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Vol. 63. Issue 4.
Pages 334-344 (July - August 2021)
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Vol. 63. Issue 4.
Pages 334-344 (July - August 2021)
Update in Radiology
Clinical and radiological findings for the new multisystem inflammatory syndrome in children associated with COVID-19
Revisión de los hallazgos clínicos y radiológicos del nuevo síndrome inflamatorio multisistémico pediátrico vinculado a la COVID-19
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R. Sánchez-Oroa,
Corresponding author
raquel_sanchez_oro@hotmail.com

Corresponding author.
, M.L. Fatahi Bandpeya, E. García Martínezb, M.Á. Edo Pradesc, E.M. Alonso Muñozb
a Servicio de Radiodiagnóstico, Hospital General de Teruel Obispo Polanco, Teruel, Spain
b Servicio de Radiodiagnóstico, Hospital Arnau de Vilanova de Valencia - Hospital de Llíria, Valencia, Spain
c Servicio de Radiodiagnóstico, Hospital General Universitario de Castellón, Castellón, Spain
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Tables (3)
Table 1. Definitions of SIM-PedS by WHO, RCPCH, CDC.
Table 2. Clinical pictures compatible with SIM-PedS and differential diagnosis proposed by the Asociación Española de Pediatría in its consensus document.18
Table 3. Differences between SIM-PedS imaging test findings and typical pediatric COVID-19 findings.
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Abstract

The World Health Organization defines the multisystem inflammatory syndrome in children (MIS-C) as a new syndrome reported in patients aged <19 years old who have a history of exposure to SARS-CoV-2. The onset of this syndrome is characterized by persistent fever that is associated with lethargy, abdominal pain, vomiting and/or diarrhea, and, less frequently, rash and conjunctivitis. The course and severity of the signs and symptoms vary; in some children, MIS-C worsens rapidly and can lead to hypotension, cariogenic shock, or even damage to multiple organs. The characteristic laboratory findings are elevated markers of inflammation and heart dysfunction. The most common radiological findings are cardiomegaly, pleural effusion, signs of heart failure, ascites, and inflammatory changes in the right iliac fossa. In the context of the current COVID-19 pandemic, radiologists need to know the clinical, laboratory, and radiological characteristics of this syndrome to ensure the correct diagnosis.

Keywords:
Multisystem inflammatory syndrome in children
COVID-19
SARS-CoV-2
Resumen

El síndrome inflamatorio multisistémico pediátrico vinculado a la COVID-19 (SIM-PedS) es, según la Organización Mundial de la Salud, un nuevo síndrome descrito en pacientes menores de 19 años con historia previa de exposición a SARS-CoV-2. La presentación inicial de este síndrome se caracteriza por fiebre persistente que asocia debilidad, dolor abdominal, vómitos y/o diarrea. Menos frecuentemente los pacientes pueden presentar también erupción cutánea y conjuntivitis. El cuadro clínico tiene expresividad y evolución variables, por lo que algunos pacientes pediátricos afectados pueden empeorar rápidamente, desarrollando desde hipotensión y shock cardiogénico a daño multiorgánico. Los hallazgos analíticos característicos del síndrome consisten en elevación de marcadores inflamatorios y disfunción cardíaca. Los hallazgos radiológicos más frecuentes son cardiomegalia, derrame pleural, signos de insuficiencia cardíaca, ascitis y cambios inflamatorios en la fosa ilíaca derecha. En la pandemia actual por COVID-19 es necesario que el radiólogo conozca las características clínico-analíticas y radiológicas de este síndrome para realizar un correcto diagnóstico.

Palabras clave:
Síndrome inflamatorio multisistémico pediátrico
COVID-19
SARS-CoV-2

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