Phlegmonous Ileocolitis as a Presentation of Post SARS-CoV-2 (COVID-19) Multisystem Inflammatory Syndrome in Children

Shahein, Abdul R; Young, Heather; Dalabih, Abdallah

doi:10.1097/pg9.0000000000000040

Cited by 6 publications

(2 citation statements)

References 5 publications

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“…Therefore, the American Academy of Pediatrics and the American Heart Association guideline suggested the use of high doses of immunoglobulins (2 g/kg) within 8–12 h with high doses of aspirin for the treatment of KD ( Newburger et al, 2004 ). Several studies reported the use of IVIG for the treatment of MIS-C either alone or in combination with other therapies ( Consiglio et al, 2020 ; Diorio et al, 2020 ; Garcia-Dominguez et al, 2020 ; Kaushik et al, 2020 ; Appleberry et al, 2021 ; Hasan et al, 2021 ; Jonat et al, 2021 ; Karthika et al, 2021 ; Shahein et al, 2021 ; Yasuhara et al, 2021 ). For example, in a study by Pouletty et al on 16 patients with MIS-C, 15 patients received IVIG, and only 5 (31%) showed remission after single IVIG treatment and others required second-line treatment ( Pouletty et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Multisystem Inflammatory Syndrome and Autoimmune Diseases Following COVID-19: Molecular Mechanisms and Therapeutic Opportunities

Hosseini

Fallahi

Erabi

et al. 2022

Front. Mol. Biosci.

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Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), has led to huge concern worldwide. Some SARS-CoV-2 infected patients may experience post–COVID-19 complications such as multisystem inflammatory syndrome, defined by symptoms including fever and elevated inflammatory markers (such as elevation of C reactive protein (CRP), erythrocyte sedimentation rate, fibrinogen, procalcitonin test, D-dimer, ferritin, lactate dehydrogenase or IL-6, presence of neutrophilia, lymphopenia, decreased albumin, and multiple organ dysfunction). Post–COVID-19 complications may also manifest as autoimmune diseases such as Guillain-Barré syndrome and systemic lupus erythematosus. Signaling disorders, increased inflammatory cytokines secretion, corticosteroid use to treat COVID-19 patients, or impaired immune responses are suggested causes of autoimmune diseases in these patients. In this review, we discuss the molecular and pathophysiological mechanisms and therapeutic opportunities for multisystem inflammatory syndrome and autoimmune diseases following SARS-CoV-2 infection with the aim to provide a clear view for health care providers and researchers.

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Section: Introductionmentioning

confidence: 99%

Multisystem Inflammatory Syndrome and Autoimmune Diseases Following COVID-19: Molecular Mechanisms and Therapeutic Opportunities

Hosseini

Fallahi

Erabi

et al. 2022

Front. Mol. Biosci.

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“…Rare manifestations of SARS-CoV-2 GI involvement have also been reported in children, including acute appendicitis [79,80], ileocolitis [81], intussusception [82–85], pneumatosis intestinalis and protein-losing enteropathy [86,87].…”

Section: Gastrointestinal Symptoms Of Severe Acute Respiratory Syndro...mentioning

confidence: 99%

Gastrointestinal coronavirus disease 2019 manifestations in childhood

Sansotta

Norsa

D’Antiga

2022

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of reviewThe pandemic of coronavirus disease 2019 , caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has emerged and caused a massive global health crisis. The aim of this review is first, to provide the latest evidence on what is known about the pathophysiology and the transmission of SARS-CoV-2 and then to focus on the manifestations of the gastrointestinal (GI) tract in children with COVID-19. Lastly, we summarise the impact of COVID-19 on patients with preexisting GI diseases. Recent findingsEven though the virus is mostly transmitted from human to human via respiratory droplets, ACE2 is known to be expressed throughout the GI tract, and SARS-CoV-2 ribonucleic acid has been isolated from patients' stools. GI symptoms including abdominal pain, diarrhoea and vomiting are frequently reported in paediatric patients. Interestingly, a small number of patients seem to exhibit solely GI symptoms. In addition, a multisystem inflammatory syndrome in children (MIS-C) related to SARS-COV-2 described in children, has a high rate of GI involvement. Several etiopathogenetic mechanisms have been postulated to explain the GI involvement of COVID-19. SummaryClinicians should not underestimate or disregard these early or mild GI symptoms, because the patients may be infected and transmit the virus, or develop a more severe condition such as MIS-C.

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Acute abdomen in multisystem inflammatory syndrome in children: A systematic review

2021

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Aim Multisystem inflammatory syndrome in children (MIS‐C), a rare severe complication of SARS‐CoV‐2 infection, has been recently reported to mimic acute abdomen and lead to surgical interventions, posing challenges for clinicians. In this systematic review, we evaluated the rate of acute abdomen and abdominal surgical emergencies in children with MIS‐C. Methods Systematic review of all MIS‐C cases presented with acute abdomen. Results A total of 385 patients with MIS‐C, from 38 studies, were included. Gastrointestinal manifestations were prominent in 233/385 (60.5%) children. Acute abdomen was noted in 72/385 (18.7%) of MIS‐C cases and in 72/233 (30.9%) of MIS‐C cases with gastrointestinal symptoms. Final diagnoses were mostly non‐surgical (55/72, 76.4%), such as mesenteric lymphadenitis (23/72, 31.9%), terminal ileitis/ileocolitis (19/72, 26.4%), free abdominal fluid/ascites (8/72, 11.1%) and paralytic ileus (3/72, 4.2%). Laparotomy was performed in 35/72 (48.6%) of children with MIS‐C, and acute abdomen and was proven unnecessary in 18/35 (51.4%) cases. True abdominal surgical emergencies, such as appendicitis and obstructive ileus, were confirmed in 17/72 (23.6%) cases. Conclusion MIS‐C often presents with acute abdomen, mostly due to non‐surgical intestinal inflammatory pathology. However, surgical complications occur in patients with MIS‐C; therefore, a high index of suspicion should remain.

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Phlegmonous Ileocolitis as a Presentation of Post SARS-CoV-2 (COVID-19) Multisystem Inflammatory Syndrome in Children

Cited by 6 publications

References 5 publications

Multisystem Inflammatory Syndrome and Autoimmune Diseases Following COVID-19: Molecular Mechanisms and Therapeutic Opportunities

Multisystem Inflammatory Syndrome and Autoimmune Diseases Following COVID-19: Molecular Mechanisms and Therapeutic Opportunities

Gastrointestinal coronavirus disease 2019 manifestations in childhood

Acute abdomen in multisystem inflammatory syndrome in children: A systematic review

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