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Case Reports
. 2022 Feb 2:2022:3373289.
doi: 10.1155/2022/3373289. eCollection 2022.

A Case of COVID-19-Associated Pediatric Multisystem Inflammatory Syndrome in Shock Managed by Cytokine Filtration

Priyanka Lalwani  1   2 , Subashini Baskaran  1   2 , Diego Arango Uribe  1 , Anil Ramaiah  1 , Aqdas Saqib  1   2 , Mohammed ElMesserey  1   2 , Emad M Fathi  1 , Yuichi Tabata  1 , Christoph Fink  1 , Marco Pallavidino  1   2
Affiliations
Case Reports

A Case of COVID-19-Associated Pediatric Multisystem Inflammatory Syndrome in Shock Managed by Cytokine Filtration

Priyanka Lalwani et al. Case Rep Pediatr. .

Abstract

Multisystem inflammatory syndrome in children (MIS-C) after COVID-19 has been recognized as a complication arising due to cytokine storm. Several management strategies including intravenous immunoglobulin and immunomodulators have been reported. This case report highlights the use of a cytokine filter (oXiris®) in the management of MIS-C. Cytokine filters eliminate cytokines and reduce the demand for vasopressors in patients with other inflammatory conditions. A 7-year-old child with prolonged fever, vomiting, hypotension, elevated inflammatory mediators, and dilatation of coronary arteries on echocardiography was found to have positive SARS-CoV-2 IgG and PCR. He was diagnosed as MIS-C and was managed in the pediatric intensive care unit. He required ventilatory support, vasopressors, and continuous renal replacement therapy (CRRT) with a cytokine filter. He showed marked improvement within 24 hours of initiating CRRT. Cytokine filters may have a potential role in the management of severely ill children due to MIS-C. To our knowledge, this is the first report of successful use of the oXiris® membrane in MIS-C. However, further case series and controlled trials are needed to establish its use in this condition.

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Conflict of interest statement

No potential conflicts of interest relevant to this article are reported.

Figures

Figure 1
Figure 1
Timeline of events.
Figure 2
Figure 2
Trend of CRP and procalcitonin.
Figure 3
Figure 3
Trend of interleukin 6 (IL-6).
Figure 4
Figure 4
Trend of ferritin.
Figure 5
Figure 5
Trend of fibrinogen.
Figure 6
Figure 6
Trend of D-dimer.
See this image and copyright information in PMC

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