Who Would Have Predicted Multisystem Inflammatory Syndrome in Children?

Purpose of Review Multisystem inflammatory disease in children (MIS-C) is a novel post-infectious phenomenon following coronavirus disease-19 (COVID-19). Herein, we present an in-depth review of the latest MIS-C literature related to clinical findings, pathophysiology, imaging and laboratory studies, treatment algorithms, and disease outcomes. Recent Findings With its non-specific presentation of fever, gastrointestinal symptoms, cardiovascular injury and shock, systemic inflammation, and Kawasaki disease (KD)-like features, MIS-C can be a diagnostic challenge, overlapping with KD and active COVID-19 infection. However, common laboratory features, imaging findings, and historical clues can lead to accurate diagnosis and allow for appropriate treatment with a variety of immunomodulatory therapies, including intravenous immunoglobulin (IVIG). Aggressive treatment of MIS-C leads to good outcomes. Longitudinal studies continue to illuminate long-term cardiac sequelae and recovery. MIS-C presents with fever, KD features, gastrointestinal symptoms, cardiac inflammation, and shock. Early recognition and prompt institution of IVIG and glucocorticoids provide for rapid improvement.

Automated summary

This review provides an in-depth analysis of multisystem inflammatory disease in children (MIS-C) following COVID-19. It discusses the clinical findings, pathophysiology, imaging and laboratory studies, treatment algorithms, and disease outcomes. MIS-C can be challenging to diagnose due to its non-specific presentation, but accurate diagnosis can be achieved through common laboratory features, imaging findings, and historical clues, enabling appropriate treatment with therapies such as IVIG. Aggressive treatment leads to good outcomes, and longitudinal studies shed light on long-term cardiac sequelae and recovery.