Acute Abdomen as a Clinical Presentation of COVID-19-Associated Multisystem Inflammatory Syndrome in Children

Background. On December 2019, a novel coronavirus disease (COVID-19) spread worldwide and became a pandemic. Multisystem inflammatory syndrome in children (MIS-C) due to cytokine release syndrome following COVID-19 presents with various manifestations. We hypothesize that one of the rare manifestati...

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Main Authors: Elmira Hajiesmaeil Memar, Fatemeh Tahghighi, Sedigheh Yousefzadegan, Parisa Sadeghirad, Ashraf Mousavi, Ramin Zare Mahmoudabadi, Hossein Saeidi, Mehri Ayati, Sahar Naderi, Sara Memarian, Seyedmusa Zeinalabedin, Bahar Ashjaei, Hojatollah Raji, Leila Tahernia, Hosein Alimadadi, Vahid Ziaee
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/2024/9941131
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author Elmira Hajiesmaeil Memar
Fatemeh Tahghighi
Sedigheh Yousefzadegan
Parisa Sadeghirad
Ashraf Mousavi
Ramin Zare Mahmoudabadi
Hossein Saeidi
Mehri Ayati
Sahar Naderi
Sara Memarian
Seyedmusa Zeinalabedin
Bahar Ashjaei
Hojatollah Raji
Leila Tahernia
Hosein Alimadadi
Vahid Ziaee
author_facet Elmira Hajiesmaeil Memar
Fatemeh Tahghighi
Sedigheh Yousefzadegan
Parisa Sadeghirad
Ashraf Mousavi
Ramin Zare Mahmoudabadi
Hossein Saeidi
Mehri Ayati
Sahar Naderi
Sara Memarian
Seyedmusa Zeinalabedin
Bahar Ashjaei
Hojatollah Raji
Leila Tahernia
Hosein Alimadadi
Vahid Ziaee
author_sort Elmira Hajiesmaeil Memar
collection DOAJ
description Background. On December 2019, a novel coronavirus disease (COVID-19) spread worldwide and became a pandemic. Multisystem inflammatory syndrome in children (MIS-C) due to cytokine release syndrome following COVID-19 presents with various manifestations. We hypothesize that one of the rare manifestations is acute abdomen. Case Presentation. In this case series, eight cases (five girls and three boys) of gastrointestinal (GI) involvement and acute abdomen were reported to be associated with the cytokine storm due to COVID-19 infection. All patients were of Iranian nationality (Caucasian ethnicity), with a mean age of 8.9 years (range 3.5–14). They all presented with fever and acute abdominal pain. Additionally, maculopapular rash and edema of the extremities were common presentations. Free fluid on abdominal ultrasound or computerized tomography (CT) scan was observed in all patients. All cases tested positive for COVID-19. In six cases, laparotomy or abdominal surgery was performed for a diagnosis of acute abdomen, but appendicitis was confirmed in only one case. None of the cases presented with phlegmon. Elevated serum lipase and amylase levels were noted in two cases. Seven patients received corticosteroid pulse therapy. Clinical symptoms improved after one or two doses, and all patients were discharged after 4 weeks of follow-up with no mortality or morbidity. Conclusion. Patients experiencing unexplained acute abdominal pain along with fever, skin rash, and peripheral edema, who had a history of COVID-19 infection prior to or during the episode of acute abdomen symptoms, should be considered to have MIS-C. Furthermore, methylprednisolone pulse therapy could be a safe treatment option, reducing hospitalization duration in this patient population.
