<unk>  (MIS-C), or paediatric inflammatory<unk>  syndrome (PIMS / PIMS-TS), or systemic inflammatory syndrome in COVID-19 (SISCoV), is a rare systemic illness involving persistent fever and extreme inflammation following exposure to SARS-CoV-2, the virus responsible for COVID-19. MISC-C is also recognized as a potential pediatric adverse event following COVID-19 vaccination. It can rapidly lead to medical emergencies such as insufficient blood flow around the body (a condition known as shock). Failure of one or more organs can occur. A warning sign is unexplained persistent fever with severe symptoms following exposure to COVID-19. Prompt referral to paediatric specialists is essential, and families need to seek urgent medical assistance. Most affected children will need intensive care. All affected children have persistent fever. Other clinical features vary. The first symptoms often include acute abdominal pain with diarrhoea or vomiting. Muscle pain and general tiredness are frequent, and low blood pressure is also common. Symptoms can also include pink eye, rashes, enlarged lymph nodes, swollen hands and feet, and "strawberry tongue". Various mental disturbances are possible. A cytokine storm may take place, in which the child's innate immune system stages an excessive and uncontrolled inflammatory response. Heart failure is common. Clinical complications can include damage to the heart muscle, respiratory distress, acute kidney injury, and increased blood coagulation. Coronary artery abnormalities can develop (ranging from dilatation to aneurysms). This life-threatening disease has proved fatal in under 2% of reported cases. Early recognition and prompt specialist attention are essential. Anti-inflammatory treatments have been used, with good responses being recorded for intravenous immunoglobulin (IVIG), with or without corticosteroids. Oxygen is often needed. Supportive care is key for treating clinical complications. Most children who receive expert hospital care survive. Knowledge of this newly described syndrome is evolving rapidly. Its clinical features may appear somewhat similar to Kawasaki disease, a rare disease of unknown origin that typically affects young children, in which blood vessels become inflamed throughout the body. It can also show features of other serious inflammatory conditions of childhood, including toxic shock and macrophage activation syndromes. Nevertheless, it appears to be a separate syndrome. Older children tend to be affected. This emerging condition has been defined slightly differently (using different names), by the World Health Organization (WHO), the Royal College of Paediatrics and Child Health (RCPCH), and the Centers for Disease Control and Prevention (CDC). Although the condition is thought to follow SARS-CoV-2 viral infection, antigen or antibody tests are not always positive. Exclusion of alternative causes, including bacterial and other infections, is essential for differential diagnosis. Some general clinical guidance has been provided by the RCPCH, the National Institutes of Health, the American College of Rheumatology, and the American Academy of Pediatrics. Clusters of new cases have been reported two to six weeks after local peaks in viral transmission. The disease is thought to be driven by a delayed biological mechanism in certain predisposed children. The European Centre for Disease Prevention and Control (ECDC) has rated risk to children in Europe as being 'low' overall, based on a 'very low' likelihood of a child developing this 'high impact' disease. Regarding ethnicity, the condition seems to affect more children of African, Afro-Caribbean, and Hispanic descent, whereas Kawasaki disease affects more of East Asian ancestry. Initial reports regarded children in various parts of Europe and the United States, and it was unclear to what extent the condition had gone unrecognized elsewhere. Reports have since emerged of cases in various other countries around the world. In adults, a similar condition has occasionally been reported, which has been called<unk>  inflammatory syndrome in adults (MIS-A).
Multisystem inflammatory syndrome in children
Kawasaki disease
Cutaneous manifestations of COVID-19
Systemic inflammatory response syndrome
Chest pain in children
complications of Typhus
Multiple organ dysfunction syndrome
complications of Sepsis