Comparison of Multisystem Inflammatory Syndrome (MIS-C) and Dengue in Hospitalized Children
Date
2023-07
Journal Title
Journal ISSN
Volume Title
Publisher
Dr. K C Chaudhuri Foundation
Abstract
Objective Multisystem infammatory syndrome (MIS-C) in children is a febrile illness that has overlapping presentation with other locally prevalent illnesses. Clinicolaboratory profle of children admitted with MIS-C and dengue were compared to understand their presentation at the outset. Methods This was a retrospective study of children?12 y admitted with MIS-C (WHO defnition) or laboratory-confrmed dengue between August 2020 and January 2021 at a tertiary center in North India. Results A total of 84 children (MIS-C - 40; dengue - 44) were included. The mean (SD) age [83.5 (39) vs. 91.6 (35) mo] was comparable. Rash (72.5% vs. 22.7%), conjunctival injection (60% vs. 2.3%), oral mucocutaneous changes (27.5% vs. 0) and gallop rhythm (15% vs. 0) were seen more frequently with MIS-C, while petechiae [29.5% vs. 7.5%], myalgia (38.6% vs. 10%), headache (22.7% vs. 2.5%), and hepatomegaly (68.2% vs. 27.5%) were more common with dengue. Children with MIS-C had signifcantly higher C-reactive protein (124 vs. 3.2 mg/L) and interleukin 6 (95.3 vs. 20.7 ng/mL), while those with dengue had higher hemoglobin (12 vs. 10.2 g/dL) lower mean platelet count (26 vs. 140× 109 /L), and greater elevation in aspartate (607 vs. 44 IU/L) and alanine (235.5 vs. 56 IU/L) aminotransferases. The hospital stay was longer with MIS-C; however, PICU stay and mortality were comparable. Conclusion In hospitalized children with acute febrile illness, the presence of mucocutaneous features and highly elevated CRP could distinguish MIS-C from dengue. The presence of petechiae, hepatomegaly, and hemoconcentration may favor a diagnosis of dengue.
Description
Keywords
Dengue, MIS-C, PIMS-TS, COVID-19, SARS-CoV-2
Citation
Randhawa Manjinder Singh, Jayashree Muralidharan, Angurana Suresh Kumar, Nallasamy Karthi, Minz Ranjana W., Kumar Mahendra, Ravikumar Namita, Awasthi Puspraj, Ghosh Arnab, Ratho R. K., Kumar Rohit Manoj, Bansal Arun. Comparison of Multisystem Inflammatory Syndrome (MIS-C) and Dengue in Hospitalized Children. Indian Journal of Pediatrics. 2023 Jul; 90(7): 654–659