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Inflammatory Bowel Disease Presenting With Concurrent COVID-19 Multisystem Inflammatory Syndrome
Journal article   Peer reviewed

Inflammatory Bowel Disease Presenting With Concurrent COVID-19 Multisystem Inflammatory Syndrome

Katherine F. Sweeny, Yanjia J. Zhang, Bonnie Crume, Colin A. Martz, Melissa M. Blessing and Stacy A. Kahn
Pediatrics (Evanston), Vol.147(4), p.1
04/01/2021
DOI: 10.1542/peds.2020-027763
PMCID: PMC8015148
PMID: 33414238

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Abstract

Coronavirus disease 2019 is associated with a postinfectious multisystem inflammatory syndrome in children (MIS-C). This syndrome is marked by cytokine storm and multiorgan dysfunction, often affecting the gastrointestinal tract, the heart, and the hematopoietic system. We describe the case of a 16-year-old boy with an initial presentation of severe inflammatory bowel disease and concurrent MIS-C. He presented with abdominal pain, diarrhea, and hematochezia and met criteria for the systemic inflammatory response syndrome. Laboratory inflammatory profiling revealed markedly elevated ferritin, D-dimer, C-reactive protein, soluble interleukin 2, and interleukin 6 levels. Endoscopy and colonoscopy revealed severe active gastroduodenitis, patchy colitis, and a normal-appearing terminal ileum. The patient was treated with a combination of steroids, intravenous immunoglobulin, and infliximab, and his symptoms slowly resolved over a 3-week period. In this case, we describe coincident MIS-C with a remarkably severe and difficult-to-treat initial presentation of inflammatory bowel disease and highlight the need to investigate the effect of coronavirus disease 2019 and MIS-C on inflammatory disorders. COVID-19 MIS-C and its sequelae are still being defined. We present an MIS-C case with concurrent new diagnosis of IBS.
Life Sciences & Biomedicine Pediatrics Science & Technology

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