Multisystem Inflammatory Syndrome
no more "C"
Welcome back to the PEM E-Newsletter. From Philadelphia “The City of Brotherly Love” to your inbox - a brand new Pediatric Emergency Medicine resource to educate, enlighten, and entertain! Hundreds of your colleagues have already signed up and are receiving the E-newsletter in their inbox!
Some major changes in what we know about MIS since our CHOP PEM Podcast on the topic available here — listen to the MIS-C Podcast featuring Dr. Josh Rocker [PEM], Dr. Hamid Bassiri [ID] and Dr. Katie Chiotos [PICU] and read about all the references/updates in this E-Newsletter
DID YOU KNOW
MIS-C is no longer just for kids, as the CDC now refers to it as “Multisystem Inflammatory Syndrome” or “MIS” to encompass individuals >21 with the disease
Most children with MIS (54-73%) are previously healthy (obesity and asthma are the most commonly reported co-morbidities)
The rate of ICU care in children with MIS is high (60-70%), but death is relatively low (2%)
MIS has clinical and laboratory findings distinct from Kawasaki Disease (KD), including older age (9 yrs vs. 2.7 years KD), higher neutrophils, lower lymphocytes, lower platelets, higher CRP, lower albumin, higher troponin and BNP levels
We are still learning about the long-term outcomes of MIS, but it appears that most children do well on outpatient follow-up, with normalization of labs and echo abnormalities
MIS or KAWASAKI or SEVERE COVID-19?
LABS in MIS - by age
EVIDENCE-BASED LITERATURE
What are the risk factors for SEVERE OUTCOMES in patients with MIS?
Have time to read only ONE ARTICLE?—here is an MIS-C CONSENSUS paper written by multiple sub-specialists
CLINICAL PEARLS
special thank you to CHOP PEM contributor Laura Sartori, MD--look for her upcoming Review Article on MIS in Pediatric Emergency Care soon!