E-Paper
Patients suffering from MIS-C with other illnesses can be fatal: KEM hosp study
Doctors from city-based KEM hospital during their research have found that post Covid, multisystem inflammatory syndrome in children (MIS-C) had overlapping symptoms with other major illnesses, which could be fatal
Doctors from city-based KEM hospital during their research have found that post Covid, multisystem inflammatory syndrome in children (MIS-C) had overlapping symptoms with other major illnesses, which could be fatal.
In their study of 11 patients, researching doctors highlighted their experience in treating post Covid children with MIS-C and emphasised the need to consider other diagnosis before treating children as a case of post covid MIS-C in a recent research paper.
MIS-C is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.
Doctors advised that post Covid infection, if the child suffers from high fever after 8 to 10 days, immediate medical attention should be given to the patient.
Dr Ambrish Mishra, Dr Sarita Verma Kokane, Dr Sandeep Kadam and Dr Abhijeet Botre from the departments of paediatrics were involved in this study which came out in a paper ‘Revisiting MIS-C: Extending the Exclusions’, published in the journal Indian Pediatrics on August 15.
Kokane said that the paper reports 11 children, initially treated as MIS-C, who got a different final diagnosis.
“Out of these 11 patients, four were diagnosed at our centre and seven were referred from outside after MIS-C treatment. The cases which we have reported here came to us between December 2020 and November 2021. We reported that during Covid, it was found that many children were diagnosed with MIS-C, but since there were overlapping symptoms with other major illnesses, we found that above 11 patients had different final diagnosis” said Kokane.
Dr Abhijeet Botre, author of the paper said that inflammation being a known hallmark in collagen vascular diseases, the criteria for case definition of MIS-C are met by many children with these disorders.
“However, our cohort had mainly hematolymphoid and collagen vascular diseases masquerading as MIS-C. Recently, American College of Rheumatology guidelines recommend ruling out malignancy and autoimmune disorders before making a diagnosis of MIS-C. At the peak of the pandemic, steroids were utilised extensively as a life-saving measure to treat MIS-C. However, two patients with hematolymphoid malignancies in our cohort succumbed, as steroids induced partial remission,” said Dr Botre.
The research also emphasised that parents should follow up with doctors up to six months.
Speaking about this, Dr Ambrish Mishra said,
“Patients diagnosed and treated as MIS-C need to do a follow up to ensure absence of an alternate diagnosis and complete relief of symptoms. Parents should look out for symptoms like high fever after four weeks of Covid infection in children and they should follow up with doctors for at least six months. Moreover, during peak Covid, the definition of MIS-C by the World Health Organisation (WHO) was kept very wide. But this paper shows that there are multiple diseases that should not be ruled out before treating the child for MIS-C,” said Dr Mishra.
