Pathogenesis, immunology, and immune-targeted management of the multisystem inflammatory syndrome in children (MIS-C) or pediatric inflammatory multisystem syndrome (PIMS) : EAACI Position Paper
© 2023 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd..
Multisystem inflammatory syndrome in children (MIS-C) is a rare, but severe complication of coronavirus disease 2019 (COVID-19). It develops approximately 4 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and involves hyperinflammation with multisystem injury, commonly progressing to shock. The exact pathomechanism of MIS-C is not known, but immunological dysregulation leading to cytokine storm plays a central role. In response to the emergence of MIS-C, the European Academy of Allergy and Clinical Immunology (EAACI) established a task force (TF) within the Immunology Section in May 2021. With the use of an online Delphi process, TF formulated clinical statements regarding immunological background of MIS-C, diagnosis, treatment, follow-up, and the role of COVID-19 vaccinations. MIS-C case definition is broad, and diagnosis is made based on clinical presentation. The immunological mechanism leading to MIS-C is unclear and depends on activating multiple pathways leading to hyperinflammation. Current management of MIS-C relies on supportive care in combination with immunosuppressive and/or immunomodulatory agents. The most frequently used agents are systemic steroids and intravenous immunoglobulin. Despite good overall short-term outcome, MIS-C patients should be followed-up at regular intervals after discharge, focusing on cardiac disease, organ damage, and inflammatory activity. COVID-19 vaccination is a safe and effective measure to prevent MIS-C. In anticipation of further research, we propose a convenient and clinically practical algorithm for managing MIS-C developed by the Immunology Section of the EAACI.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:34 |
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| Enthalten in: |
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology - 34(2023), 1 vom: 27. Jan., Seite e13900 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Feleszko, Wojciech [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 Vaccines |
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| Anmerkungen: |
Date Completed 30.01.2023 Date Revised 19.02.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1111/pai.13900 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a © 2023 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. | ||
| 520 | |a Multisystem inflammatory syndrome in children (MIS-C) is a rare, but severe complication of coronavirus disease 2019 (COVID-19). It develops approximately 4 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and involves hyperinflammation with multisystem injury, commonly progressing to shock. The exact pathomechanism of MIS-C is not known, but immunological dysregulation leading to cytokine storm plays a central role. In response to the emergence of MIS-C, the European Academy of Allergy and Clinical Immunology (EAACI) established a task force (TF) within the Immunology Section in May 2021. With the use of an online Delphi process, TF formulated clinical statements regarding immunological background of MIS-C, diagnosis, treatment, follow-up, and the role of COVID-19 vaccinations. MIS-C case definition is broad, and diagnosis is made based on clinical presentation. The immunological mechanism leading to MIS-C is unclear and depends on activating multiple pathways leading to hyperinflammation. Current management of MIS-C relies on supportive care in combination with immunosuppressive and/or immunomodulatory agents. The most frequently used agents are systemic steroids and intravenous immunoglobulin. Despite good overall short-term outcome, MIS-C patients should be followed-up at regular intervals after discharge, focusing on cardiac disease, organ damage, and inflammatory activity. COVID-19 vaccination is a safe and effective measure to prevent MIS-C. In anticipation of further research, we propose a convenient and clinically practical algorithm for managing MIS-C developed by the Immunology Section of the EAACI | ||
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| 700 | 1 | |a Bloomfield, Marketa |e verfasserin |4 aut | |
| 700 | 1 | |a Sediva, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Bautista-Rodriguez, Carles |e verfasserin |4 aut | |
| 700 | 1 | |a Brough, Helen A |e verfasserin |4 aut | |
| 700 | 1 | |a Eigenmann, Philippe A |e verfasserin |4 aut | |
| 700 | 1 | |a Eiwegger, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Eljaszewicz, Andrzej |e verfasserin |4 aut | |
| 700 | 1 | |a Eyerich, Stefanie |e verfasserin |4 aut | |
| 700 | 1 | |a Gomez-Casado, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Fraisse, Alain |e verfasserin |4 aut | |
| 700 | 1 | |a Janda, Jozef |e verfasserin |4 aut | |
| 700 | 1 | |a Jiménez-Saiz, Rodrigo |e verfasserin |4 aut | |
| 700 | 1 | |a Kallinich, Tilmann |e verfasserin |4 aut | |
| 700 | 1 | |a Krohn, Inge Kortekaas |e verfasserin |4 aut | |
| 700 | 1 | |a Mortz, Charlotte G |e verfasserin |4 aut | |
| 700 | 1 | |a Riggioni, Carmen |e verfasserin |4 aut | |
| 700 | 1 | |a Sastre, Joaquin |e verfasserin |4 aut | |
| 700 | 1 | |a Sokolowska, Milena |e verfasserin |4 aut | |
| 700 | 1 | |a Strzelczyk, Ziemowit |e verfasserin |4 aut | |
| 700 | 1 | |a Untersmayr, Eva |e verfasserin |4 aut | |
| 700 | 1 | |a Tramper-Stranders, Gerdien |e verfasserin |4 aut | |
| 700 | 0 | |a Immunology Section and Working Group Infections of the EAACI |e verfasserin |4 aut | |
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