{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:49:07Z","timestamp":1747190947107,"version":"3.40.5"},"reference-count":11,"publisher":"Wiley","license":[{"start":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T00:00:00Z","timestamp":1659916800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Rheumatology"],"published-print":{"date-parts":[[2022,8,8]]},"abstract":"<jats:p>The COVID-19 virus has impacted global health on a wide scale, affecting humans of all ages and ethnicities. While most have mild upper respiratory viral symptoms, some have died due to severe pneumonia, acute respiratory distress syndrome (ARDS), or coagulopathies to mention a few. It has been postulated that the COVID-19 virus can initiate an autoinflammatory reaction in the body via multiple pathways of cytokine activation. The virus can cause delayed response after 4\u20138 weeks of acute infection, which resembles a cytokine storm or MAS (macrophage activation syndrome). This highly inflammatory syndrome, called MIS-C or multisystem inflammatory response syndrome, needs to be diagnosed and treated early to prevent multiorgan damage and mortality. There are widespread lab abnormalities including highly elevated acute phase reactants ferritin, D-Dimer, lactate dehydrogenase (LDH), creatinine kinase (CK), sedimentation rate (ESR), and C-reactive protein (CRP) as well as markers of cardiac damage including troponin and brain natriuretic peptide (BNP). The syndrome can present in unique ways from classic MIS-C with hypovolemic shock to Kawasaki disease-like presentation. We present a case of a 12-year-old boy who presented to Le Bonheur Children\u2019s Hospital in Memphis with classic signs and symptoms of \u201csevere\u201d MIS-C requiring intubation, multiple pressors, ECMO, and renal replacement therapy. He was treated successfully with immunomodulating medicines including intravenous immune globulin (IVIG), steroids, interleukin-6 inhibitor, tumor necrosis factor-a inhibitor, interleukin-1 inhibitor, and Janus kinase inhibitor.<\/jats:p>","DOI":"10.1155\/2022\/6181922","type":"journal-article","created":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T10:50:57Z","timestamp":1660042257000},"page":"1-4","source":"Crossref","is-referenced-by-count":0,"title":["A Case of Severe Multisystem Inflammatory Syndrome in Children (MIS-C) Treated with Multiple Biologics"],"prefix":"10.1155","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1330-2078","authenticated-orcid":true,"given":"Beenish","family":"Zulfiqar","sequence":"first","affiliation":[{"name":"University of Tennessee Memphis, Department of Rheumatology, Memphis, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hira","family":"Imran","sequence":"additional","affiliation":[{"name":"University of Tennessee Memphis, Department of Rheumatology, Memphis, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen","family":"Collins","sequence":"additional","affiliation":[{"name":"University of Tennessee Memphis, Department of Rheumatology, Memphis, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"article-title":"Emergency preparedness and response: multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19)","year":"2019","author":"Centers for Disease Control and Prevention","key":"1"},{"key":"2","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMoa2021680","article-title":"Multisystem inflammatory syndrome in U.S. children and adolescents","volume":"383","author":"L. R. Feldstein","year":"2020","journal-title":"The New England Journal of Medicine"},{"article-title":"Multisystem Inflammatory Syndrome in Children and Adolescents with COVID-19","year":"2022","author":"WHO","key":"3"},{"key":"4","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2020.100527","article-title":"Multisystem inflammatory syndrome in children: a systematic review","volume":"26","author":"M. Ahmed","year":"2020","journal-title":"EClinicalMedicine"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1002\/path.1570"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-018-0343-9"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kep418"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1101\/2020.12.01.20241364"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2020.110263"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1097\/inf.0000000000002802"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1002\/art.41285"}],"container-title":["Case Reports in Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/crirh\/2022\/6181922.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crirh\/2022\/6181922.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crirh\/2022\/6181922.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T10:51:01Z","timestamp":1660042261000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/crirh\/2022\/6181922\/"}},"subtitle":[],"editor":[{"given":"Constantine","family":"Saadeh","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,8,8]]},"references-count":11,"alternative-id":["6181922","6181922"],"URL":"https:\/\/doi.org\/10.1155\/2022\/6181922","relation":{},"ISSN":["2090-6897","2090-6889"],"issn-type":[{"type":"electronic","value":"2090-6897"},{"type":"print","value":"2090-6889"}],"subject":[],"published":{"date-parts":[[2022,8,8]]}}}