Abstract:

Objective To explore the clinical features and key points of diagnosis and treatment of multisystem inflammatory syndrome in children (MIS-C). Methods The clinical data of two children with MIS-C diagnosed and treated in the Department of Rheumatology and Immunology of XJTU Affiliated Children's Hospital were retrospectively analyzed and the relevant literature was reviewed. Results There were two patients (1 male and 1 female), the age of male was 2 years and 1 month, and the age of female was 3 years and 8 months. Both had a history of SARS-CoV-2 infection 4 weeks before their illness onset. At the beginning of the disease, Kawasaki Disease-like symptoms were the main clinical manifestations, with multi-system involvement in the course of the disease, including prominent gastrointestinal, cardiac, hematologic and respiratory, and one of them with neurologic symptoms. MIS-C was finally diagnosed according to the results of laboratory examination. All of them were treated with intravenous immunoglobulin and glucocorticoids. One of them was treated with continuous kidney replacement therapy and noninvasive mechanical ventilation due to progressive disease, and both patients had a good prognosis. Conclusion MIS-C should be considered in patients with recent SARS-CoV-2 infection followed by Kawasaki disease-like symptoms. The disease progresses rapidly and involves multiple systems, so early recognition and intervention are needed to improve the prognosis.

Key words: child, multisystem inflammatory syndrome, diagnosis and treatment