COVID-19 Associated Multisystem Inflammatory Syndrome in Children Presenting as Acute Necrotizing Pancreatitis with Walled-off Pancreatic Necrosis (WOPN)
Aim and objective: To highlight the importance of looking for multisystem inflammatory syndrome in children (MIS-C) as an etiology of pancreatitis in children.
Background: MIS-C is a newly recognized, potentially serious illness in children related to COVID-19. MIS-C has varied symptoms that affect several organ systems in body. Many children have symptoms resembling Kawasaki disease. Some children have signs of excessive blood clotting, gastrointestinal symptoms, kidney injury, or neurological symptoms. To date, very few cases have been reported with acute pancreatitis with SARS CoV-2 infection in children and only two cases with subsequent inflammatory syndrome.
Case description: A 12-year old male child with severe necrotizing pancreatitis managed with IVIg and I/V methylprednisolone, which later on developed walled-off pancreatic necrosis (WOPN) required surgical intervention.
Conclusion: It is important to look for etiology of pancreatitis and in present era MIS-C is important cause. Clinicians should always search for this etiology as management is entirely different from other causes of pancreatitis.
Clinical significance: We describe first case of necrotizing pancreatitis with walled-off pancreatic necrosis requiring surgical intervention associated with MIS-C. Management required IVIg and/or steroids which is entirely different from pancreatitis associated with other etiologies.
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