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Recognizing a MIS-Chievous Cause of Acute Viral Gastroenteritis

Authors :
Keely G Smith
Audrey Wanger
Ankur A Kamdar
Melissa R. Van Arsdall
Yuying Liu
Kokila Kakarala
Shabba A Armbrister
Rhea Daniel
Jon Marc Rhoads
Anthony R Flores
Rohit Josyabhatla
Konstantinos Boukas
Source :
Frontiers in Pediatrics, Vol 9 (2021), Frontiers in Pediatrics
Publication Year :
2021
Publisher :
Frontiers Media SA, 2021.

Abstract

Historically, children evaluated for vomiting and diarrhea secondary to viral enteritis have symptoms lasting 2–4 days and respond to supportive care, including oral rehydration and anti-emetics if required. Recently, within a 14-day timespan, we encountered three children with severe diarrhea who rapidly became dehydrated and went into hypotensive shock. Although SARS-CoV-2 molecular tests were negative by nasopharyngeal swab, all were later found to have MIS-C. This small case series underscores features reported in previous larger studies and emphasizes the rapid clinical evolution of this condition. We highlight the importance of early recognition of cardinal laboratory findings characteristic of MIS-C (i.e., lymphopenia, markedly elevated acute phase reactants, and hypoalbuminemia). We also show serologic evidence that the pathophysiological mechanism of SARS-CoV-2 related diarrhea may differ from other causes of dehydrating vomiting and diarrhea, with no serologic evidence of villus cell injury.

Details

ISSN :
22962360
Volume :
9
Database :
OpenAIRE
Journal :
Frontiers in Pediatrics
Accession number :
edsair.doi.dedup.....160a57053b23defe6af4469e55e42512