Aspirin/steroids

Abstract

An 11-year-old boy developed gastrointestinal haemorrhage following treatment with aspirin and unspecified steroids for multisystem inflammatory syndrome in children (MIS-C) [dosages and routes not stated].The boy was admitted to paediatric ICU. Considering clinical appearance, laboratory evaluation and SARS-CoV-2 antibody profile, he was diagnosed with MIS-C. He presented with mild shock, dysarthria and encephalopathy. Brain MRI revealed cytotoxic oedema of the corpus callosum. He received IV immune globulin [immunoglobulin] and pulse dose of unspecified steroids. Subsequently, he convalesced and was discharged home. His discharge medications included aspirin, unspecified tapered steroids and unspecified proton pump inhibitors. After four days, he presented with shock and life-threatening gastrointestinal haemorrhage.The boy was treated with large scale resuscitation with unspecified vasoactive agents and twice his own circulatory volume delivered by a rapid infusion system. An angiography along with extensive evaluation revealed bleeding from two arterial vessels supplying the duodenum. He underwent successful coil embolization of two arteries and did not demonstrate any further bleeding.