Gå direkt till huvudinnehållet

Multisystem inflammatory syndrome in children (MIS-C)

Senast uppdaterad: Publicerad:
Definition:
Multisystem inflammatory syndrome (MIS-C) ses hos barn och ungdomar med aktiv eller nyligen genomgådd SARS-CoV-2.
Förekomst:
Mycket ovanligt tillstånd, men rapporterade fall finns i Sverige. I USA 570 fall under perioden mars-juli 2020.
Symtom:
Ett spektrum av symtom inkluderande hög feber samt varierande grad av påverkan på ett eller flera organ. Två eller flera organsystem involverade, hög andel av chock, andningsbesvär och behov av intensivvård.
Kliniska fynd:
Feber, buksmärta, takypné, utslag, konjunktivit, tecken på hjärtskada, nedsatt allmänt tillstånd.
Diagnostik:
Feber, påvisande av multiorgan-sjukdom, förhöjda inflammationsmarkörer och tecken på ökad koagulering.
Behandling:
Intensivvårdsbehandling, eventuellt ventilationsstöd. IVIG och acetylsalicylsyra till alla som också uppfyller Kawasaki-kriterierna.
  1. Horne AC, Nordenhäll L. Hyperinflammation hos barn kan ha samband med covid-19. Läkartidningen. 2020;117:20094
  2. Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet 2020;395:1607–8. PMID: 32386565 PubMed  
  3. Whittaker E, Bamford A, Kenny J, et al.; PIMS-TS Study Group and EUCLIDS and PERFORM Consortia. Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2. JAMA 2020;324:259–69. PMID: 32511692 PubMed  
  4. Godfred-Cato S, Bryant B, Leung J, et al. COVID-19–Associated Multisystem Inflammatory Syndrome in Children — United States, March–July 2020. MMWR Morb Mortal Wkly Rep. ePub: 7 August 2020. doi: 10.15585/mmwr.mm6932e2 DOI  
  5. Belhadjer Z, Méot M, Bajolle F, et al. Acute heart failure in multisystem inflammatory syndrome in children (MIS-C) in the context of global SARS-CoV-2 pandemic. Circulation 2020. E-pub May 17, 2020
  6. Verdoni L, Mazza A, Gervasoni A, et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet 2020;395:1771–8. PMID: 32410760 PubMed  
  7. Dufort EM, Koumans EH, Chow EJ, et al.; New York State and CDC Multisystem Inflammatory Syndrome in Children Investigation Team. Multisystem inflammatory syndrome in children in New York State. N Engl J Med 2020;383:347–58. PMID: 32598830 PubMed  
  8. Toubiana J, Poirault C, Corsia A, et al. Outbreak of Kawasaki disease in children during COVID-19 pandemic in Paris, France: prospective observational study. BMJ 2020;369:m2094. PMID: 32493739 PubMed  
  9. Feldstein LR, Rose EB, Horwitz SM, et al.; Overcoming COVID-19 investigators and the CDC COVID-19 Response Team. Multisystem inflammatory syndrome in U.S. children and adolescents. N Engl J Med 2020;383:334–46. PMID: 32598831 PubMed  
  10. Boston Children’s Hospital; Fliesler N. Covid-19 and a serious inflammatory syndrome in children: unpacking recent warnings. 8 maj 2020. https://discoveries.childrenshospital.org/covid-19-inflammatory-syndrome-children/
  11. Belay ED, Abrams J, Oster ME. Trends in Geographic and Temporal Distribution of US Children With Multisystem Inflammatory Syndrome During the COVID-19 Pandemic.JAMA Pediatr. Published online April 6, 2021. doi:10.1001/jamapediatrics.2021.0630 DOI  
  12. Holm M, Espenhain L, Glenthøj J, et al. Risk and Phenotype of Multisystem Inflammatory Syndrome in Vaccinated and Unvaccinated Danish Children Before and During the Omicron Wave. JAMA Pediatr 2022. pmid:35675054 PubMed  
  13. Rhedin S, et al. Lancet Reg Health Eur. Epub 22 jun 2022. doi: 10.1016/j.lanepe.2022.100443 DOI  
  14. Bautista-Rodriguez C, Sanchez-de-Toledo J, Clark BC. Multisystem Inflammatory Syndrome in Children: An International Survey. Pediatrics Feb 2021, 147 (2) e2020024554; DOI: 10.1542/peds.2020-024554 DOI  
  15. Carlin R, Fischer AM, Pitkowsky Z, et al. Discriminating MIS-C Requiring Treatment from Common Febrile Conditions in Outpatient Settings. J Pediatr 2020. pmid:33065115 PubMed  
  16. Penner J, Abdel-Mannan O, Grant K, Maillard S, Kucera F, Hassell J, Eyre M, Berger Z, Hacohen Y, Moshal K; GOSH PIMS-TS MDT Group. 6-month multidisciplinary follow-up and outcomes of patients with paediatric inflammatory multisystem syndrome (PIMS-TS) at a UK tertiary paediatric hospital: a retrospective cohort study. Lancet Child Adolesc Health. 2021 Jul;5(7):473-482. doi: 10.1016/S2352-4642(21)00138-3. Epub 2021 May 25. PMID: 34043958. PubMed