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Case Report: MIS-C With Prominent Hepatic and Pancreatic Involvement in a Vaccinated Adolescent – A Critical Reasoning

Multisystem inflammatory syndrome in children (MIS-C) is a pathologic condition that has emerged during the coronavirus disease 2019 (COVID-19) pandemic. Although the epidemiological evidence of association between MIS-C and SARS-CoV-2 infection has been demonstrated, its pathogenic mechanism is sti...

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Autores principales: Consolini, Rita, Costagliola, Giorgio, Spada, Erika, Colombatto, Piero, Orsini, Alessandro, Bonuccelli, Alice, Brunetto, Maurizia R., Peroni, Diego G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9149168/
https://www.ncbi.nlm.nih.gov/pubmed/35652054
http://dx.doi.org/10.3389/fped.2022.896903
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author Consolini, Rita
Costagliola, Giorgio
Spada, Erika
Colombatto, Piero
Orsini, Alessandro
Bonuccelli, Alice
Brunetto, Maurizia R.
Peroni, Diego G.
author_facet Consolini, Rita
Costagliola, Giorgio
Spada, Erika
Colombatto, Piero
Orsini, Alessandro
Bonuccelli, Alice
Brunetto, Maurizia R.
Peroni, Diego G.
author_sort Consolini, Rita
collection PubMed
description Multisystem inflammatory syndrome in children (MIS-C) is a pathologic condition that has emerged during the coronavirus disease 2019 (COVID-19) pandemic. Although the epidemiological evidence of association between MIS-C and SARS-CoV-2 infection has been demonstrated, its pathogenic mechanism is still undefined. We describe the case of a 17-year old female, previously vaccinated against SARS-CoV-2, presenting with a history of asthenia, fever, cough, anorexia, abdominal pain, and vomiting. During the hospitalization, the patient developed bilateral conjunctivitis, hand vasculitis, cutaneous rash, and multiple pulmonary nodules, following by hepatitis and pancreatitis. As she reported a high-risk contact with a SARS-CoV-2 positive patient 10 days before admission, the epidemiological link and the clinical picture characterized by multi-system organ disfunction and inflammatory biomarkers increase led us to the diagnosis of MIS-C. Therefore, the patient was treated with intravenous immunoglobulin and corticosteroids, resulting in a rapid resolution of fever, cutaneous, and pulmonary involvement, while the recovery of hepatitis and pancreatitis was observed in the following weeks. This case leads to the discussion on whether SARS-CoV-2 immunized children and adolescents should be considered at risk of developing MIS-C and on their possible presentation with non-classic clinical features. Additionally, due to the increasing number of vaccinated children and adolescents, the issues resulting either from the diagnostic suspect of MIS-C or from the consequent need of an early therapeutic approach are discussed.
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spelling pubmed-91491682022-05-31 Case Report: MIS-C With Prominent Hepatic and Pancreatic Involvement in a Vaccinated Adolescent – A Critical Reasoning Consolini, Rita Costagliola, Giorgio Spada, Erika Colombatto, Piero Orsini, Alessandro Bonuccelli, Alice Brunetto, Maurizia R. Peroni, Diego G. Front Pediatr Pediatrics Multisystem inflammatory syndrome in children (MIS-C) is a pathologic condition that has emerged during the coronavirus disease 2019 (COVID-19) pandemic. Although the epidemiological evidence of association between MIS-C and SARS-CoV-2 infection has been demonstrated, its pathogenic mechanism is still undefined. We describe the case of a 17-year old female, previously vaccinated against SARS-CoV-2, presenting with a history of asthenia, fever, cough, anorexia, abdominal pain, and vomiting. During the hospitalization, the patient developed bilateral conjunctivitis, hand vasculitis, cutaneous rash, and multiple pulmonary nodules, following by hepatitis and pancreatitis. As she reported a high-risk contact with a SARS-CoV-2 positive patient 10 days before admission, the epidemiological link and the clinical picture characterized by multi-system organ disfunction and inflammatory biomarkers increase led us to the diagnosis of MIS-C. Therefore, the patient was treated with intravenous immunoglobulin and corticosteroids, resulting in a rapid resolution of fever, cutaneous, and pulmonary involvement, while the recovery of hepatitis and pancreatitis was observed in the following weeks. This case leads to the discussion on whether SARS-CoV-2 immunized children and adolescents should be considered at risk of developing MIS-C and on their possible presentation with non-classic clinical features. Additionally, due to the increasing number of vaccinated children and adolescents, the issues resulting either from the diagnostic suspect of MIS-C or from the consequent need of an early therapeutic approach are discussed. Frontiers Media S.A. 2022-05-16 /pmc/articles/PMC9149168/ /pubmed/35652054 http://dx.doi.org/10.3389/fped.2022.896903 Text en Copyright © 2022 Consolini, Costagliola, Spada, Colombatto, Orsini, Bonuccelli, Brunetto and Peroni. 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
Consolini, Rita
Costagliola, Giorgio
Spada, Erika
Colombatto, Piero
Orsini, Alessandro
Bonuccelli, Alice
Brunetto, Maurizia R.
Peroni, Diego G.
Case Report: MIS-C With Prominent Hepatic and Pancreatic Involvement in a Vaccinated Adolescent – A Critical Reasoning
title Case Report: MIS-C With Prominent Hepatic and Pancreatic Involvement in a Vaccinated Adolescent – A Critical Reasoning
title_full Case Report: MIS-C With Prominent Hepatic and Pancreatic Involvement in a Vaccinated Adolescent – A Critical Reasoning
title_fullStr Case Report: MIS-C With Prominent Hepatic and Pancreatic Involvement in a Vaccinated Adolescent – A Critical Reasoning
title_full_unstemmed Case Report: MIS-C With Prominent Hepatic and Pancreatic Involvement in a Vaccinated Adolescent – A Critical Reasoning
title_short Case Report: MIS-C With Prominent Hepatic and Pancreatic Involvement in a Vaccinated Adolescent – A Critical Reasoning
title_sort case report: mis-c with prominent hepatic and pancreatic involvement in a vaccinated adolescent – a critical reasoning
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9149168/
https://www.ncbi.nlm.nih.gov/pubmed/35652054
http://dx.doi.org/10.3389/fped.2022.896903
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