PMID- 33469522 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20210122 IS - 2296-2360 (Print) IS - 2296-2360 (Electronic) IS - 2296-2360 (Linking) VI - 8 DP - 2020 TI - Case Report: Case Series of Children With Multisystem Inflammatory Syndrome Following SARS-CoV-2 Infection in Switzerland. PG - 594127 LID - 10.3389/fped.2020.594127 [doi] LID - 594127 AB - Since the beginning of the severe SARS-CoV-2 pandemic, an increasing number of countries reported cases of a systemic hyperinflammatory condition defined as multi-system inflammatory syndrome in children (MIS-C). The clinical features of MIS-C can be an overlap of Kawasaki Disease (KD), Toxic Shock Syndrome (TSS), Macrophage Activation Syndrome (MAS), or have often an acute abdominal presentation. Intravenous immunoglobulin (IVIG) is recommended as first line therapy in KD. Recent evidence suggests intravenous immunoglobulins (IVIG) resistance in some cases of SARS-CoV-2 related MIS-C, thereby questioning the benefit of immunomodulators such as IL-1 or IL-6 blocking agents. We report on a cohort of 6 Swiss children with SARS-CoV2 related MIS-C presenting with clinical features compatible with Incomplete KD and Toxic Shock Syndrome associated to a cytokine storm. Serum cytokine profile investigations showed increased IL1RA levels (8 to 22-fold) in 5 of the 6 patients (one patient had not been tested), whereas, IL-6 serum levels were increased only in the 3 patients of the 6 who were tested. With exception of one patient who had only benefited by Anakinra, all patients received at least one dose of IVIG. One patient has only received Anakinra with favorable evolution, and three patients had also a steroid treatment. In addition to all this anti-inflammatory medication two patients have also received one dose of anti-IL6. In conclusion, our case series reports on clinical and laboratory findings of most of Swiss cases with MIS-C and suggests the use of Anakinra as an alternative to steroids in these children, most of whom presented with high IL-1RA levels. CI - Copyright (c) 2021 Fouriki, Fougere, De Camaret, Blanchard Rohner, Grazioli, Wagner, Relly, Pachlopnik Schmid, Truck, Kottanatu, Perez, Perez, Schaffner, Asner and Hofer. FAU - Fouriki, Athina AU - Fouriki A AD - Pediatric Immuno-Rheumatology of Western Switzerland, Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland. AD - Pediatric Immuno-Rheumatology, Department of Paediatrics, University Hospital, Geneva, Switzerland. FAU - Fougere, Yves AU - Fougere Y AD - Pediatric Infectious Diseases and Vaccinology Unit, Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland. FAU - De Camaret, Caroline AU - De Camaret C AD - Pediatric Immuno-Rheumatology of Western Switzerland, Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland. AD - Pediatric Immuno-Rheumatology, Department of Paediatrics, University Hospital, Geneva, Switzerland. FAU - Blanchard Rohner, Geraldine AU - Blanchard Rohner G AD - Pediatric Immunology and Vaccinology Unit, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland. FAU - Grazioli, Serge AU - Grazioli S AD - Division of Neonatal and Pediatric Intensive Care, Department of Paediatrics, Gynecology and Obstetrics, Geneva University Hospital, Geneva, Switzerland. FAU - Wagner, Noemie AU - Wagner N AD - Pediatric Infectious Diseases Unit, Department of Paediatrics, Gynecology and Obstetrics, Geneva University Hospital, Geneva, Switzerland. FAU - Relly, Christa AU - Relly C AD - Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Zurich, Switzerland. FAU - Pachlopnik Schmid, Jana AU - Pachlopnik Schmid J AD - Pediatric Immunology, University Children's Hospital Zurich, Zurich, Switzerland. FAU - Truck, Johannes AU - Truck J AD - Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Zurich, Switzerland. AD - Pediatric Immunology, University Children's Hospital Zurich, Zurich, Switzerland. FAU - Kottanatu, Lisa AU - Kottanatu L AD - Pediatric Infectious Diseases, Pediatric Institute of Southern Switzerland, Regional Hospital of Bellinzona, Bellinzona, Switzerland. FAU - Perez, Estefania AU - Perez E AD - Hopital intercantonal de la Broye, Payerne, Switzerland. FAU - Perez, Marie-Helene AU - Perez MH AD - Pediatric Intensive Care Unit, Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland. FAU - Schaffner, Damien AU - Schaffner D AD - Pediatric Cardiology Unit, Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland. FAU - Asner, Sandra Andrea AU - Asner SA AD - Pediatric Infectious Diseases and Vaccinology Unit, Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland. FAU - Hofer, Michael AU - Hofer M AD - Pediatric Immuno-Rheumatology of Western Switzerland, Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland. AD - Pediatric Immuno-Rheumatology, Department of Paediatrics, University Hospital, Geneva, Switzerland. LA - eng PT - Case Reports DEP - 20210105 PL - Switzerland TA - Front Pediatr JT - Frontiers in pediatrics JID - 101615492 PMC - PMC7813982 OTO - NOTNLM OT - Anakinra OT - IL-1ra OT - MIS-C OT - SARS-CoV-2 OT - child COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2021/01/21 06:00 MHDA- 2021/01/21 06:01 PMCR- 2021/01/05 CRDT- 2021/01/20 05:54 PHST- 2020/08/12 00:00 [received] PHST- 2020/11/23 00:00 [accepted] PHST- 2021/01/20 05:54 [entrez] PHST- 2021/01/21 06:00 [pubmed] PHST- 2021/01/21 06:01 [medline] PHST- 2021/01/05 00:00 [pmc-release] AID - 10.3389/fped.2020.594127 [doi] PST - epublish SO - Front Pediatr. 2021 Jan 5;8:594127. doi: 10.3389/fped.2020.594127. eCollection 2020.