Paediatric inflammatory multisystem syndrome: statement by the paediatric section of the European society of emergency medicine and European academy of paediatrics
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
A rise in cases with a new hyperinflammatory disease in children has been reported in Europe and in the Unites States of America, named the Paediatric Inflammatory Multisystem Syndrome – temporally associated with SARS-CoV-2 (PIMS-TS). There appears to be a wide spectrum of signs and symptoms with varying degrees of severity, including a toxic shock like presentation with hypovolaemia and shock, and a Kawasaki-like presentation with involvement of the coronary arteries. Most of these children have evidence of a previous infection with SARS-CoV-2, or a history of significant exposure, but not all. Limited data exist on the incidence of PIMS-TS, but it remains a rare condition. Early recognition and escalation of care is important to prevent the development of serious sequelae, such as coronary artery aneurysms. Clinicians assessing febrile children in primary and secondary care should include PIMS-TS in their differential diagnoses. In children fulfilling the case definition, additional investigations should be undertaken to look for evidence of inflammation and multiorgan involvement. Suspected cases should be discussed with experts in paediatric infectious diseases at an early stage, and advice should be sought from critical care in more severe cases early. There is limited consensus on treatment; but most children have been treated with immunoglobulins or steroids, and with early consideration of biologicals such anti-TNF and anti-IL1 agents. Treatment should ideally be within the context of controlled treatment trials. Clinicians are encouraged to document and share their cases using research registries.
Date Issued
2020-08
Date Acceptance
2020-07-13
Citation
Frontiers in Pediatrics, 2020, 8, pp.1-10
ISSN
2296-2360
Publisher
Frontiers Media
Start Page
1
End Page
10
Journal / Book Title
Frontiers in Pediatrics
Volume
8
Copyright Statement
© 2020 Nijman, De Guchtenaere, Koletzko, Ross Russell, Copley, Titomanlio, del Torso and Hadjipanayis. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
License URL
Sponsor
National Institute of Health and Medical Research
Identifier
https://www.frontiersin.org/articles/10.3389/fped.2020.00490/full
Grant Number
CL-2018-21-007
Subjects
Science & Technology
Life Sciences & Biomedicine
Pediatrics
children
COVID-19
SARS-CoV-2
PIMS-TS
MIS-C
Kawasaki-like disease
fever
KAWASAKI-LIKE DISEASE
CHILDREN
CORONAVIRUS
COVID-19
Kawasaki-like disease
MIS-C
PIMS-TS
SARS-CoV-2
children
fever
1114 Paediatrics and Reproductive Medicine
1199 Other Medical and Health Sciences
Publication Status
Published
Article Number
490
Date Publish Online
2020-08-28