{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:58:30Z","timestamp":1788350310099,"version":"build-2803163510"},"reference-count":13,"publisher":"American Diabetes Association","issue":"4","license":[{"start":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T00:00:00Z","timestamp":1643846400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To report and describe cases of children presenting with coronavirus disease 2019 (COVID-19)-related multisystem inflammatory syndrome in children (MIS-C) with new-onset type 1 diabetes mellitus (T1DM) in severe diabetic ketoacidosis (DKA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>This prospective observational study was conducted to characterize children with COVID-19\u2013related MIS-C and new-onset T1DM who were in DKA. MIS-C was diagnosed if Centers for Disease Control and Prevention and World Health Organization criteria were fulfilled.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Six cases were identified. The patients were critically ill and in nonfluid responsive shock (combined hypovolemic and cardiogenic or distributive shock). All had cardiac involvement. One patient had a Kawasaki shock-like presentation. All needed aggressive treatment with careful monitoring of fluid balance (because of associated cardiac dysfunction), early institution of vasoactive\/inotropic supports, and use of methylprednisolone and intravenous immunoglobulins. The latter are better administered after DKA resolution to avoid undue volume overload and fluid shifts while the patients are in DKA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Awareness of MIS-C coexistence with DKA at T1DM onset is crucial for rapid proper management.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc21-1094","type":"journal-article","created":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T14:45:01Z","timestamp":1643899501000},"page":"983-989","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":14,"title":["COVID-19\u2013Related Multisystem Inflammatory Syndrome in Children Presenting With New-Onset Type 1 Diabetes in Severe Ketoacidosis: A Case Series"],"prefix":"10.2337","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4287-465X","authenticated-orcid":false,"given":"Hanan H.","family":"Aly","sequence":"first","affiliation":[{"name":"Division of Pediatric Diabetology, Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman M.","family":"Fouda","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology, Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyaa A.","family":"Kotby","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sondos M.","family":"Magdy","sequence":"additional","affiliation":[{"name":"Division of Pediatric Intensive Care, Department of Pediatrics, Ain Shams University Faculty of Medicine, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed R.","family":"Rezk","sequence":"additional","affiliation":[{"name":"Division of Pediatric Intensive Care, Department of Pediatrics, Ain Shams University Faculty of Medicine, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwa W.A.","family":"Nasef","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2022,2,3]]},"reference":[{"key":"2022041419335121600_B1","doi-asserted-by":"crossref","first-page":"e83","DOI":"10.2337\/dc20-1088","article-title":"Type 1 diabetes and COVID-19: preliminary findings from a multicenter surveillance study in the U.S","volume":"43","author":"Ebekozien","year":"2020","journal-title":"Diabetes Care"},{"key":"2022041419335121600_B2","doi-asserted-by":"crossref","first-page":"e170","DOI":"10.2337\/dc20-1551","article-title":"New-onset type 1 diabetes in children during COVID-19: multicenter regional findings in the U.K","volume":"43","author":"Unsworth","year":"2020","journal-title":"Diabetes Care"},{"key":"2022041419335121600_B3","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1136\/archdischild-2020-321220","article-title":"New-onset type 1 diabetes in Finnish children during the COVID-19 pandemic","volume":"107","author":"Salmi","year":"2022","journal-title":"Arch Dis Child"},{"key":"2022041419335121600_B4","unstructured":"Centers for Disease Control and Prevention\n          . Information for healthcare providers about multisystem inflammatory syndrome in children (MIS-C). Accessed 14 May 2021. Available from https:\/\/www.cdc.gov\/mis-c\/hcp\/"},{"key":"2022041419335121600_B5","unstructured":"World Health Organization\n          . Multisystem Inflammatory Syndrome in Children and Adolescents Temporally Related to COVID-19. Accessed 14 May 2021. Available from https:\/\/www.who.int\/news-room\/commentaries\/detail\/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19"},{"key":"2022041419335121600_B6","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1111\/pedi.12701","article-title":"ISPAD Clinical Practice Consensus Guidelines 2018: diabetic ketoacidosis and the hyperglycemic hyperosmolar state","volume":"19","author":"Wolfsdorf","year":"2018","journal-title":"Pediatr Diabetes"},{"key":"2022041419335121600_B7","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1001\/jama.2021.2091","article-title":"Characteristics and outcomes of US children and adolescents with multisystem inflammatory syndrome in children (MIS-C) compared with severe acute COVID-19","volume":"325","author":"Feldstein","year":"2021","journal-title":"JAMA"},{"key":"2022041419335121600_B8","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/S2352-4642(21)00050-X","article-title":"Factors linked to severe outcomes in multisystem inflammatory syndrome in children (MIS-C) in the USA: a retrospective surveillance study","volume":"5","author":"Abrams","year":"2021","journal-title":"Lancet Child Adolesc Health"},{"key":"2022041419335121600_B9","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.15585\/mmwr.mm6932e2","article-title":"COVID-19-associated multisystem inflammatory syndrome in children - United States, March-July 2020","volume":"69","author":"Godfred-Cato","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022041419335121600_B10","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1056\/NEJMoa2021756","article-title":"Multisystem inflammatory syndrome in children in New York State","volume":"383","author":"Dufort","year":"2020","journal-title":"N Engl J Med"},{"key":"2022041419335121600_B11","doi-asserted-by":"crossref","first-page":"2079","DOI":"10.2337\/diabetes.53.8.2079","article-title":"Proinflammatory cytokines, markers of cardiovascular risks, oxidative stress, and lipid peroxidation in patients with hyperglycemic crises","volume":"53","author":"Stentz","year":"2004","journal-title":"Diabetes"},{"key":"2022041419335121600_B12","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1515\/jpem-2020-0426","article-title":"New onset diabetes with diabetic ketoacidosis in a child with multisystem inflammatory syndrome due to COVID-19","volume":"34","author":"Naguib","year":"2020","journal-title":"J Pediatr Endocrinol Metab"},{"key":"2022041419335121600_B13","first-page":"2333794X21990339","article-title":"The \u201cgolden hours\u201d algorithm for the management of the multisystem inflammatory syndrome in children (MIS-C)","volume":"8","author":"Mahmoud","year":"2021","journal-title":"Glob Pediatr Health"}],"updated-by":[{"DOI":"10.2337\/dc22-er07b","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T00:00:00Z","timestamp":1649894400000}}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/45\/4\/983\/672977\/dc211094.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/45\/4\/983\/672977\/dc211094.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T19:34:03Z","timestamp":1649964843000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/45\/4\/983\/144527\/COVID-19-Related-Multisystem-Inflammatory-Syndrome"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,3]]},"references-count":13,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,2,3]]},"published-print":{"date-parts":[[2022,4,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc21-1094","relation":{"correction":[{"id-type":"doi","id":"10.2337\/dc22-er07b","asserted-by":"object"}]},"ISSN":["0149-5992"],"issn-type":[{"value":"0149-5992","type":"print"}],"subject":[],"published":{"date-parts":[[2022,2,3]]}}}