made -- an atypical form. The administration of IVIG has shown a favorable evolution and the remission of fever, rash, and inflammatory markers, in a couple of days. A relapse with fever and returning rash occurred a week later but with reinstating IV IG and CS the patient's state was evolving well again. Conclusions: This case was interpreted in the end as an MIS-C evolving later into an atypical KD. This case is a good example of the overlapping in the clinical presentation of MIS-C and KD. The first phase of the disease, with neurological manifestations and SARSCOV2 antibodies, pointed at MIS-C. In a later phase, coronary dilations were indicative of KD since MIS-C is more commonly manifested with myocardial changes.
- Subjects
GERMANY; POST-acute COVID-19 syndrome; CONFERENCES &; conventions; MULTISYSTEM inflammatory syndrome; MUCOCUTANEOUS lymph node syndrome
- Publication
Acta Marisiensis. Seria Medica, 2024, Vol 70, p16
- ISSN
2668-7755
- Publication type
Article