A Case of COVID-19-Associated Pediatric Multisystem Inflammatory Syndrome in Shock Managed by Cytokine Filtration

Multisystem inflammatory syndrome in children (MIS-C) after COVID-19 has been recognized as a complication arising due to cytokine storm. Several management strategies including intravenous immunoglobulin and immunomodulators have been reported. This case report highlights the use of a cytokine filt...

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Main Authors: Priyanka Lalwani, Subashini Baskaran, Diego Arango Uribe, Anil Ramaiah, Aqdas Saqib, Mohammed ElMesserey, Emad M. Fathi, Yuichi Tabata, Christoph Fink, Marco Pallavidino
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2022/3373289
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author Priyanka Lalwani
Subashini Baskaran
Diego Arango Uribe
Anil Ramaiah
Aqdas Saqib
Mohammed ElMesserey
Emad M. Fathi
Yuichi Tabata
Christoph Fink
Marco Pallavidino
author_facet Priyanka Lalwani
Subashini Baskaran
Diego Arango Uribe
Anil Ramaiah
Aqdas Saqib
Mohammed ElMesserey
Emad M. Fathi
Yuichi Tabata
Christoph Fink
Marco Pallavidino
author_sort Priyanka Lalwani
collection DOAJ
description Multisystem inflammatory syndrome in children (MIS-C) after COVID-19 has been recognized as a complication arising due to cytokine storm. Several management strategies including intravenous immunoglobulin and immunomodulators have been reported. This case report highlights the use of a cytokine filter (oXiris®) in the management of MIS-C. Cytokine filters eliminate cytokines and reduce the demand for vasopressors in patients with other inflammatory conditions. A 7-year-old child with prolonged fever, vomiting, hypotension, elevated inflammatory mediators, and dilatation of coronary arteries on echocardiography was found to have positive SARS-CoV-2 IgG and PCR. He was diagnosed as MIS-C and was managed in the pediatric intensive care unit. He required ventilatory support, vasopressors, and continuous renal replacement therapy (CRRT) with a cytokine filter. He showed marked improvement within 24 hours of initiating CRRT. Cytokine filters may have a potential role in the management of severely ill children due to MIS-C. To our knowledge, this is the first report of successful use of the oXiris® membrane in MIS-C. However, further case series and controlled trials are needed to establish its use in this condition.
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spelling doaj-art-5a1dcd307e1d46e986f5fe234124e5082025-08-20T03:34:57ZengWileyCase Reports in Pediatrics2090-68112022-01-01202210.1155/2022/3373289A Case of COVID-19-Associated Pediatric Multisystem Inflammatory Syndrome in Shock Managed by Cytokine FiltrationPriyanka Lalwani0Subashini Baskaran1Diego Arango Uribe2Anil Ramaiah3Aqdas Saqib4Mohammed ElMesserey5Emad M. Fathi6Yuichi Tabata7Christoph Fink8Marco Pallavidino9Pediatric Intensive Care UnitPediatric Intensive Care UnitPediatric Intensive Care UnitPediatric Intensive Care UnitPediatric Intensive Care UnitPediatric Intensive Care UnitPediatric Intensive Care UnitPediatric Intensive Care UnitPediatric Intensive Care UnitPediatric Intensive Care UnitMultisystem inflammatory syndrome in children (MIS-C) after COVID-19 has been recognized as a complication arising due to cytokine storm. Several management strategies including intravenous immunoglobulin and immunomodulators have been reported. This case report highlights the use of a cytokine filter (oXiris®) in the management of MIS-C. Cytokine filters eliminate cytokines and reduce the demand for vasopressors in patients with other inflammatory conditions. A 7-year-old child with prolonged fever, vomiting, hypotension, elevated inflammatory mediators, and dilatation of coronary arteries on echocardiography was found to have positive SARS-CoV-2 IgG and PCR. He was diagnosed as MIS-C and was managed in the pediatric intensive care unit. He required ventilatory support, vasopressors, and continuous renal replacement therapy (CRRT) with a cytokine filter. He showed marked improvement within 24 hours of initiating CRRT. Cytokine filters may have a potential role in the management of severely ill children due to MIS-C. To our knowledge, this is the first report of successful use of the oXiris® membrane in MIS-C. However, further case series and controlled trials are needed to establish its use in this condition.http://dx.doi.org/10.1155/2022/3373289
spellingShingle Priyanka Lalwani
Subashini Baskaran
Diego Arango Uribe
Anil Ramaiah
Aqdas Saqib
Mohammed ElMesserey
Emad M. Fathi
Yuichi Tabata
Christoph Fink
Marco Pallavidino
A Case of COVID-19-Associated Pediatric Multisystem Inflammatory Syndrome in Shock Managed by Cytokine Filtration
Case Reports in Pediatrics
title A Case of COVID-19-Associated Pediatric Multisystem Inflammatory Syndrome in Shock Managed by Cytokine Filtration
title_full A Case of COVID-19-Associated Pediatric Multisystem Inflammatory Syndrome in Shock Managed by Cytokine Filtration
title_fullStr A Case of COVID-19-Associated Pediatric Multisystem Inflammatory Syndrome in Shock Managed by Cytokine Filtration
title_full_unstemmed A Case of COVID-19-Associated Pediatric Multisystem Inflammatory Syndrome in Shock Managed by Cytokine Filtration
title_short A Case of COVID-19-Associated Pediatric Multisystem Inflammatory Syndrome in Shock Managed by Cytokine Filtration
title_sort case of covid 19 associated pediatric multisystem inflammatory syndrome in shock managed by cytokine filtration
url http://dx.doi.org/10.1155/2022/3373289
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