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Recognizing a MIS-Chievous Cause of Acute Viral Gastroenteritis

Historically, children evaluated for vomiting and diarrhea secondary to viral enteritis have symptoms lasting 2–4 days and respond to supportive care, including oral rehydration and anti-emetics if required. Recently, within a 14-day timespan, we encountered three children with severe diarrhea who r...

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Autores principales: Josyabhatla, Rohit, Kamdar, Ankur A., Armbrister, Shabba A., Daniel, Rhea, Boukas, Konstantinos, Smith, Keely G., Van Arsdall, Melissa R., Kakarala, Kokila, Flores, Anthony R., Wanger, Audrey, Liu, Yuying, Rhoads, Jon Marc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8588082/
https://www.ncbi.nlm.nih.gov/pubmed/34778138
http://dx.doi.org/10.3389/fped.2021.748368
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author Josyabhatla, Rohit
Kamdar, Ankur A.
Armbrister, Shabba A.
Daniel, Rhea
Boukas, Konstantinos
Smith, Keely G.
Van Arsdall, Melissa R.
Kakarala, Kokila
Flores, Anthony R.
Wanger, Audrey
Liu, Yuying
Rhoads, Jon Marc
author_facet Josyabhatla, Rohit
Kamdar, Ankur A.
Armbrister, Shabba A.
Daniel, Rhea
Boukas, Konstantinos
Smith, Keely G.
Van Arsdall, Melissa R.
Kakarala, Kokila
Flores, Anthony R.
Wanger, Audrey
Liu, Yuying
Rhoads, Jon Marc
author_sort Josyabhatla, Rohit
collection PubMed
description Historically, children evaluated for vomiting and diarrhea secondary to viral enteritis have symptoms lasting 2–4 days and respond to supportive care, including oral rehydration and anti-emetics if required. Recently, within a 14-day timespan, we encountered three children with severe diarrhea who rapidly became dehydrated and went into hypotensive shock. Although SARS-CoV-2 molecular tests were negative by nasopharyngeal swab, all were later found to have MIS-C. This small case series underscores features reported in previous larger studies and emphasizes the rapid clinical evolution of this condition. We highlight the importance of early recognition of cardinal laboratory findings characteristic of MIS-C (i.e., lymphopenia, markedly elevated acute phase reactants, and hypoalbuminemia). We also show serologic evidence that the pathophysiological mechanism of SARS-CoV-2 related diarrhea may differ from other causes of dehydrating vomiting and diarrhea, with no serologic evidence of villus cell injury.
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spelling pubmed-85880822021-11-13 Recognizing a MIS-Chievous Cause of Acute Viral Gastroenteritis Josyabhatla, Rohit Kamdar, Ankur A. Armbrister, Shabba A. Daniel, Rhea Boukas, Konstantinos Smith, Keely G. Van Arsdall, Melissa R. Kakarala, Kokila Flores, Anthony R. Wanger, Audrey Liu, Yuying Rhoads, Jon Marc Front Pediatr Pediatrics Historically, children evaluated for vomiting and diarrhea secondary to viral enteritis have symptoms lasting 2–4 days and respond to supportive care, including oral rehydration and anti-emetics if required. Recently, within a 14-day timespan, we encountered three children with severe diarrhea who rapidly became dehydrated and went into hypotensive shock. Although SARS-CoV-2 molecular tests were negative by nasopharyngeal swab, all were later found to have MIS-C. This small case series underscores features reported in previous larger studies and emphasizes the rapid clinical evolution of this condition. We highlight the importance of early recognition of cardinal laboratory findings characteristic of MIS-C (i.e., lymphopenia, markedly elevated acute phase reactants, and hypoalbuminemia). We also show serologic evidence that the pathophysiological mechanism of SARS-CoV-2 related diarrhea may differ from other causes of dehydrating vomiting and diarrhea, with no serologic evidence of villus cell injury. Frontiers Media S.A. 2021-10-29 /pmc/articles/PMC8588082/ /pubmed/34778138 http://dx.doi.org/10.3389/fped.2021.748368 Text en Copyright © 2021 Josyabhatla, Kamdar, Armbrister, Daniel, Boukas, Smith, Van Arsdall, Kakarala, Flores, Wanger, Liu and Rhoads. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Josyabhatla, Rohit
Kamdar, Ankur A.
Armbrister, Shabba A.
Daniel, Rhea
Boukas, Konstantinos
Smith, Keely G.
Van Arsdall, Melissa R.
Kakarala, Kokila
Flores, Anthony R.
Wanger, Audrey
Liu, Yuying
Rhoads, Jon Marc
Recognizing a MIS-Chievous Cause of Acute Viral Gastroenteritis
title Recognizing a MIS-Chievous Cause of Acute Viral Gastroenteritis
title_full Recognizing a MIS-Chievous Cause of Acute Viral Gastroenteritis
title_fullStr Recognizing a MIS-Chievous Cause of Acute Viral Gastroenteritis
title_full_unstemmed Recognizing a MIS-Chievous Cause of Acute Viral Gastroenteritis
title_short Recognizing a MIS-Chievous Cause of Acute Viral Gastroenteritis
title_sort recognizing a mis-chievous cause of acute viral gastroenteritis
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8588082/
https://www.ncbi.nlm.nih.gov/pubmed/34778138
http://dx.doi.org/10.3389/fped.2021.748368
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