ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 1640

Multisystem Inflammatory Syndrome in Children at Two Tertiary Hospitals in Cape Town, South Africa: Clinical Phenotype and Distinguishing Features from Similar Acute Inflammatory Conditions

Claire Butters1, Deepthi Abraham2, Heidi Facey-Thomas1, Debbie Abrahams1, Ayodele Faleye3, Helena Rabie2, Christiaan Scott4, Liesl Zühlke5 and Kate Webb6, 1Paediatric Rheumatology, University of Cape Town, Cape Town, South Africa, 2Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa, 3Lagos state university teaching hospital Ikeja, Lagos, Nigeria, 4University of Cape Town, Faculty of Health Science, Cape Town, South Africa, 5Paediatric Cardiology, University of Cape Town, Cape Town, South Africa, 6University of Cape Town, Cape Town, South Africa

Meeting: ACR Convergence 2021

Keywords: Cohort Study, COVID-19, Inflammation, Miscellaneous Rheumatic and Inflammatory Diseases, Pediatric rheumatology

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Tuesday, November 9, 2021

Title: Pediatric Rheumatology – Clinical Poster III: Miscellaneous Rheumatic Disease (1614–1644)

Session Type: Poster Session D

Session Time: 8:30AM-10:30AM

Background/Purpose: Distinguishing Multisystem Inflammatory Syndrome in Children (MIS-C) associated with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) from acute, pyrexial childhood illness can be challenging. We present a case series from two tertiary hospitals and compare the clinical phenotype of MIS-C with mimicking systemic inflammatory disorders.

Methods: Children with MIS-C admitted to two tertiary hospitals in a province between 22 June 2020 and 5 March 2021 were recruited. At one of the two hospitals, children with suspected MIS-C with an ultimate alternate diagnosis (inflammatory controls) were also recruited. Clinical data were collected. Statistics were performed using SPSS V. 27.

Results: During the time period, 70 children had confirmed MIS-C and 27 suspected MIS-C cases had an alternate diagnosis including typhoid, tuberculosis, sepsis and appendicitis among others. Sixty five percent of children with MIS-C had no SARS-CoV2 contact but all had evidence of SARS-CoV2 exposure by antibody (90%) or PCR tests (14%). There was no difference in age, sex or ethnic distribution between children with MIS-C and inflammatory controls (Table 1). The most common presenting features of MIS-C were fever (100%), tachycardia (99%), rash (86%), conjunctivitis (79%), and abdominal pain (60%). Compared to inflammatory controls, the presence of tachycardia, abdominal pain and conjunctivitis resulted in 96%; 93% and 91% respectively increased odds of a diagnosis of MIS-C after controlling for all other presenting features. Compared to inflammatory controls, children with MIS-C had lower platelets, sodium and albumin and higher troponin-T and pro-brain natriuretic peptide (pro-BNP)(Table 1).

The median minimum ejection fraction in MIS-C was lower than inflammatory controls (52% vs 63%, p=0.048). Ninety four percent of MIS-C patients received at least one dose of intravenous immunoglobulin (IVIG), 63% required methylprednisolone and 6% received IL-6 inhibition. Children with MIS-C were more commonly admitted to the intensive care unit (ICU) compared to inflammatory controls (38% vs 12.5%, p=0.013) although there was no difference in mean hospital stay which was 8.2 days in MIS-C. There was no difference in requirement for inotropes (p=0.142) or ventilation (p=0.493). No children died.

Conclusion: Distinguishing MIS-C from acute infectious or inflammatory causes of childhood fever may be challenging. The presence of conjunctivitis, tachycardia or abdominal pain associates with higher odds of MIS-C in this population. Differences in widely available blood tests like sodium, albumin and platelets may be useful to differentiate MIS-C in the acute setting.


Disclosures: C. Butters, None; D. Abraham, None; H. Facey-Thomas, None; D. Abrahams, None; A. Faleye, None; H. Rabie, None; C. Scott, None; L. Zühlke, None; K. Webb, None.

To cite this abstract in AMA style:

Butters C, Abraham D, Facey-Thomas H, Abrahams D, Faleye A, Rabie H, Scott C, Zühlke L, Webb K. Multisystem Inflammatory Syndrome in Children at Two Tertiary Hospitals in Cape Town, South Africa: Clinical Phenotype and Distinguishing Features from Similar Acute Inflammatory Conditions [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/multisystem-inflammatory-syndrome-in-children-at-two-tertiary-hospitals-in-cape-town-south-africa-clinical-phenotype-and-distinguishing-features-from-similar-acute-inflammatory-conditions/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to ACR Convergence 2021

ACR Meeting Abstracts - https://acrabstracts.org/abstract/multisystem-inflammatory-syndrome-in-children-at-two-tertiary-hospitals-in-cape-town-south-africa-clinical-phenotype-and-distinguishing-features-from-similar-acute-inflammatory-conditions/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology