Evidence map›Paper›PMID 40937188›Full record

ArticleCase reports in pediatrics2025

Pediatric Gastrointestinal Disorders in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated With COVID-19: A Case Series.

Michele di Toma, Ilaria Cassitti, Benedetta Ciccone, Enrica Manca, Alessandra Marinari, Isabella Patisso, Maria Nobili, Angelo Campanozzi

Abstract readCase Reports
In one paragraph

Article in Case reports in pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Michele di TomaPediatrics, University Hospital of Foggia, Foggia, Italy.ORCID https://orcid.org/0009-0006-9972-3365
Ilaria CassittiUniversity of Foggia, Foggia, Italy.
Benedetta CicconeUniversity of Foggia, Foggia, Italy.
Enrica MancaPediatrics, University Hospital of Foggia, Foggia, Italy.ORCID https://orcid.org/0000-0002-8723-0129
Alessandra MarinariPediatrics, University Hospital of Foggia, Foggia, Italy.
Isabella PatissoPediatrics, University Hospital of Foggia, Foggia, Italy.
Maria NobiliPediatric Surgery, University Hospital of Foggia, Foggia, Italy.
Angelo CampanozziPediatrics, University Hospital of Foggia, Foggia, Italy.ORCID https://orcid.org/0000-0002-3489-2524

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Multisystem inflammatory syndrome in children (MIS-C) is an immune activation syndrome associated with prior SARS-CoV-2 infection. Clinical manifestations of MIS-C develop 2-6 weeks after SARS-CoV-2 infection with possible involvement of the heart, lungs, kidneys, skin, central nervous system, and digestive tract. Five children with MIS-C (6.6 ± 1.3 years, M:F = 3:2) were admitted to our hospital from January 2021 to March 2022. They all presented with gastrointestinal manifestations, with SARS-CoV-2 molecular swab negativity and positive serology. One child was reported to have a known previous asymptomatic SARS-CoV-2 infection (more than 4 weeks prior to admission). Another one was reported to have received COVID-19 vaccine (second dose four weeks prior to admission). Three/5 were obese children (BMI greater than 95th percentile). All patients experienced fever, abdominal pain, and lack of appetite. Four/5 had vomiting, 3/5 presented diarrhea, 2/5 had constipation, and two male patients had scrotal edema. Three/5 presented with severe gastrointestinal involvement, mimicking appendicopathy; one of them underwent exploratory laparoscopy without histological features of appendicitis. None of them had increased levels of transaminases but one child showed pancreatitis. The median peak value of: IL-6 was 186.5 pg/mL (range: 15.1-692.5; normal values: 0.5-6.4); CRP was 191.4 mg/L (range: 131-386.7; normal values: 0-2); procalcitonin was 19.8 ng/mL (range: 4.27-100; normal value: < 0.5). We treated all patients with intravenous immunoglobulins and steroids. One patient needed oxygen therapy and parenteral nutrition. Nobody died. According to published data, patients with MIS-C have a high rate of abdominal symptoms. Fever and gastrointestinal symptoms were reported in all cases, some of them mimicking acute appendicitis. In the literature, appendectomy was performed in the majority of patients admitted as suspected appendicitis. Moreover, histopathology demonstrated only serosal inflammation, without the typical involvement of acute appendicitis. Following the diagnosis of MIS-C, specific therapy was started, leading to clinical improvement. In conclusion, during the COVID-19 pandemic, MIS-C should always be taken into account in children with persistent fever and severe gastrointestinal symptoms to avoid unnecessary surgical exploration.

Identifiers

PMID40937188
PMCPMC12422849

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