{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T10:59:34Z","timestamp":1771671574364,"version":"3.50.1"},"reference-count":59,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,14]],"date-time":"2022-08-14T00:00:00Z","timestamp":1660435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Acute abdominal pain in children has been noticed to be a primary reason to seek medical attention in multisystem inflammatory disorder (MIS-C), which can prevail separately or together with acute appendicitis. Our aim was to distinguish regular appendicitis cases from MIS-C and to suggest the best clinical and laboratory criteria for it. Materials and methods: Cases of patients, admitted to the Pediatric Surgery Department over a six-month period in 2021, were retrospectively analyzed. Confirmed MIS-C or acute appendicitis cases were selected. MIS-C cases were either separate\/with no found inflammation in the appendix or together with acute appendicitis. Acute appendicitis cases were either regular cases or with a positive COVID-19 test. Four groups were formed and compared: A-acute appendicitis, B-MIS-C with acute appendicitis, C-MIS-C only and D-acute appendicitis with COVID-19. Results: A total of 76 cases were overall analyzed: A-36, B-6, C-29 and D-5. The most significant differences were found in duration of disease A\u20141.4 days, B\u20144.5 days, C\u20144 days, D\u20144 days (p &lt; 0.0001), C reactive protein (CRP) values A-19.3 mg\/L B-112.5 m\/L, C-143.8 mg\/L and D-141 mg\/L (p &lt; 0.0001), presence of febrile fever A-13.9%, B-66.7%, C-96.6% and D-40% (p &lt; 0.0001) and other system involvement: A 0%, B 100%, C 100% and D 20%. A combination of these factors was entered into a ROC curve and was found to have a possibility to predict MIS-C in our analyzed cases (with or without acute appendicitis) with an AUC = 0.983, p &lt; 0.0001, sensitivity of 94.3% and specificity of 92.7% when at least three criteria were met. Conclusions: MIS-C could be suspected even when clinical data and performed tests suggest acute appendicitis especially when at least three out of four signs are present: CRP &gt; 55.8 mg, symptoms last 3 days or longer, febrile fever is present, and any kind of other system involvement is noticed, especially with a known prior recent COVID-19 contact, infection or a positive COVID-19 antibody IgG test.<\/jats:p>","DOI":"10.3390\/medicina58081101","type":"journal-article","created":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T03:33:20Z","timestamp":1660534400000},"page":"1101","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Does Multisystem Inflammatory Syndrome Only Mimic Acute Appendicitis in Children or Can It Coexist: When Should We Suspect MIS-C?"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7578-7483","authenticated-orcid":false,"given":"Idil\u0117","family":"Vansevi\u010dien\u0117","sequence":"first","affiliation":[{"name":"Pediatric Surgery Department, Lithuanian University of Health Sciences, Eiveni\u0173 Str. 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ugn\u0117","family":"Krunkaityt\u0117","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Lithuanian University of Health Sciences, Eiveni\u0173 Str. 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2613-7390","authenticated-orcid":false,"given":"Inga","family":"Dekeryt\u0117","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Lithuanian University of Health Sciences, Eiveni\u0173 Str. 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mindaugas","family":"Ber\u017eanskis","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Lithuanian University of Health Sciences, Eiveni\u0173 Str. 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6624-0686","authenticated-orcid":false,"given":"Au\u0161ra","family":"Luko\u0161i\u016bt\u0117-Urbonien\u0117","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Lithuanian University of Health Sciences, Eiveni\u0173 Str. 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dalius","family":"Malcius","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Lithuanian University of Health Sciences, Eiveni\u0173 Str. 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vidmantas","family":"Barauskas","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Lithuanian University of Health Sciences, Eiveni\u0173 Str. 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1111\/ced.14483","article-title":"Skin manifestations of COVID-19 in children: Part 3","volume":"46","author":"Andina","year":"2020","journal-title":"Clin. 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