PMID- 34805048
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220303
IS  - 2296-2360 (Print)
IS  - 2296-2360 (Electronic)
IS  - 2296-2360 (Linking)
VI  - 9
DP  - 2021
TI  - MIS-C Treatment: Is IVIG Always Necessary?
PG  - 753123
LID - 10.3389/fped.2021.753123 [doi]
LID - 753123
AB  - Background: MIS-C is a potentially severe inflammatory syndrome associated with 
      SARS-CoV-2 exposure. Intravenous immunoglobulin (IVIG) is considered the 
      first-tier therapy, but it implies infusion of large fluid volumes that may 
      worsen cardiac function. Patients and Methods: Since April 2020, we have 
      developed a treatment protocol that avoids the infusion of IVIG as first-line 
      therapy in the early phase of MIS-C. In this study, we retrospectively analyzed a 
      cohort of consecutive patients treated according to this protocol between 
      01/04/2020 and 01/04/2021. Results: In the last year, 31 patients have been 
      treated according to the protocol: 25 with high-dose pulse MP (10 mg/kg) and 6 
      with 2 mg/kg. 67.7% of the patients responded to the initial treatment, while the 
      others needed a step-up, either with Anakinra (25.8%) or with MP dose increase 
      (6.5%). IVIG was administered in four patients. Overall, only one patient (3.2%) 
      needed ICU admission and inotropic support; one patient developed a small 
      coronary artery aneurysm. Conclusions: Timely start of MP therapy and careful 
      fluid management might improve the outcomes of MIS-C patients.
CI  - Copyright (c) 2021 Licciardi, Baldini, Dellepiane, Covizzi, Mogni, Pruccoli, Orsi, 
      Rabbone, Parodi, Mignone and Montin.
FAU - Licciardi, Francesco
AU  - Licciardi F
AD  - Department of Pediatrics and Public Health, Universita degli Studi di Torino, 
      Turin, Italy.
AD  - Ospedale Infantile Regina Margherita, Citta della Salute e della Scienza, Turin, 
      Italy.
FAU - Baldini, Letizia
AU  - Baldini L
AD  - Postgraduate School of Pediatrics, Universita degli Studi di Torino, Turin, 
      Italy.
FAU - Dellepiane, Marta
AU  - Dellepiane M
AD  - Department of Pediatrics and Public Health, Universita degli Studi di Torino, 
      Turin, Italy.
FAU - Covizzi, Carlotta
AU  - Covizzi C
AD  - Postgraduate School of Pediatrics, Universita degli Studi di Torino, Turin, 
      Italy.
FAU - Mogni, Roberta
AU  - Mogni R
AD  - Postgraduate School of Pediatrics, Universita degli Studi di Torino, Turin, 
      Italy.
FAU - Pruccoli, Giulia
AU  - Pruccoli G
AD  - Department of Pediatrics and Public Health, Universita degli Studi di Torino, 
      Turin, Italy.
FAU - Orsi, Cecilia
AU  - Orsi C
AD  - Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.
FAU - Rabbone, Ivana
AU  - Rabbone I
AD  - Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.
FAU - Parodi, Emilia
AU  - Parodi E
AD  - Department of Pediatrics and Public Health, Universita degli Studi di Torino, 
      Turin, Italy.
AD  - Ospedale Infantile Regina Margherita, Citta della Salute e della Scienza, Turin, 
      Italy.
FAU - Mignone, Federica
AU  - Mignone F
AD  - Department of Pediatrics and Public Health, Universita degli Studi di Torino, 
      Turin, Italy.
AD  - Ospedale Infantile Regina Margherita, Citta della Salute e della Scienza, Turin, 
      Italy.
FAU - Montin, Davide
AU  - Montin D
AD  - Department of Pediatrics and Public Health, Universita degli Studi di Torino, 
      Turin, Italy.
AD  - Ospedale Infantile Regina Margherita, Citta della Salute e della Scienza, Turin, 
      Italy.
LA  - eng
PT  - Journal Article
DEP - 20211103
PL  - Switzerland
TA  - Front Pediatr
JT  - Frontiers in pediatrics
JID - 101615492
EIN - Front Pediatr. 2022 Feb 14;9:826518. PMID: 35237545
PMC - PMC8595395
OTO - NOTNLM
OT  - IVIG (intravenous immunoglobulin) administration
OT  - MIS-C
OT  - SARS-CoV-2
OT  - steroid
OT  - therapy
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- 2021/11/23 06:00
MHDA- 2021/11/23 06:01
PMCR- 2021/11/03
CRDT- 2021/11/22 06:53
PHST- 2021/08/04 00:00 [received]
PHST- 2021/10/04 00:00 [accepted]
PHST- 2021/11/22 06:53 [entrez]
PHST- 2021/11/23 06:00 [pubmed]
PHST- 2021/11/23 06:01 [medline]
PHST- 2021/11/03 00:00 [pmc-release]
AID - 10.3389/fped.2021.753123 [doi]
PST - epublish
SO  - Front Pediatr. 2021 Nov 3;9:753123. doi: 10.3389/fped.2021.753123. eCollection 
      2021.