As a result of the Covid-19 pandemic, many new health disorders or diseases are emerging, one of which affects children and adolescents.
The disease is called pediatric multisystem inflammatory syndrome (MIS-C), a condition believed to be linked to Covid-19.
However, there is still a lot of unknown about the disease.
What is Multisystem Inflammatory Syndrome?
The pediatric multisystem inflammatory syndrome itself is defined differently by the Centers for Disease Control and Prevention and the World Health Organization (WHO), they named the condition after multisystem inflammatory syndrome in children.
Multisystem inflammatory or inflammatory syndrome in children (MIS-C) is a condition in which inflammation occurs in different parts of the body. Includes the heart, lungs, brain, skin, eyes, or even digestive organs.
Not only can it occur in children, this syndrome can also occur in adolescents. There is still much to learn about this new inflammatory syndrome. The cause of MIS-C it is still unknown.
However, many children who experience MIS-C has a virus that causes COVID-19, or have been around people affected by COVID-19.
Pediatric Multisystem Inflammatory Syndrome Symptoms similar to Kawasaki disease
MIS C reflects the symptoms of a rare childhood disease, Kawasaki disease, which involves inflammation of blood vessels, especially the heart and coronary arteries.
Pediatric Multisystem inflammatory syndrome resembles Kawasaki disease because it can lead to soaring inflammation.
Other symptoms of Kawasaki disease include:
- Fever that lasts for 5 days
- Red eyes for no reason
- Lips, tongue, or throat is reddish or cracked
- Swelling or redness of the hands or feet
- Peeling skin, generally starting around the nails
- The rash is mostly on the torso (torso or the middle part of the body), but can sometimes appear in other parts
- Swelling of the lymph nodes in the neck
Symptoms of pediatric multisystem inflammatory syndrome are the same as Kawasaki’s, but are accompanied by
- Diarrhea and
- Other gastrointestinal symptoms (gastrointestinal infections).
Kawasaki disease usually affects children and it is considered rare, as is a pediatric multisystem inflammatory syndrome.
Some children with multisystem inflammatory syndrome also show symptoms of
- Toxic shock syndrome (bacterial blood poisoning) and
- Sepsis (inflammation throughout the body due to infection),
- Abdominal pain,
- Fever, and
- Low blood pressure.
The WHO has called on health services around the world to share data on potential cases of this multisystem inflammatory syndrome. Here are some of the criteria set by the WHO and CDC for diagnosing MIS-C cases.
A person suspected of experiencing MIS-C is a child/adolescent aged 0-19 years with fever symptoms of more than 380C for more than 3 days accompanied by a minimum of 2 (two) the following:
- Redness of the skin (rash) or infection of both eyes (conjunctivitis) or signs of inflammation of the mouth, hands or feet
- Low blood pressure (hypotension) or shock.
- The presence of abnormalities in the heart (myocardial infarction, pericarditis, valvulitis) confirmed by ultrasound examination of the heart and laboratory
- Blood clotting disorders (coagulopathy)
- Digestive problems such as abdominal pain, diarrhea, and vomiting.
These symptoms should be accompanied by positive confirmation of Covid-19 through Polymerase Chain Reaction (PCR) examination, serology or antigen test and or there is contact with covid-19 positive patients within 4 (four) weeks before the onset of symptoms.
Why does MIS-C get important attention by the WHO as well as the medical world? Although in children, the symptoms of Covid-19 are generally mild, experts say the signs of MIS-C can be seen when the body is overwhelmed when fighting infection. MIS-C usually appears 4 – 6 weeks after exposure from Covid-19.
Multisystem Inflammatory Syndrome Treatment
Most children with MIS-C need to be hospitalized, and some will need care in the child intensive care unit.
Treatment usually involves different types of therapies that target the immune system and reduce inflammation. Depending on the symptoms and condition of the child, your child may receive anti-inflammatory drugs and other medications to reduce inflammation in the affected vital organs, such as the heart or kidneys, and protect them from permanent damage.
The results suggest that high-dose immunoglobulins should be used to limit the effects of autoantibodies, anakinra (an immunosuppressive active ingredient that blocks interleukin-1 receptors) and cortisone should be used to treat children with Multisystem Inflammatory Syndrome at an early stage to block secondary inflammation due to vascular damage.
Conversely, the use of tocilizumab (anti-IL6) and TNF- A inhibitor drug is not recommended in children patients. For patients with Kawasaki, the data shows for the first time the potential efficacy of the inhibitory drug IL-17 (secukinumab) to control the inflammation underlying the disease.