{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T01:40:02Z","timestamp":1756777202265,"version":"3.44.0"},"reference-count":19,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"unspecified","delay-in-days":41,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Multisystem inflammatory syndrome in children is a systemic disorder that involves incessant fever, extreme inflammation, and organ dysfunction, which is at first associated with exposure to COVID-19. This case, however, presents a unique twist. A 7-year-old paediatric patient, initially presenting with fever and rash, exhibited a polymorphous rash varying from macular to maculopapular, with a cutis marmorata-like appearance, particularly on the extremities. What followed was a rapid deterioration, with the patient developing tachypnoeic respiration and moderate hypotension (80\/35 mm Hg). Elevated D-dimer levels, troponin, ferritin, a low platelet count, a low albumin level, and lymphopenia were detected, further complicating the case. This unique case challenges our understanding of multisystem inflammatory syndrome in children and prompts further investigation.<\/jats:p><jats:p>Despite the severity of the case, the patient\u2019s condition improved significantly with treatment. The patient\u2019s COVID-19 polymerase chain reaction test was negative, but the COVID-19 immunoglobulin G test was positive. Transthoracic echocardiography demonstrated a mild\/moderate systolic dysfunction of the left ventricular (Ejection fraction 52%, SF 25%), echogenicity of coronary vessels, and a first-degree mitral insufficiency was detected. Thorax CT showed pulmonary oedema. Milrinone and noradrenaline were promptly started for hemodynamic support. Intravenous immunoglobulin, methylprednisolone, favipiravir, and anakinra were started for his treatment. On the second day of hospitalisation, the patient\u2019s condition was ameliorated. On the 10<jats:sup>th<\/jats:sup> day of hospitalisation, the patient was discharged from the hospital, marking a successful recovery from a complex and severe case. This successful recovery serves as a beacon of hope in the management of multisystem inflammatory syndrome in children.<\/jats:p>","DOI":"10.1017\/s1047951125101431","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T08:26:36Z","timestamp":1754900796000},"page":"1482-1486","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["A rare case of cutaneous vascular phenomena and fulminant cardiac involvement in paediatric multisystem inflammatory syndrome in children following asymptomatic COVID-19 exposure in a 7-year-old child"],"prefix":"10.1017","volume":"35","author":[{"given":"Emel","family":"Torun","sequence":"first","affiliation":[{"name":"Biruni University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammed Talha","family":"Karado\u011fan","sequence":"additional","affiliation":[{"name":"Istanbul Cerrahpasa University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ismail","family":"Yurtsever","sequence":"additional","affiliation":[{"name":"Bezmialem Vakif University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah","family":"Sert","sequence":"additional","affiliation":[{"name":"Biruni University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5164-8534","authenticated-orcid":false,"given":"Yilmaz","family":"Yozgat","sequence":"additional","affiliation":[{"name":"Istanbul Medipol University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"S1047951125101431_ref2","unstructured":"2. \u201cGuidance - Paediatric multisystem inflammatory syndrome temporally associated with COVID-19 (PIMS)\u201d. RCPCH. Royal College of Paediatrics and Child Health. 2020. Archived from the original on 16 June 2020."},{"key":"S1047951125101431_ref18","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piaa061"},{"key":"S1047951125101431_ref13","doi-asserted-by":"publisher","DOI":"10.1111\/dth.13594"},{"key":"S1047951125101431_ref6","first-page":"e212","article-title":"Cutaneous manifestations in COVID-19: a first perspective","volume":"34","author":"Recalcati","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"S1047951125101431_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31094-1"},{"key":"S1047951125101431_ref10","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-020-0448-7"},{"key":"S1047951125101431_ref16","doi-asserted-by":"publisher","DOI":"10.1111\/dth.13770"},{"key":"S1047951125101431_ref9","doi-asserted-by":"publisher","DOI":"10.1038\/s41577-020-0367-5"},{"key":"S1047951125101431_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.abd.2022.08.003"},{"key":"S1047951125101431_ref7","unstructured":"7. \u201cMultisystem inflammatory syndrome in children (MIS-C) interim guidance\u201d. services.aap.org. American Academy of Pediatrics. 2020. Archived from the original on 17 July 2020."},{"key":"S1047951125101431_ref17","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-1711"},{"key":"S1047951125101431_ref3","doi-asserted-by":"publisher","DOI":"10.1002\/art.41454"},{"key":"S1047951125101431_ref1","unstructured":"1. \u201cMultisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19)\u201d. emergency.cdc.gov. Centers for Disease Control and Prevention. 2020. Archived from the original on 15 May 2020."},{"key":"S1047951125101431_ref14","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002032"},{"key":"S1047951125101431_ref11","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19807"},{"key":"S1047951125101431_ref4","unstructured":"4. Erika, E. At least 85 kids across U.S. have developed rare, mysterious COVID-19-linked illness. 2020. Retrieved from. https:\/\/www.nbcnews.com\/health\/health-news\/least-85-kids-across-u-s-have-developed-rare-mysterious-n1202186."},{"key":"S1047951125101431_ref19","first-page":"177","article-title":"COVID19: potential cardiovascular issues in pediatric patients","volume":"91","author":"Bertoncelli","year":"2020","journal-title":"Acta Biomed"},{"key":"S1047951125101431_ref5","unstructured":"5. Haella, T. Novel inflammatory syndrome in children possibly linked to COVID-19. 2020. Retrieved from. https:\/\/www.medscape.com\/viewarticle\/930223."},{"key":"S1047951125101431_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-020-03766-6"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951125101431","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T01:04:03Z","timestamp":1756775043000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951125101431\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":19,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["S1047951125101431"],"URL":"https:\/\/doi.org\/10.1017\/s1047951125101431","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"type":"print","value":"1047-9511"},{"type":"electronic","value":"1467-1107"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. 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