Open AccessSuspected Case of Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 Infection Presenting as Acute Pancreatitis in a Child With Leukemia
Author(s) -
Ronald E. Goldstein,
D. Kogan,
Theresa M. Fiorito,
Chana L. Glasser
Publication year - 2021
Publication title -
infectious diseases in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.145
H-Index - 21
eISSN - 1536-9943
pISSN - 1056-9103
DOI - 10.1097/ipc.0000000000001013
Subject(s) - medicine , acute pancreatitis , coagulopathy , pancreatitis , respiratory distress , leukemia , immunology , pediatrics , gastroenterology , surgery
Multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 may present with fever, elevated inflammatory markers, and multiorgan involvement. Although the gastrointestinal system is commonly affected in MIS-C patients, associated necrotizing pancreatitis is rare. We present an 11-year-old boy with B-cell acute lymphoblastic leukemia in remission undergoing maintenance chemotherapy presenting with acute necrotizing pancreatitis. He developed fevers, fluid and electrolyte imbalance, respiratory distress, cytopenias, and coagulopathy, and was found to have markedly elevated inflammatory markers and positive SARS-CoV-2 antibodies. The patient met criteria for MIS-C and was treated with intravenous immunoglobulin with significant clinical improvement. This is the first known reported case of a child with B-cell acute lymphoblastic leukemia who met criteria for MIS-C presenting as acute pancreatitis, and highlights the importance of considering a broader differential for pancreatitis in children given the current SARS-CoV-2 pandemic.