Multisystem inflammatory syndrome in children (MIS-C) and “Near MIS-C”: A continuum?

• DOI: 10.3389/fped.2022.988706
• Publication Date: 2023-01-05T17:09:22Z
• Authors: Sarah Khafaja; Nour Youssef; Zeinab El Zein; Celina F. Boutros; Samer Bou Karroum; Nour Abdel-Halim; Rim Salameh; Daniella Hodroj; Nour El Meski; Oussama Nasrallah; Aram Bidikian; Ghassan Bou Saba; Mariam T. Arabi; Rima Hanna-Wakim; Ghassan S. Dbaibo
• Keywords: Mucocutaneous zone

Reports of multisystem inflammatory syndrome in children (MIS-C), following severe acute respiratory coronavirus 2 (SARS-CoV-2) infection, have been increasing worldwide, with an incidence varying significantly across studies based on the definition used for diagnosis. At our tertiary medical center Lebanon, we encountered several cases that presented a diagnostic challenge because they mimicked MIS-C but did not meet US Centers Disease Control and Prevention (CDC) definition. We decided to review these describe their features comparison met CDC criteria those had alternative diagnosis.This is retrospective chart subjects aged <19 years old admitted American University Beirut Medical Center (AUBMC) between March 1, 2020, May 31, 2021, suspected or confirmed MIS-C, documented COVID-19 sufficient insufficient Subjects were classified into 3 groups: "MIS-C", "Near MIS-C" "Alternative Diagnosis".A total number 29 included cohort. Fever was present all subjects. In group, evidence cardiovascular system involvement most common feature followed by mucocutaneous gastrointestinal systems. Diagnosis" symptoms only one patient cardiac abnormalities none coagulopathy. typical presentation higher markers when compared other groups. Almost positive IgG SARS-CoV-2. Of subjects, Royal College Paediatrics Child Health (RCPCH) case would identified without diagnosis as whereas World Organization (WHO) definitions excluded 6 10 respectively.MIS-C presents due nonspecific symptoms, lack pathognomonic findings, potentially fatal complications. More research needed fully understand its pathogenesis, clinical spectrum, criteria. Based experience, favor hypothesis has continuum severity necessitates revisiting unifying current definitions.