Multisystem inflammatory syndrome
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At least five New Jersey children have been treated for serious cardiac issues at a local hospital’s intensive care unit. The children aged 6-12 all had a rare but serious pediatric inflammatory disease called multisystem inflammatory syndrome that’s currently being investigated due to links to the novel coronavirus.

Multisystem inflammatory syndrome (MIS-C) is a new health condition associated with COVID-19 that’s similar to other serious inflammatory conditions including toxic shock and Kawasaki disease. MIS-C (previously called pediatric multisystem inflammatory syndrome or PMIS) has also affected more than 60 New York City children in recent weeks.

“MIS-C is an illness characterized by prolonged fever that can also affect other organ systems, such as the heart, kidneys, lungs and intestinal tract,” Nicole Garcia, MD, a pediatrician at Summit Medical Group told New Jersey Family. “This represents a new diagnosis separate from the inflammatory illness previously known as Kawasaki disease. A new diagnosis was created based on reports of children showing a similar grouping of symptoms, which was first documented in Europe, but has now been seen in a number of children in the United States. The cases are mostly concentrated in the tristate area at this time.”

Although MIS-C is a rare condition, there are signs and symptoms parents should be on the lookout for including:

  • Fever lasting several days
  • Irritability or decreased activity
  • Abdominal pain
  • Diarrhea
  • Vomiting
  • Rash
  • Conjunctivitis
  • Poor feeding
  • Red, cracked lips or red, bumpy tongue that looks like a strawberry
  • Swollen hands and feet, which might also be red

“MIS-C appears to be triggered by COVID-19 infection in the cases that have been documented thus far,” said Dr. Garcia. “The diagnosis requires a positive test confirming novel coronavirus infection.”

Dr. Garcia also said that the current definition of MIS-C requires more than 24 hours of fever associated with evidence of inflammation in the body, on blood work, as well as symptoms affecting at least two other organ systems, with the most common being the lungs (severe cough and/or labored breathing), intestinal tract (abdominal pain with associated vomiting and/or diarrhea) and skin (rapidly spreading rash).

Although this all sounds scary, Dr. Garcia said that parents should be cautious but calm.

“The important thing to know is that this inflammatory condition is rare,” she said. “I recommend parents be aware of its existence, but not alarmed. In my mind, parents should be monitoring for the same things they would be looking for with any other viral illness. If your child has more than five days of consecutive fever, if they have fever that is not responding well to fever reducer with acetaminophen or ibuprofen, or if their symptoms are rapidly changing (especially with new labored breathing, abdominal pain with poor appetite or spreading rash), you should call your doctor immediately. The other great news about this illness is that we have a number of treatment options that we have been using for a long time with inflammatory conditions, and children are recovering well in the vast majority of cases. Kids are a lot stronger and more resilient than we are as adults, which is why I’m in pediatrics!”