Keywords
pediatric multisystem inflammatory disease, COVID-19 related
abdomen, acute
appendicitis
How to Cite
Abstract
In the context of the disease caused by the new coronavirus SARS-CoV-2, an unusual condition called multisystem inflammatory syndrome in children associated with COVID-19 has been described, and its most common symptoms are gastrointestinal. Severe acute abdominal pain occurs in up to 60% of cases, requiring mainly a differential diagnosis with acute appendicitis. It is described the clinical case of an adolescent who presented abdominal pain, bloating, fever and diarrhea, with very high C-reactive protein and tomographic findings compatible with acute appendicitis, for which he underwent surgery. He was later diagnosed with the disease, after consulting again with fever and abdominal pain. Acute appendicitis related to this syndrome is associated with ischemia due to intestinal vasculitis and is a life-threatening immunological complication due to the risk of intestinal perforation.
References
Henderson LA, Canna SW, Friedman KG, Gorelik M, Lapidus SK, Bassiri H, et al. American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS–CoV-2 and Hyperinflammation in Pediatric COVID-19: Version 3.
Arthritis Rheumatol. 2021;73(4): e13–e29. 2. F Son MB, Friedman K. COVID-19: Multisystem inflammatory syndrome in children (MIS-C) clinical features, evaluation, and diagnosis. UpToDate. 2020.
Bittmann S, Weissenstein A, Luchter E, Moschüring-Alieva E, Villalon G. Multisystem inflammatory syndrome in children (MIS-C): The role of viral superantigens in COVID-19 disease. J Allergy Infect Dis. 2020;1(1):18–20.
Ospina M, Prieto F. ANEXO. VIGILANCIA EN SALUD PÚBLICA DEL SÍNDROME INFLAMATORIO MULTISISTÉMICO EN NIÑOS ASOCIADO A INFECCIÓN POR SARS-COV2 [Internet]. Bogotá: Instituto Nacional de Salud; 2021. Disponible en: http://www.saludcapital.gov.co/CTDLab/Publicaciones/2021/Vigil_Sindrome_infl_M_ninos_SARS-CoV2.pdf.
Ahmed M, Advani S, Moreira A, Zoretic S, Martínez J, Chorath K, et al. Multisystem inflammatory syndrome in children: A systematic review. EClinicalMedicine [Internet]. 2020; 26:100527. Disponible en: https://doi.org/10.1016/j.eclinm.2020.100527.
Miller J, Cantor A, Zachariah P, Ahn D, Martínez M, Margolis KG. Gastrointestinal Symptoms as a Major Presentation Component of a Novel Multisystem Inflammatory Syndrome in Children That Is Related to Coronavirus Disease 2019: A Single Center Experience of 44 Cases. Gastroenterology [Internet]. 2020; 159(4):1571- 1574.e2. Available from: https://doi.org/10.1053/j.gastro.2020.05.079.
Naka F, Melnick L, Gorelik M, Morel KD. A dermatologic perspective on multisystem inflammatory syndrome in children. Clin Dermatol. 2021;39(1):163-68.
Colomba C, La Placa S, Saporito L, Corsello G, Ciccia F, Medaglia A, et al. Intestinal Involvement in Kawasaki Disease. J Pediatr. 2018;202:186-93.
Toubiana J, Poirault C, Corsia A, Bajolle F, Fourgeaud J, Angoulvant F, et al. Kawasakilike multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study. BMJ. 2020;369:m2094.
F Son MB, Friedman K. COVID-19: Multisystem inflammatory syndrome in children (MIS-C) management and outcome. uptodate. 2020.
Sahn B, Eze OP, Edelman MC, Chougar CE, Thomas RM, Schleien CL, et al. Features of Intestinal Disease Associated With COVIDRelated Multisystem Inflammatory Syndrome in Children. J Pediatr Gastroenterol Nutr. 2021;72(3):384–7.
Puoti MG, Rybak A, Kiparissi F, Gaynor E, Borrelli O. SARS-CoV-2 and the Gastrointestinal Tract in Children. Front Pediatr. 2021;9(February).
Fernández-Sarmiento J, De Souza D, Jabornisky R, González GA, Arias López M del P, Palacio G. Paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS): a narrative review and the viewpoint of the Latin American Society of Pediatric Intensive Care (SLACIP) Sepsis Committee. BMJ Paediatr Open. 2021;5: e000894.
Yock-Corrales A, Lenzi J, Ulloa-Gutiérrez R, Gómez-Vargas J, Antúnez-Montes OY, Ríos Aida JA, et al. Acute Abdomen and Appendicitis in 1010 Pediatric Patients with COVID-19 or MIS-C: A Multinational Experience from Latin America. Pediatr Infect Dis J. 2021;40(10):364–9.
Valitutti F, Verde A, Pepe A, Sorrentino E, Veneruso D, Ranucci G, et al. Multisystem inflammatory syndrome in children. An emerging clinical challenge for pediatric surgeons in the COVID 19 era. J Pediatr Surg Case Reports. 2021;69: 101838.
Khesrani LS, Chana K, Sadar FZ, Dahdouh A, Ladjadj Y, Bouguermouh D. Intestinal ischemia secondary to Covid-19. J Pediatr Surg Case Reports [Internet]. 2020 [Oct];61(Enero):1-5. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S2213576620302384.
Lishman J, Kohler C, De Vos C, Van Der Zalm MM, Itana J, Redfern A, et al. Acute Appendicitis in Multisystem Inflammatory Syndrome in Children with COVID-19. Pediatr Infect Dis J. 2020;39(12): E472–3.
Jackson RJ, Chavarria HD, Hacking SM. A Case of Multisystem Inflammatory Syndrome in Children Mimicking Acute Appendicitis in a COVID-19 Pandemic Area. Cureus. 2020;12(9):1–5.
Olmos García JM, Pareja Marín F, Martínez Bayo Á, Silvestre Beneyto R, Escrivá Tomás P. Apendicitis aguda en niños con síndrome inflamatorio multisistémico pediátrico asociado a SARS-CoV-2 (SIM-PedS). Una complicación a considerar. An Pediatr (Barc). 2021; 95(6):479- 482.
Hwang M, Wilson K, Wendt L, Pohlman J, Densmore E, Kaeppler C, et al. The Great Gut Mimicker: A case report of MIS-C and appendicitis clinical presentation overlap in a teenage patient. BMC Pediatr. 2021;21(1):258.
Trevisan M, Amaddeo A, Taddio A, Boscarelli A, Barbi E, Cozzi G. Case Report: Simil-Appendicitis Presentation May Precede Cardiac Involvement in MIS-C Patient. Front Pediatr. 2022; 10:832391.
Malhotra A, Sturgill M, Whitley-Williams P, Lee YH, Esochaghi C, Rajasekhar H, et al. Pediatric COVID-19 and Appendicitis: A Gut Reaction to SARS-CoV-2? Pediatr Infect Dis J. 2021;40(2):49- 55.
Azlll MN, Güney D, Oztorun CI, Ertürk A, Erten EE, Demir S, et al. Determination of Factors to Distinguish MIS-C from Acute Appendicitis in Children with Acute Abdominal Pain. Eur J Pediatr Surg. 2022;32(3):240-250.
Antúnez-Montes OY, Escamilla MI, FigueroaUribe AF, Arteaga-Menchaca E, LavariegaSaráchaga M, Salcedo-Lozada P, et al. COVID-19 and Multisystem Inflammatory Syndrome in Latin American Children: A Multinational Study. Pediatr Infect Dis J. 2021;40(1):1-6.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2022 Médicas UIS