Unique Complications of MIS-C and Its Treatment: Encephalopathy in a Child with MIS-C Who Developed Life-Threatening Gastrointestinal Hemorrhage.

Autor: Burton L; University of Alabama at Birmingham, Birmingham, AL, USA., Manchikalapati A; University of Alabama at Birmingham, Birmingham, AL, USA., Rutledge C; University of Alabama at Birmingham, Birmingham, AL, USA., Loberger JM; University of Alabama at Birmingham, Birmingham, AL, USA., Rockwell N; University of Alabama at Birmingham, Birmingham, AL, USA., Cooper J; University of Alabama at Birmingham, Birmingham, AL, USA., Lawrence M; Children's of Alabama, Birmingham, Alabama, USA., Sasser WC; University of Alabama at Birmingham, Birmingham, AL, USA.
Jazyk: angličtina
Zdroj: Case reports in critical care [Case Rep Crit Care] 2022 Oct 22; Vol. 2022, pp. 7244434. Date of Electronic Publication: 2022 Oct 22 (Print Publication: 2022).
DOI: 10.1155/2022/7244434
Abstrakt: In this case report, we describe a previously healthy eleven-year-old male diagnosed with multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019. The patient presented with shock and neurologic symptoms including altered mental status and dysarthria. Brain magnetic resonance imaging, obtained to rule out thromboembolic injury, demonstrated cytotoxic edema of the corpus callosum, an imaging finding similar in nature to several previous reports of MRI abnormalities in children with MIS-C. Following administration of intravenous immunoglobulin and pulse-dose steroids, the patient convalesced and was discharged home. Medications prescribed upon discharge included a steroid taper, daily aspirin, and proton pump inhibitor. Four days later, he was readmitted with shock and life-threatening gastrointestinal (GI) hemorrhage. After extensive evaluation of potential bleeding sources, angiography revealed active bleeding from two arterial vessels supplying the duodenum. The patient demonstrated no further signs of bleeding following successful coil embolization of the two vessels. We hypothesize that the vasculitic nature of MIS-C combined with anti-inflammatory and antithrombotic therapy placed him at risk of GI hemorrhage. This case highlights unique radiologic features of MIS-C as well as potential complications of treatment.
Competing Interests: The authors declare no conflict of interest.
(Copyright © 2022 Luke Burton et al.)
Databáze: MEDLINE
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