Case Report: Case Series of Children With Multisystem Inflammatory Syndrome Following SARS-CoV-2 Infection in Switzerland.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_0BF8F37EE29A
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Case Report: Case Series of Children With Multisystem Inflammatory Syndrome Following SARS-CoV-2 Infection in Switzerland.
Journal
Frontiers in pediatrics
Author(s)
Fouriki A., Fougère Y., De Camaret C., Blanchard Rohner G., Grazioli S., Wagner N., Relly C., Pachlopnik Schmid J., Trück J., Kottanatu L., Perez E., Perez M.H., Schaffner D., Asner S.A., Hofer M.
ISSN
2296-2360 (Print)
ISSN-L
2296-2360
Publication state
Published
Issued date
2020
Peer-reviewed
Oui
Volume
8
Pages
594127
Language
english
Notes
Publication types: Case Reports
Publication Status: epublish
Abstract
Since the beginning of the severe SARS-CoV-2 pandemic, an increasing number of countries reported cases of a systemic hyperinflammatory condition defined as multi-system inflammatory syndrome in children (MIS-C). The clinical features of MIS-C can be an overlap of Kawasaki Disease (KD), Toxic Shock Syndrome (TSS), Macrophage Activation Syndrome (MAS), or have often an acute abdominal presentation. Intravenous immunoglobulin (IVIG) is recommended as first line therapy in KD. Recent evidence suggests intravenous immunoglobulins (IVIG) resistance in some cases of SARS-CoV-2 related MIS-C, thereby questioning the benefit of immunomodulators such as IL-1 or IL-6 blocking agents. We report on a cohort of 6 Swiss children with SARS-CoV2 related MIS-C presenting with clinical features compatible with Incomplete KD and Toxic Shock Syndrome associated to a cytokine storm. Serum cytokine profile investigations showed increased IL1RA levels (8 to 22-fold) in 5 of the 6 patients (one patient had not been tested), whereas, IL-6 serum levels were increased only in the 3 patients of the 6 who were tested. With exception of one patient who had only benefited by Anakinra, all patients received at least one dose of IVIG. One patient has only received Anakinra with favorable evolution, and three patients had also a steroid treatment. In addition to all this anti-inflammatory medication two patients have also received one dose of anti-IL6. In conclusion, our case series reports on clinical and laboratory findings of most of Swiss cases with MIS-C and suggests the use of Anakinra as an alternative to steroids in these children, most of whom presented with high IL-1RA levels.
Keywords
Anakinra, IL-1ra, MIS-C, SARS-CoV-2, child
Pubmed
Web of science
Open Access
Yes
Create date
26/01/2021 12:14
Last modification date
30/04/2021 6:08
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