Çocuklarda Multi̇si̇stem Enflamatuvar Sendrom (MIS-C)
Synopsis
Multisystem Inflammatory Syndrome in Children (MIS-C) is a dangerous pediatric condition characterized by persistent fever, elevated laboratory hyperinflammation markers, and multiple organ systemic dysfunction, typically appearing 3-4 weeks following SARS-CoV-2 infection. The median age of cases is 8.6 years, with a male predominance (52.3-59%) and a higher incidence observed in children of African descent. CDC case definition criteria include age under 21, fever lasting at least 24 hours, severe illness requiring hospitalization, involvement of at least two organ systems (cardiac, renal, respiratory, gastrointestinal, dermatologic, etc.), elevated CRP, ESR, ferritin, procalcitonin, and D-dimer, along with laboratory or epidemiological evidence of SARS-CoV-2. The most common clinical findings are fever (98-100%), gastrointestinal symptoms (70-88%), hypotension (40-74%), rash, and conjunctivitis. MIS-C is distinguished from Kawasaki disease by its occurrence in older age groups, higher frequency in populations of African descent, higher rate of shock (56-63%), severe gastrointestinal/neurological involvement, and more prominent lymphopenia/thrombocytopenia. First-line treatment includes IVIG and corticosteroids; in refractory cases, anakinra is added, alongside aspirin and anticoagulant therapy based on clinical features. While 68-71% of cases require intensive care monitoring, the mortality rate is around 1-2%.
References
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