A Large-Vessel Arteritis in SARS-CoV-2–related Multisystem Inflammatory Syndrome in Children

Salman, Rida; Masand, Prakash; Huisman, Thierry A.G.M.; Pereira, Maria Fernanda Bádue; Kearney, Debra L.; Guillerman, R. Paul; Jadhav, Siddharth P.

doi:10.1148/ryct.2020200535

Cited by 6 publications

(6 citation statements)

References 15 publications

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“…According to these data and the increasing evidence suggesting an association between the SARS-CoV-2 infection and autoimmunity [ 17 ], it is possible to hypothesize the presence of a link between SARS-CoV-2 infection and vasculitis. Indeed, during the pandemic, several SARS-CoV-2-associated Takayasu arteritis cases in young patients of a similar age to our clinical case have been described [ 18 , 19 , 20 ]. Mendes et al described the case report of a 19-year-old woman who presented fatigue and malaise one month after a SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 56%

Is COVID-19 All That Glitters?

Spampinato

Marco

Mammolito

et al. 2023

JCM

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Over the last three years, the Coronavirus-19 disease has been a global health emergency, playing a primary role in the international scientific community. Clinical activity and scientific research have concentrated their efforts on facing the pandemic, allowing the description of novel pathologies correlated to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), such as the Multisystemic Inflammatory Syndrome in Children and Adults (MIS-C, MIS-A). Conversely, this shift of attention to COVID-19 disease and its complications could, in some cases, have delayed and underestimated the diagnosis of diseases not associated with SARS-CoV-2, including rare diseases. Here we describe the diagnostic process that led to the definition of a rare vasculitis in a young woman with a recent clinical history of SARS-CoV-2.

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Section: Discussionmentioning

confidence: 56%

Is COVID-19 All That Glitters?

Spampinato

Marco

Mammolito

et al. 2023

JCM

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“…MIS-Cusually present with fever, GI symptoms including abdominal pain, diarrhea and vomiting, in addition to skin rash, and respiratory symptoms. Only one case has been reported with large vessel vasculitis in association with MIS-C( 12 ), we report the first case of MIS to present with limping secondary to large vessel vasculitis.…”

Section: Introductionmentioning

confidence: 66%

“…Salman et al has reported a MIS-C case manifesting with extensive aortic and branch artery abnormalities including aortitis, mural thrombus, saccular aneurysms and severe stenosis of the left renal artery ostium in a teenager presented with fever, palpitation, fatigability, vomiting and hypertension ( 12 ). In Salman et al, the patient had cardiac involvement, the arteritis in aorta and renal artery were diagnosed based on radiological finding and biopsy findings.…”

Section: Discussionmentioning

confidence: 99%

Limping as Presenting Symptom of Multisystem Inflammatory Syndrome in Children (MIS-C): a Case Report of Large Vessel Vasculitis in MIS-C

aiteh,

Momani,

Elhaj

et al. 2023

Med Arch

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Background: Multisystem Inflammatory Syndrome of children (MIS) is a pathological condition that occurs in response to a SARS-CoV-2 infection, the syndrome has been described as a "Kawasaki disease"-like illness and the spectrum of associated abnormalities, including vascular complications, remain to be fully defined. Objective: The aim of this article was to present a case of MISC presented with limping and associated with large vessel vasculitis. Case presentation: In this article we present a case of 10-year-old male presented to emergency department complaining of limping of one-week duration and left hip pain, associated with high grade prolonged fever, abdominal pain and weight loss. The patient was ill looking, couldn’t bear weight and was admitted to pediatric intensive care unit. Laboratory workup have rule out infectious and malignant causes as well as known rheumatological causes. Inflammatory markers were elevated. Ultrasound, Doppler ultrasound, CT scan of the affected hip showed evidence of vasculitis extending from the left femoral artery reaching the left common iliac artery with intramural thrombus. According to WHO criteria the patient diagnoses was MIS-C. treatment was started immediately with IVIG and steroids in addition to anticoagulants, dramatic improvement was noticed within 24 hours. Patient was discharged after 10 days of hospitalization. Conclusion: MIS-C is a new emerging medical diagnosis after the pandemic of COVID-19. it is described a Kawasaki-like syndrome that affect small to medium vessels. This case reports a large vessel vasculitis associated with MIS-C, it helps the understand the extend of this new syndrome and the variety of complaints that may result from large vessels involvement

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“…COVID-19-associated large- and/or medium-sized-vessel vasculitis is rare. 8 9 10 The underlying mechanism for COVID-19-associated large- and medium-vessel pathology is most likely multifactorial and a combination of infectious and immunologic components. 11 The role of angiotensin-converting enzyme (ACE)-2 in cardiovascular disease and its distribution on the cell membranes of arterial and venous endothelia is well documented.…”

Section: Discussionmentioning

confidence: 99%

“… 7 There are now emerging reports of large-vessel vasculitis in pediatric and adult patients in association with COVID-19. 8 9 10 A better understanding of the incidence of COVID-19-associated large- and medium-sized-vessel vasculitis is important to guide clinician decision-making regarding treatment and surveillance imaging. The purpose of this study was to identify patients with COVID-19-associated large- and medium-sized vessel pathologies based on computed tomography (CT) imaging and review their baseline characteristics, COVID-19 clinical course, and outcomes.…”

Section: Introductionmentioning

confidence: 99%

COVID-19-Associated Large- and Medium-Sized-Vessel Pathology: A Case Series

et al. 2022

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Background Coronavirus disease-19 (COVID-19) remains a public health crisis. The epidemiology of COVID-19-associated large- and medium-sized-vessel pathology is not well characterized. The aim of this study is to identify patients with possible COVID-19-associated large- and medium-sized-vessel pathology based on computed tomography (CT) imaging to provide insight into this rare, but potentially devastating, cardiovascular manifestation. Methods This is a single-center retrospective review of patients with CT chest, abdomen, and/or pelvis concerning for large- and medium-vessel pathology and confirmed COVID-19 infection from March 1, 2020 to October 31, 2020. Results During the study period, 6,553 CT reports were reviewed and pertinent imaging was identified in 139 patients. Of these, 8 patients (median age: 59 years, range 51–82) were COVID-19 positive. All patients had preexisting cardiovascular risk factors and three (37.5%) had an autoimmune disease. Four patients were never hospitalized for COVID-19. Among these, two presented to the hospital at a median of 39 days (range: 27–50) after their initial COVID-19 test with chest and back pain where imaging revealed extensive aortic pathology. One patient required surgical management for aortic pathology. All other patients were treated with expectant management and outpatient follow-up. Conclusion The clinical and radiological presentations of COVID-19-associated large- and medium-vessel pathology are heterogeneous and can be a late finding after COVID-19 recovery. Close clinical follow-up and surveillance imaging for large- and medium-sized-vessel pathology may be warranted in COVID-19 patients.

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A Large-Vessel Arteritis in SARS-CoV-2–related Multisystem Inflammatory Syndrome in Children

Cited by 6 publications

References 15 publications

Is COVID-19 All That Glitters?

Is COVID-19 All That Glitters?

Limping as Presenting Symptom of Multisystem Inflammatory Syndrome in Children (MIS-C): a Case Report of Large Vessel Vasculitis in MIS-C

COVID-19-Associated Large- and Medium-Sized-Vessel Pathology: A Case Series

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