Randall Cron, MD, PhD: Multisystem Inflammatory Syndrome in Children

The ongoing coronavirus disease 2019 (COVID-19) pandemic has exposed new pathologies and conditions that were once unheard of or considered unlikely in the pediatric population. Cases of multisystem Inflammatory Syndrome in Children (MIS-C) is a new condition that has recently emerged in pediatric rheumatology.

“This is a new entity that seems to be a post-infectious process in COVID-19 that children seem to be at higher risk for than adults,” said Randall Cron, MD, PhD, Professor of Pediatrics and Medicine, University of Alabama at Birmingham, in an interview with HCPLive®.

In many patients, MIS-C presents features similar to Kawasacki disease, with coronary artery changes in a small subpopulation. Furthermore, shock and gastrointestinal illnesses can be a result of the syndrome if the child is sick enough. Features of a cytokine storm may also occur.

Cron explained that, in addition to treating the shock, it would be typical to manage the hyperinflammation. Because of the syndrome’s shared features with Kawasacki disease, the patient then might receive intravenous immunoglobulin to prevent other complications, such as coronary aneurysms.

“I don’t know who would have predicted MIS-C, or PMIS, or PIMS, or whatever you want to call it. I certainly didn’t predict it,” he concluded. “It’s a fascinating new entity, unfortunately, for pediatric rheumatologists and others.”