The manifestation of Multisystem Inflammatory Syndrome in Children(MISC): report of 3 cases

In spring 2020 and after the universal spreading of COVID-19, a specific form of multiple organ involvement following of corona infection emerged in pediatric population. in this syndrome, no vital organ, including heart, kidneys, liver, gastrointestinal system and brain were spared. Although, the severity of involvement of different organs in this syndrome was significant, fortunately, and by early usage of intravenous immunoglobulin (IVIG) and corticosteroid, the mortality rate was low. In this article, we introduce three patients with triple manifestations of MISC. The first patient, a 9-year-old boy, with a history of contact with Covid-19 about two weeks ago, presented with gastrointestinal and respiratory symptoms and progressed to acute liver failure. The second patient, a 4-month-old infant presented to emergency room with fever, shock and frequent seizures. brain imaging showed bilateral involvement of the basal ganglia. also, he had a history of contact with COVID-19 about two weeks ago. The third patient, a 5.5-year-old boy, presented with symptoms of abdominal pain, respiratory distress and tachycardia. Radiological and echocardiographic examinations revealed systolic heart failure and pleural/pericardial effusion. he progressed to renal failure and was treated with the diagnosis of MISC. All three patients were discharged from the intensive care unit in good general condition. The incidence of Multisystem Inflammatory Syndrome in Children in patients referred to pediatric emergency rooms is not far from expected. Most of them have had a history of contact with COVID-19. The diagnostic criteria may be incomplete at the time of presentation. Therefore, in line with global studies, the Iranian Children's Rheumatology Association has used the term certain and probable to describe this syndrome. Rapid diagnosis and timely treatment of these patients with IVIG, corticosteroids or a combination of these two agents, greatly reduces the mortality and complications of the disease.