A Case of Multisystem Inflammatory Syndrome in Children (MIS-C) with Heart Failure due to Myocardial Damage

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  • YUKI Tomoyasu
    Department of Pediatrics, Nagano Prefectural Federation of Agricultural Cooperatives for Health and Welfare Hokushin General Hospital
  • HACHIYA Akira
    Department of Pediatrics, Nagano Prefectural Federation of Agricultural Cooperatives for Health and Welfare Hokushin General Hospital
  • ARAI Moeko
    Department of Pediatrics, Nagano Prefectural Federation of Agricultural Cooperatives for Health and Welfare Hokushin General Hospital
  • SHIMA Yousuke
    Department of Pediatrics, Nagano Prefectural Federation of Agricultural Cooperatives for Health and Welfare Hokushin General Hospital

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Other Title
  • 心筋障害により心不全を呈した小児多系統炎症性症候群（MIS-C）の１例
  • シンキン ショウガイ ニ ヨリ シンフゼン オ テイシタ ショウニ タケイトウ エンショウセイ ショウコウグン(MIS-C)ノ 1レイ

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Multisystem Inflammatory Syndrome in Children (MIS-C) is a new disease that develops after coronavirus disease 2019 (COVID-19) and is known to cause severe inflammation in multiple organs, gastrointestinal symptoms, respiratory distress, and shock. <br>The patient was an 8-year-old boy who developed MIS-C one month after COVID-19 and presented with left ventricular systolic dysfunction and hypotension. Prednisolone (PSL) and high-dose immunoglobulin therapy (IVIG) improved some symptoms and part of the laboratory findings, but ferritin and D-dimer remained elevated, suggesting a cytokine storm. After infliximab (IFX) administration, ferritin and D-dimer improved, suggesting that IFX may be useful in suppressing cytokines that were not suppressed by the combination of PSL and IVIG. NT-proBNP and troponin T were elevated the day before shock and decreased with improvement in left ventricular contractility. We suggest that measurement of NT-proBNP and troponin T help in early prediction of shock in MIS-C.

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