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India is currently facing a double burden of severe dengue and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Co-infection/complication due to these viruses can result in severe morbidity. We present five cases of severe dengue with multisystem inflammatory syndrome in children (MIS-C) due to SARS-CoV-2 infection in children. All children presented with shock with variable degrees of plasma leakage. They were treated initially as severe dengue cases; however, due to refractory symptoms such as persistent fever and inotropic requirement, an alternate diagnosis was suspected and established. They were successfully managed according to the World Health Organization Dengue Shock Syndrome and MIS-C Guidelines with intravenous (IV) fluids, methylprednisolone, aspirin, and IV immunoglobulin. Severe dengue in endemic regions overlapping with MIS-C makes it difficult to diagnose which needs early recognition and appropriate management.

Maternal alloantibodies against erythrocyte antigens Rh (D) usually cause clinically significant hemolysis in neonatal period. Anti-c is the next most common cause of severe HDNB after anti-D. We present In this article, a case of HDNB due to anti-c antibody incompatibility, which is a rare cause of anemia. A Preterm 35 weeks GA male baby with birth weight 2240 grams, Bilirubin total was 28.9 mg/dl, DCT was positive, Hb 10.5 gm/dl. Then minor blood group incompatibility was suspected and sent for analysis. Meanwhile baby was given ivig @1gm/kg over 6hrs. Extended Rh phenotyping turned out to be Anti-c antibody positive in mother's serum causing alloimmune hemolytic anemia in baby. Anti-c antibodies may occur due to prior exposures such as blood transfusions, abruptio placenta, spontaneous abortion, previous cesarean section. In newborns presenting with evidence of neonatal jaundice due to hemolysis not due to Rh and ABO incompatibilities, possibility of minor blood group incompatibility should be considered. There is a necessity for introduction of antibody screening for pregnant woman as a part of antenatal care in order to reduce burden of HDNB. [ABSTRACT FROM AUTHOR]