{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T23:32:59Z","timestamp":1782516779614,"version":"3.54.5"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T00:00:00Z","timestamp":1599696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Edinburgh Children\u2019s Hospital Charity-Catherine McEwan Foundation Research Fellowship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 [PIMS-TS] is a newly described condition. It has a spectrum of presentations proposed to occur as part of a post-infectious immune response. We report the first case of PIMS-TS in a child on established anti-tumour necrosis factor alpha [anti-TNF\u03b1] therapy; a 10 year-old girl with ulcerative colitis treated with infliximab. The patient had 6 weeks of daily fever with mucocutaneous, gastrointestinal, renal, and haematological involvement. Biomarkers of hyperinflammation were present including: hyperferritinaemia [up to 691 \u00b5\/L; normal 15\u201380 \u00b5g\/L], C-reactive protein [CRP] [\u2005&amp;gt;100mg\/L for \u2005&amp;gt;10 days, normal 0\u20135 mg\/L], erythrocyte sedimentation rate [ESR] consistently \u2005&amp;gt;100mm\/h [normal 0\u201315 mm\/h], raised white cell count with neutrophilia, elevated D-dimer and lactate dehydrogenase [LDH], anaemia and Mott cells on bone marrow analysis. Extensive investigations for alternative diagnoses for pyrexia of unknown origin [PUO] were negative. The condition was refractory to treatment with intravenous immunoglobulin [IVIG] but improved within 24 h of high-dose methylprednisolone. Infliximab treatment followed and the patient has remained well at follow-up. Polymerase chain reaction [PCR] and serology for SARS-CoV-2 were negative. Current series report such negative findings in up to half of cases. The patient experienced a milder clinical phenotype without cardiac involvement, shock, or organ failure. Accepting the wide spectrum of PIMS-TS presentations, it is possible that previous anti-TNF\u03b1 therapy may have attenuated the disease course. Given the uncertainty around therapeutic strategies for PIMS-TS, this case supports the need for further investigation into continuing infliximab as a treatment option for the condition.<\/jats:p>","DOI":"10.1093\/ecco-jcc\/jjaa201","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T19:16:44Z","timestamp":1601320604000},"page":"687-691","source":"Crossref","is-referenced-by-count":8,"title":["Paediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 [PIMS-TS] in a Patient Receiving Infliximab Therapy for Inflammatory Bowel Disease"],"prefix":"10.1093","volume":"15","author":[{"given":"Joseph","family":"Meredith","sequence":"first","affiliation":[{"name":"Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Sick Children, Edinburgh, Uk"},{"name":"Child Life and Health, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cher-Antonia","family":"Khedim","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Sick Children, Edinburgh, Uk"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Henderson","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Sick Children, Edinburgh, Uk"},{"name":"Child Life and Health, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Sick Children, Edinburgh, Uk"},{"name":"Child Life and Health, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard K","family":"Russell","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Sick Children, Edinburgh, Uk"},{"name":"Child Life and Health, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,9,10]]},"reference":[{"key":"2021040620130154200_CIT0001","author":"Royal College of Paediatrics and Child Health"},{"key":"2021040620130154200_CIT0002","article-title":"Multi-system Inflammatory Syndrome in Children & Adolescents [MIS-C]: A systematic review of clinical features and presentation","author":"Radia","year":"2020","journal-title":"Paediatr Respir Rev"},{"key":"2021040620130154200_CIT0003","article-title":"Hyperinflammatory shock in children during COVID-19 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