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http://dx.doi.org/10.14776/piv.2021.28.e17

A Case of Multisystem Inflammatory Syndrome in Children (MIS-C) with Acute Myocarditis  

Lim, Jin Gyu (Department of Pediatrics, Seoul National University Bundang Hospital)
Lee, Da Hye (Department of Pediatrics, Seoul National University Children's Hospital)
Oh, Kyung Jin (Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center)
Choi, Sujin (Department of Pediatrics, Seoul National University College of Medicine)
Song, Young Hwan (Department of Pediatrics, Seoul National University Bundang Hospital)
Lee, Joowon (Department of Pediatrics, Seoul National University Bundang Hospital)
Lee, Hyunju (Department of Pediatrics, Seoul National University Bundang Hospital)
Publication Information
Pediatric Infection and Vaccine / v.28, no.3, 2021 , pp. 173-180 More about this Journal
Abstract
After initial reports of multisystem inflammatory syndrome in children (MIS-C) in April 2020 in Europe, this disease has been known to occur in children with recent history of coronavirus disease 2019 (COVID-19) and most cases have been reported in Europe and the Unites States of America. We report a case of a 14-year-old girl who was diagnosed with MIS-C with acute myocarditis and successfully treated with intravenous immunoglobulin (IVIG), methylprednisolone, and anakinra. At initial presentation, she had persistent high fever, generalized rash, generalized swelling, abdominal pain, and low blood pressure. She showed a remarkably elevated level of inflammation and cardiac enzyme markers and had a previous history of COVID-19 5 weeks before the initial presentation. After extensive work up, other infectious and non-infectious causes were excluded. She was diagnosed with MIS-C and initially treated with IVIG and high-dose methylprednisolone; however, despite treatment, her heart function deteriorated and coronary artery dilatation progressed. Therefore, anakinra, an interleukin-1 receptor antagonist, was administered on hospital day 6, after which her cardiac function exhibited improvement. She was discharged on hospital day 19 without any symptoms, and follow-up echocardiography after 1 month revealed fully recovered heart function with normal coronary arteries.
Keywords
COVID-19; SARS-CoV-2; Pediatric multisystem inflammatory disease, COVID-19 related; Myocarditis;
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