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spelling doaj-art-55f262ef11bb4c7f9a76f6a23e27c4232025-02-03T05:54:41ZengWileyCase Reports in Surgery2090-69192024-01-01202410.1155/2024/9941131Acute Abdomen as a Clinical Presentation of COVID-19-Associated Multisystem Inflammatory Syndrome in ChildrenElmira Hajiesmaeil Memar0Fatemeh Tahghighi1Sedigheh Yousefzadegan2Parisa Sadeghirad3Ashraf Mousavi4Ramin Zare Mahmoudabadi5Hossein Saeidi6Mehri Ayati7Sahar Naderi8Sara Memarian9Seyedmusa Zeinalabedin10Bahar Ashjaei11Hojatollah Raji12Leila Tahernia13Hosein Alimadadi14Vahid Ziaee15Department of PediatricsDepartment of PediatricsDepartment of PediatricDepartment of PediatricsDepartment of PediatricDepartment of PediatricDepartment of PediatricDepartment of PediatricsChildren’s Medical CenterDepartment of PediatricsChildren’s Medical CenterChildren’s Medical CenterChildren’s Medical CenterChildren’s Medical CenterDepartment of PediatricsDepartment of PediatricsBackground. On December 2019, a novel coronavirus disease (COVID-19) spread worldwide and became a pandemic. Multisystem inflammatory syndrome in children (MIS-C) due to cytokine release syndrome following COVID-19 presents with various manifestations. We hypothesize that one of the rare manifestations is acute abdomen. Case Presentation. In this case series, eight cases (five girls and three boys) of gastrointestinal (GI) involvement and acute abdomen were reported to be associated with the cytokine storm due to COVID-19 infection. All patients were of Iranian nationality (Caucasian ethnicity), with a mean age of 8.9 years (range 3.5–14). They all presented with fever and acute abdominal pain. Additionally, maculopapular rash and edema of the extremities were common presentations. Free fluid on abdominal ultrasound or computerized tomography (CT) scan was observed in all patients. All cases tested positive for COVID-19. In six cases, laparotomy or abdominal surgery was performed for a diagnosis of acute abdomen, but appendicitis was confirmed in only one case. None of the cases presented with phlegmon. Elevated serum lipase and amylase levels were noted in two cases. Seven patients received corticosteroid pulse therapy. Clinical symptoms improved after one or two doses, and all patients were discharged after 4 weeks of follow-up with no mortality or morbidity. Conclusion. Patients experiencing unexplained acute abdominal pain along with fever, skin rash, and peripheral edema, who had a history of COVID-19 infection prior to or during the episode of acute abdomen symptoms, should be considered to have MIS-C. Furthermore, methylprednisolone pulse therapy could be a safe treatment option, reducing hospitalization duration in this patient population.http://dx.doi.org/10.1155/2024/9941131
spellingShingle Elmira Hajiesmaeil Memar
Fatemeh Tahghighi
Sedigheh Yousefzadegan
Parisa Sadeghirad
Ashraf Mousavi
Ramin Zare Mahmoudabadi
Hossein Saeidi
Mehri Ayati
Sahar Naderi
Sara Memarian
Seyedmusa Zeinalabedin
Bahar Ashjaei
Hojatollah Raji
Leila Tahernia
Hosein Alimadadi
Vahid Ziaee
Acute Abdomen as a Clinical Presentation of COVID-19-Associated Multisystem Inflammatory Syndrome in Children
Case Reports in Surgery
title Acute Abdomen as a Clinical Presentation of COVID-19-Associated Multisystem Inflammatory Syndrome in Children
title_full Acute Abdomen as a Clinical Presentation of COVID-19-Associated Multisystem Inflammatory Syndrome in Children
title_fullStr Acute Abdomen as a Clinical Presentation of COVID-19-Associated Multisystem Inflammatory Syndrome in Children
title_full_unstemmed Acute Abdomen as a Clinical Presentation of COVID-19-Associated Multisystem Inflammatory Syndrome in Children
title_short Acute Abdomen as a Clinical Presentation of COVID-19-Associated Multisystem Inflammatory Syndrome in Children
title_sort acute abdomen as a clinical presentation of covid 19 associated multisystem inflammatory syndrome in children
url http://dx.doi.org/10.1155/2024/9941131
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