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Feleszko, W.* ; Okarska-Napierała, M.* ; Buddingh, E.P.* ; Bloomfield, M.* ; Sediva, A.* ; Bautista-Rodriguez, C.* ; Brough, H.A.* ; EIgenmann, P.A.* ; Eiwegger, T.* ; Eljaszewicz, A.* ; Eyerich, S. ; Gomez-Casado, C.* ; Fraisse, A.* ; Janda, J.* ; Jiménez-Saiz, R.* ; Kallinich, T.* ; Krohn, I.K.* ; Mortz, C.G.* ; Riggioni, C.* ; Sastre, J.* ; Sokolowska, M.* ; Strzelczyk, Z.* ; Untersmayr, E.* ; Tramper-Stranders, G.*

Pathogenesis, immunology, and immune-targeted management of the multisystem inflammatory syndrome in children (MIS-C) or pediatric inflammatory multisystem syndrome (PIMS): EAACI Position Paper.

Pediatr. Allergy Immunol. 34:e13900 (2023)

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Multisystem inflammatory syndrome in children (MIS-C) is a rare, but severe complication of coronavirus disease 2019 (COVID-19). It develops approximately 4 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and involves hyperinflammation with multisystem injury, commonly progressing to shock. The exact pathomechanism of MIS-C is not known, but immunological dysregulation leading to cytokine storm plays a central role. In response to the emergence of MIS-C, the European Academy of Allergy and Clinical Immunology (EAACI) established a task force (TF) within the Immunology Section in May 2021. With the use of an online Delphi process, TF formulated clinical statements regarding immunological background of MIS-C, diagnosis, treatment, follow-up, and the role of COVID-19 vaccinations. MIS-C case definition is broad, and diagnosis is made based on clinical presentation. The immunological mechanism leading to MIS-C is unclear and depends on activating multiple pathways leading to hyperinflammation. Current management of MIS-C relies on supportive care in combination with immunosuppressive and/or immunomodulatory agents. The most frequently used agents are systemic steroids and intravenous immunoglobulin. Despite good overall short-term outcome, MIS-C patients should be followed-up at regular intervals after discharge, focusing on cardiac disease, organ damage, and inflammatory activity. COVID-19 vaccination is a safe and effective measure to prevent MIS-C. In anticipation of further research, we propose a convenient and clinically practical algorithm for managing MIS-C developed by the Immunology Section of the EAACI.

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Publication type Article: Journal article

Document type Review

Corresponding Author

Keywords Delphi ; Mis-c ; Sars-cov-2 ; Children ; Clinical Algorithm ; Clinical Guidance ; Hyperinflammation ; Intravenous Immunoglobulin ; Management ; Steroids; Bronchial Epithelium; Kawasaki-disease; United-states; Dysregulation; December; Usa

ISSN (print) / ISBN 0905-6157

e-ISSN 1399-3038

Journal Pediatric Allergy and Immunology

Quellenangaben Volume: 34, Issue: 1, Article Number: e13900

Publisher Wiley

Publishing Place 111 River St, Hoboken 07030-5774, Nj Usa

Non-patent literature Publications

Reviewing status Peer reviewed

Institute(s) Institute for Allergy Research (IAF)