Department of Immunology, University Pediatric Clinic, University Ss. Cyril and Methodius, Skopje, N Macedonia.
Department of gastroenterohepatology, University Pediatric Clinic, University Ss. Cyril and Methodius, Skopje, N Macedonia.
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2021 Oct 26;42(2):95-101. doi: 10.2478/prilozi-2021-0027.
Multisystem Inflammatory Syndrome in Children (MIS-C) is characterized by an inflammation with fever, elevated inflammatory markers, conjunctivitis, rash, impaired coagulation, gastrointestinal symptoms and cardiac abnormalities that may progress to multiorgan failure. The presence of a positive COVID-19 antigen via a PCR test, serological testing for antibodies or close contact with a person diagnosed with COVID-19 helps differentiate MIS-C from other diseases. Gastrointestinal symptoms are recognized to be associated with COVID-19 infection or MIS-C in children, presenting as abdominal pain, gastrointestinal infection with watery stools, appendicitis, ileitis, pancreatitis and hepatitis, confusing the diagnosis with other gastrointestinal diseases. In this case report, we describe an 11 year old boy with MIS-C, who presents acute phlegmona of the appendix for which he undergoes appendectomy, accompanied with acute pancreatitis. These manifestations of MIS-C in our patient resolved without additional complications after a 2 month follow up. We call attention to MIS-C presenting in pediatric patients with fever and abdominal pain which might be caused by appendicitis and pancreatitis, and we recommend abdominal imaging and additional laboratory investigation to promote earlier diagnosis.
儿童多系统炎症综合征（MIS-C）的特征是发热伴有炎症标志物升高、结膜炎、皮疹、凝血功能障碍、胃肠道症状和心脏异常，这些症状可能进展为多器官衰竭。通过 PCR 检测、血清学抗体检测或与确诊 COVID-19 患者的密切接触，发现阳性 COVID-19 抗原有助于将 MIS-C 与其他疾病区分开来。胃肠道症状被认为与儿童 COVID-19 感染或 MIS-C 有关，表现为腹痛、胃肠道感染伴水样腹泻、阑尾炎、回肠炎、胰腺炎和肝炎，这使诊断与其他胃肠道疾病混淆。在本病例报告中，我们描述了一例 11 岁男孩患有 MIS-C，表现为急性阑尾脓性痰，行阑尾切除术，同时伴有急性胰腺炎。在 2 个月的随访后，我们患者的这些 MIS-C 表现没有出现其他并发症而得到缓解。我们提醒注意儿科患者出现发热和腹痛可能是由阑尾炎和胰腺炎引起的 MIS-C，并建议进行腹部影像学和其他实验室检查以促进早期诊断。
