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Review
. 2021 Feb 1;33(1):152-158.
doi: 10.1097/MOP.0000000000000974.

Multisystem inflammatory syndrome in children

Vijaya L Soma  1 , Gail F Shust  1 , Adam J Ratner  1   2
Affiliations
Review

Multisystem inflammatory syndrome in children

Vijaya L Soma et al. Curr Opin Pediatr. .

Abstract

Purpose of review: Here we summarize current knowledge about multisystem inflammatory syndrome in children (MIS-C), a presumed postinfectious inflammatory condition that has emerged as an important COVID-19-associated complication, to help clinicians identify and manage cases.

Recent findings: Clinical presentation of MIS-C is dominated by significant inflammation. Fever, gastrointestinal symptoms, cardiac dysfunction, and hypotension are common features. Kawasaki disease-like findings are common, but epidemiologic data and recent mechanistic studies suggest that distinct inflammatory pathways mediate Kawasaki disease and MIS-C. A broad diagnostic approach is recommended, given overlapping presentations between MIS-C and many other disease processes. Current management of MIS-C is highly variable, depending on illness severity, and can range from supportive care to aggressive immune modulation. A multidisciplinary approach with early involvement of multiple pediatric subspecialists is recommended for complicated cases.

Summary: Several studies have described the clinical manifestations of MIS-C, but definitive diagnosis remains challenging. Robust information about long-term outcomes awaits further study, as do immunologic data to refine diagnostic and therapeutic strategies.

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