Multisystem inflammatory syndrome (MIS-C) in Pakistani children: A description of the phenotypes and comparison with historical cohorts of children with Kawasaki disease and myocarditis.

<h4>Objectives</h4>To determine clinical, laboratory features and outcomes of Multisystem Inflammatory Syndrome in children (MIS-C) and its comparison with historic Kawasaki Disease (KD) and Viral Myocarditis (VM) cohorts.<h4>Methods</h4>All children (1 month- 18 years) who f...

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Autores principales:	Shazia S Mohsin, Qalab Abbas, Devyani Chowdhary, Farah Khalid, Abdul Sattar Sheikh, Zuviya Ghazala Ali Khan, Nadeem Aslam, Omaima Anis Bhatti, Maha Inam, Ali Faisal Saleem, Adnan T Bhutta
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9a0e8b948bb94ff4a72bc4abbdd94ef7
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spelling	oai:doaj.org-article:9a0e8b948bb94ff4a72bc4abbdd94ef72021-12-02T20:10:18ZMultisystem inflammatory syndrome (MIS-C) in Pakistani children: A description of the phenotypes and comparison with historical cohorts of children with Kawasaki disease and myocarditis.1932-620310.1371/journal.pone.0253625https://doaj.org/article/9a0e8b948bb94ff4a72bc4abbdd94ef72021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253625https://doaj.org/toc/1932-6203<h4>Objectives</h4>To determine clinical, laboratory features and outcomes of Multisystem Inflammatory Syndrome in children (MIS-C) and its comparison with historic Kawasaki Disease (KD) and Viral Myocarditis (VM) cohorts.<h4>Methods</h4>All children (1 month- 18 years) who fulfilled the World Health Organization criteria of MIS-C presenting to two tertiary care centers in Karachi from May 2020 till August 31st were included. KD and VM admitted to one of the study centers in the last five years prior to this pandemic, was compared to MIS-C.<h4>Results</h4>Thirty children with median age of 24 (interquartile range (IQR)1-192) months met the criteria for MIS-C. Three phenotypes were identified, 12 patients (40%) with KD, ten (33%) VM and eight (26%) had features of TSS. Echocardiography showed coronary involvement in 10 (33%), and moderate to severe Left Ventricular dysfunction in 10 (33%) patients. Steroids and intravenous immunoglobulins (IVIG) were administered to 24 (80%) and 12 (41%) patients respectively while 7 (23%) received both. Overall, 20% children expired. During the last five years, 30 and 47 children were diagnosed with KD and VM, respectively. Their comparison with MIS-C group showed lymphopenia, thrombocytosis, and higher CRP as well as more frequent atypical presentation in MIS-C KD group with less coronary involvement. The MIS-C VM was more likely to present with fulminant myocarditis.<h4>Conclusions</h4>Our MIS-C cohort is younger with higher mortality compared to previous reports. MIS-C is distinct from historic cohorts of KD and VM in both in clinical features and outcomes.Shazia S MohsinQalab AbbasDevyani ChowdharyFarah KhalidAbdul Sattar SheikhZuviya Ghazala Ali KhanNadeem AslamOmaima Anis BhattiMaha InamAli Faisal SaleemAdnan T BhuttaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0253625 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Shazia S Mohsin Qalab Abbas Devyani Chowdhary Farah Khalid Abdul Sattar Sheikh Zuviya Ghazala Ali Khan Nadeem Aslam Omaima Anis Bhatti Maha Inam Ali Faisal Saleem Adnan T Bhutta Multisystem inflammatory syndrome (MIS-C) in Pakistani children: A description of the phenotypes and comparison with historical cohorts of children with Kawasaki disease and myocarditis.
description	<h4>Objectives</h4>To determine clinical, laboratory features and outcomes of Multisystem Inflammatory Syndrome in children (MIS-C) and its comparison with historic Kawasaki Disease (KD) and Viral Myocarditis (VM) cohorts.<h4>Methods</h4>All children (1 month- 18 years) who fulfilled the World Health Organization criteria of MIS-C presenting to two tertiary care centers in Karachi from May 2020 till August 31st were included. KD and VM admitted to one of the study centers in the last five years prior to this pandemic, was compared to MIS-C.<h4>Results</h4>Thirty children with median age of 24 (interquartile range (IQR)1-192) months met the criteria for MIS-C. Three phenotypes were identified, 12 patients (40%) with KD, ten (33%) VM and eight (26%) had features of TSS. Echocardiography showed coronary involvement in 10 (33%), and moderate to severe Left Ventricular dysfunction in 10 (33%) patients. Steroids and intravenous immunoglobulins (IVIG) were administered to 24 (80%) and 12 (41%) patients respectively while 7 (23%) received both. Overall, 20% children expired. During the last five years, 30 and 47 children were diagnosed with KD and VM, respectively. Their comparison with MIS-C group showed lymphopenia, thrombocytosis, and higher CRP as well as more frequent atypical presentation in MIS-C KD group with less coronary involvement. The MIS-C VM was more likely to present with fulminant myocarditis.<h4>Conclusions</h4>Our MIS-C cohort is younger with higher mortality compared to previous reports. MIS-C is distinct from historic cohorts of KD and VM in both in clinical features and outcomes.
format	article
author	Shazia S Mohsin Qalab Abbas Devyani Chowdhary Farah Khalid Abdul Sattar Sheikh Zuviya Ghazala Ali Khan Nadeem Aslam Omaima Anis Bhatti Maha Inam Ali Faisal Saleem Adnan T Bhutta
author_facet	Shazia S Mohsin Qalab Abbas Devyani Chowdhary Farah Khalid Abdul Sattar Sheikh Zuviya Ghazala Ali Khan Nadeem Aslam Omaima Anis Bhatti Maha Inam Ali Faisal Saleem Adnan T Bhutta
author_sort	Shazia S Mohsin
title	Multisystem inflammatory syndrome (MIS-C) in Pakistani children: A description of the phenotypes and comparison with historical cohorts of children with Kawasaki disease and myocarditis.
title_short	Multisystem inflammatory syndrome (MIS-C) in Pakistani children: A description of the phenotypes and comparison with historical cohorts of children with Kawasaki disease and myocarditis.
title_full	Multisystem inflammatory syndrome (MIS-C) in Pakistani children: A description of the phenotypes and comparison with historical cohorts of children with Kawasaki disease and myocarditis.
title_fullStr	Multisystem inflammatory syndrome (MIS-C) in Pakistani children: A description of the phenotypes and comparison with historical cohorts of children with Kawasaki disease and myocarditis.
title_full_unstemmed	Multisystem inflammatory syndrome (MIS-C) in Pakistani children: A description of the phenotypes and comparison with historical cohorts of children with Kawasaki disease and myocarditis.
title_sort	multisystem inflammatory syndrome (mis-c) in pakistani children: a description of the phenotypes and comparison with historical cohorts of children with kawasaki disease and myocarditis.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/9a0e8b948bb94ff4a72bc4abbdd94ef7
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Multisystem inflammatory syndrome (MIS-C) in Pakistani children: A description of the phenotypes and comparison with historical cohorts of children with Kawasaki disease and myocarditis.

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