Multisystem Inflammatory Syndrome in Children: What Parents Should Know

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Provided by Novant Health UVA Health System

Much is still unknown about COVID-19. Providers in all disciplines of medicine have been working with fervor to better understand how their patients may be affected and how to keep them safe.

Pediatric physicians are no exception. When children across the world began exhibiting mysterious multisystem inflammation, pediatricians raced to find an explanation. What they landed on: multisystem inflammatory syndrome in children, or MIS-C, resulting from exposure to the novel coronavirus (SARS-CoV-19) or a diagnosis of COVID-19.

What Is MIS-C?

The Centers for Disease Control and Prevention defines MIS-C as “a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs.”

The most prevalent symptoms are fever and gastrointestinal problems, such as abdominal pain and diarrhea. Symptoms can also include neck pain, rash, bloodshot eyes and extreme lethargy. Much like COVID-19, however, there’s no one-size-fits-all when it comes to MIS-C. Symptoms can vary widely across
those affected. Parents are encouraged to contact their child’s doctor right away if they notice any of the possible symptoms.

Anastasia Williams, M.D., FAAP is medical director for the pediatric program at Novant Health UVA Health System and lead physician for Olde Towne Pediatrics. According to Williams, one consistent factor across children who experience MIS-C is that they are unquestionably sick. “We’ve observed that MIS-C causes severe discomfort for children; it’s not something they can play through. All of the children we’ve seen have felt miserable.”

When to Act

Williams advises parents to seek emergency care immediately if a child is showing any of the following symptoms:
• Difficulty breathing
• Chest pain or pressure that does not relent
• Severe abdominal pain
• Confusion or disorientation
• Difficulty waking up or staying awake
• Bluish tint to the lips or face

“Most children diagnosed with MIS-C get better with medical care,” said Williams. “However, it is still important to take any medical diagnosis seriously and be especially diligent … Although it is similar to other known diseases, it’s important to remember that MIS-C is brand new. We’re still figuring out its causes, symptoms and long-term impacts.”

Similarities to Kawasaki Disease

Kawasaki disease is another illness that causes inflammation of the blood vessels and is almost exclusively seen in children. While Kawasaki disease bears many similarities to the new MIS-C, there are stark differences between the two.

“For starters, Kawasaki disease is usually diagnosed in children under the age of 5 … MIS-C has been diagnosed in young adults, up to age 20,” said Williams. “We also see cardiovascular strain and heart disease manifest more quickly inMIS-C cases.”

But other symptoms overlap enough that doctors have been able to use established treatments for Kawasaki disease to quickly and effectively treat MIS-C. Intravenous immunoglobulin, or IVIG, uses an antibody mixture, administered intravenously, to block the body’s inflammatory process.

Care in the Time of COVID-19

As COVID-19 remains a concern, especially to those at heightened risk of complications, Williams offers reassurance to parents who are hesitant to bring their child to a doctor’s office.

“Novant Health UVA Health System and its affiliated offices have taken the utmost precautions to protect patients and staff from COVID-19… [That includes] masking policies, cleaning protocols and visitor restrictions,” said Williams. “We also offer virtual care where we are able to assess some symptoms over
the phone or via video call, before making a recommendation on whether the child should be seen in person.”

For more information on MIS-C, visit cdc.gov/coronavirus/2019-ncov/daily-life-coping/children/mis-c.html. For the most up-to-date coronavirus information from Novant Health UVA Health System. visit novanthealthuva.org/about-us/newsroom.

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