Qalab abbas, MBBS
Assistant Professor
Aga Khan University
Karachi, Saskatchewan, United States
Disclosure information not submitted.
Shazia Mohsin, MBBS
Assistant Professor
Aga Khan University, United States
Disclosure information not submitted.
Farah Khalid, MSc
Instructor
Aga Khan University, United States
Disclosure information not submitted.
Abdul Sattar, MBBS
Assistant Professor
National Institute of Cardiovascular Diseases, United States
Disclosure information not submitted.
Zuviya Ali Khan, MBBS
Dr
Medical College, Aga Khan University, United States
Disclosure information not submitted.
Nadeem aslam, MBBS
Assistant Professor
Aga Khan University, United States
Disclosure information not submitted.
Omaima Anis, NA
Dr
Medical College, Aga Khan University, United States
Disclosure information not submitted.
Maha Inam, NA
Dr
Medical College, Aga Khan University, United States
Disclosure information not submitted.
Ali Faisal Saleem, MBBS
Associate Professor
Aga Khan University, United States
Disclosure information not submitted.
Title: Multisystem Inflammatory Syndrome in Pakistani Children: A Description of the Phenotypes
Objectives: To determine clinical, laboratory features and outcomes of Multisystem Inflammatory Syndrome in children (MIS-C) and its comparison with historic Kawasaki Disease (KD) and Viral Myocarditis (VM) cohorts.
Methods: All children (1 month – 18 years) who fulfilled the World Health Organization criteria of MIS-C presenting to two tertiary care centers in Karachi from May 2020 till August 31st were included. KD and VM admitted to one of the study centers in the last five years prior to this pandemic, was compared to MIS-C.
Results: Thirty children with median age of 24 (interquartile range (IQR)1 - 192) months met the criteria for MIS-C. Three phenotypes were identified, 12 patients (40%) with KD, ten (33%) VM and eight (26%) had features of TSS. Echocardiography showed coronary involvement in 10 (33%), and moderate to severe Left Ventricular dysfunction in 10 (33%) patients. Steroids and intravenous immunoglobulins (IVIG) were administered to 24 (80%) and 12 (41%) patients respectively while 7 (23%) received both. Overall, 20% children expired.
During the last five years, 30 and 47 children were diagnosed with KD and VM, respectively. Their comparison with MIS-C group showed lymphopenia, thrombocytosis, and higher CRP as well as more frequent atypical presentation in MIS-C KD group with less coronary involvement. The MIS-C VM was more likely to present with fulminant myocarditis.
Conclusions: Our MIS-C cohort is younger with higher mortality compared to previous reports. MIS-C is distinct from historic cohorts of KD and VM in both in clinical features and outcomes.