Inflammatory Bowel Disease Presenting With Concurrent COVID-19 Multisystem Inflammatory Syndrome.
| Autor: | Sweeny KF; Division of Gastroenterology, Hepatology and Nutrition and.; Contributed equally as co-first authors., Zhang YJ; Division of Gastroenterology, Hepatology and Nutrition and.; Contributed equally as co-first authors., Crume B; Departments of Medicine, and., Martz CA; Departments of Medicine, and., Blessing MM; Pathology, Boston Children's Hospital, Boston, Massachusetts., Kahn SA; Division of Gastroenterology, Hepatology and Nutrition and stacy.kahn@childrens.harvard.edu. |
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| Jazyk: | angličtina |
| Zdroj: | Pediatrics [Pediatrics] 2021 Apr; Vol. 147 (4). Date of Electronic Publication: 2021 Jan 07. |
| DOI: | 10.1542/peds.2020-027763 |
| Abstrakt: | Coronavirus disease 2019 is associated with a postinfectious multisystem inflammatory syndrome in children (MIS-C). This syndrome is marked by cytokine storm and multiorgan dysfunction, often affecting the gastrointestinal tract, the heart, and the hematopoietic system. We describe the case of a 16-year-old boy with an initial presentation of severe inflammatory bowel disease and concurrent MIS-C. He presented with abdominal pain, diarrhea, and hematochezia and met criteria for the systemic inflammatory response syndrome. Laboratory inflammatory profiling revealed markedly elevated ferritin, D-dimer, C-reactive protein, soluble interleukin 2, and interleukin 6 levels. Endoscopy and colonoscopy revealed severe active gastroduodenitis, patchy colitis, and a normal-appearing terminal ileum. The patient was treated with a combination of steroids, intravenous immunoglobulin, and infliximab, and his symptoms slowly resolved over a 3-week period. In this case, we describe coincident MIS-C with a remarkably severe and difficult-to-treat initial presentation of inflammatory bowel disease and highlight the need to investigate the effect of coronavirus disease 2019 and MIS-C on inflammatory disorders. Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. (Copyright © 2021 by the American Academy of Pediatrics.) |
| Databáze: | MEDLINE |
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