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. 2021 Nov 3:9:753123.
doi: 10.3389/fped.2021.753123. eCollection 2021.

MIS-C Treatment: Is IVIG Always Necessary?

Francesco Licciardi  1   2 , Letizia Baldini  3 , Marta Dellepiane  1 , Carlotta Covizzi  3 , Roberta Mogni  3 , Giulia Pruccoli  1 , Cecilia Orsi  4 , Ivana Rabbone  4 , Emilia Parodi  1   2 , Federica Mignone  1   2 , Davide Montin  1   2
Affiliations

MIS-C Treatment: Is IVIG Always Necessary?

Francesco Licciardi et al. Front Pediatr. .

Erratum in

  • Corrigendum: MIS-C Treatment: Is IVIG Always Necessary?
    Licciardi F, Baldini L, Dellepiane M, Covizzi C, Mogni R, Pruccoli G, Orsi C, Rabbone I, Parodi E, Mignone F, Montin D. Licciardi F, et al. Front Pediatr. 2022 Feb 14;9:826518. doi: 10.3389/fped.2021.826518. eCollection 2021. Front Pediatr. 2022. PMID: 35237545 Free PMC article.

Abstract

Background: MIS-C is a potentially severe inflammatory syndrome associated with SARS-CoV-2 exposure. Intravenous immunoglobulin (IVIG) is considered the first-tier therapy, but it implies infusion of large fluid volumes that may worsen cardiac function. Patients and Methods: Since April 2020, we have developed a treatment protocol that avoids the infusion of IVIG as first-line therapy in the early phase of MIS-C. In this study, we retrospectively analyzed a cohort of consecutive patients treated according to this protocol between 01/04/2020 and 01/04/2021. Results: In the last year, 31 patients have been treated according to the protocol: 25 with high-dose pulse MP (10 mg/kg) and 6 with 2 mg/kg. 67.7% of the patients responded to the initial treatment, while the others needed a step-up, either with Anakinra (25.8%) or with MP dose increase (6.5%). IVIG was administered in four patients. Overall, only one patient (3.2%) needed ICU admission and inotropic support; one patient developed a small coronary artery aneurysm. Conclusions: Timely start of MP therapy and careful fluid management might improve the outcomes of MIS-C patients.

Keywords: IVIG (intravenous immunoglobulin) administration; MIS-C; SARS-CoV-2; steroid; therapy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Treatment strategy of patients included in the study. MP was used in patients as first-tier monotherapy. Clinical response was defined as defervescence and CRP reduction after 48 h from the first MP dose. *4 patients received IVIG.
See this image and copyright information in PMC

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